Court Opinion

ID: 9482725
Source: CourtListenerOpinion
Date Created: 2023-08-05 08:59:00.118329+00
Date Added: 2024-06-11T17:49:10.364281
License: Public Domain

*281BUCKLEY, Circuit Judge,
dissenting:
It is axiomatic that in interpreting a statute, a court must begin with its language. It should also be clear by now that when that language answers the question before the court, there is no need to go further: “[W]here ... the statute’s language is plain, ‘the sole function of the courts is to enforce it according to its terms.’ ” United States v. Ron Pair Enterprises, Inc., 489 U.S. 235, 241, 109 S.Ct. 1026, 1030, 103 L.Ed.2d 290 (1989) (quoting Caminetti v. United States, 242 U.S. 470, 485, 37 S.Ct. 192, 194, 61 L.Ed. 442 (1917)). The question here is whether section 101(b)(1)(C) of the Medicare Catastrophic Coverage Repeal Act of 1989 (“Repeal Act”) can be read to support the Secretary’s effort to limit its coverage to only those persons who (1) received extended care services from a skilled nursing facility (“SNF”) for a continuous period beginning before and including January 1, 1990 and (2) also received medicare benefits for those services on December 31,1989 and January 1,1990. As I find it cannot, I would affirm the district court’s decision on the merits. I agree, however, with the panel’s treatment of the district court’s class certification order and would remand solely for the purpose of recertifying a proper class.
As my colleagues recognize, subsection (1)(C) of the transition provisions, standing alone, is not ambiguous. See Maj.Op. at 275-76. The subsection states:
(1) Inpatient hospital services and post-hospital extended care services.— In applying sections 1812 and 1813 of the Social Security Act, as restored by subsection (a)(1), with respect to inpatient hospital services and extended care services provided on or after January 1, 1990—
* * * * * #
(C) the limitation of coverage of extended care services to post-hospital extended care services shall not apply to an individual receiving such services from a skilled nursing facility during a continuous period beginning before (and including) January 1, 1990, until the end of the period of 30 consecutive days in which the individual is not provided inpatient hospital services or extended care services....
Pub.L. No. 101-234, § 101(b)(1)(C). On its face, the language “allows for only one reasonable construction.” Tataranowicz v. Sullivan, 753 F.Supp. 978, 984 (D.D.C. 1990). The provision establishes just one requirement: an individual must have received extended care services from an SNF during the transition period. There is not the slightest intimation, in subsection (1)(C), that Congress intended to add the second part of the test imposed by the Secretary. Under the traditional analysis of Chevron U.S.A. Inc. v. NRDC, 467 U.S. 837, 842, 104 S.Ct. 2778, 2781, 81 L.Ed.2d 694 (1984), because Congress “has directly spoken to the precise question” of who should benefit from the transition provision, the Secretary may not substitute his judgment for that of Congress.
I recognize that the Supreme Court has found ambiguity to exist in instances where a literal reading of a facially clear statute would conflict with a pre-existing “pervasive regulatory scheme,” Train v. Colorado Public Interest Research Group, 426 U.S. 1, 24, 96 S.Ct. 1938, 1948, 48 L.Ed.2d 434 (1976), or where a provision is rendered ambiguous by other parts of the statute. See McCarthy v. Bronson, — U.S. —, 111 S.Ct. 1737, 1740, 114 L.Ed.2d 194 (1991). No such contradictions exist in this case, however, and the majority points to no precedent in which the Supreme Court or this court has found clear statutory language ambiguous on such slender reeds as the ones on which it relies.
My colleagues assert that the title heading preceding the transition provisions in the Repeal Act renders section 101(b)(1)(C) unclear. Section 101(b) is captioned: “Transition Provisions for Medicare Beneficiaries.” They are, however, somewhat at a loss to explain how the presence of that caption makes subsection (C) any less clear. See Maj.Op. at 276-77 (clear meaning of the statute “creates at least some tension with the caption”). They also recognize that the term “beneficiaries” could refer to *282anyone who was a beneficiary during 1989. Id. Their difficulty illustrates why a subheading should not be used to create ambiguity in statutory language. The Supreme Court has cautioned that
[w]here ... text is complicated and prolific, headings and titles can do no more than indicate the provisions in a most general manner.... As a result, matters in the text which deviate from those falling within the general pattern are frequently unreflected in the headings and titles. Factors of this type have led to the wise rule that the title of a statute and the heading of a section cannot limit the plain meaning of the text. For interpretative purposes, they are of use only when they shed light on some ambiguous word or phrase.
Brotherhood of R.R. Trainmen v. Baltimore & Ohio R.R. Co., 331 U.S. 519, 528-29, 67 S.Ct. 1387, 1392, 91 L.Ed. 1646 (1947) (citations omitted). See also NRDC v. EPA, 915 F.2d 1314, 1321 (9th Cir.1990) (statutory headings “cannot create an ambiguity where none otherwise would exist”) (emphasis in the original); cf. Utah Power & Light Co. v. ICC, 747 F.2d 721, 727 (D.C.Cir.1984) (statutory title can indicate legislative intent where statutory term ambiguous). As the statutory language is clear, the caption is irrelevant.
Next, the majority suggests that the transition provisions are
self-evidently devoted to special problems of transition back to the status quo ante the Catastrophic Coverage Act. Such grandfathering typically seeks to provide special relief for persons on whom the new regime might bear with unusual severity, because it specially disrupts their lives, usually because of decisions they are likely to have taken in reliance on the prior regime.
Maj.Op. at 277. Accepting that it is self-evident that the provisions “provide special relief” for those peculiarly affected by the change in regimes, the majority fails to explain why the plaintiffs do not fall within that purpose.
If the Catastrophic Coverage Act of 1988 had remained in force, individuals who had exhausted their 150 days of coverage in 1989 but remained in their SNFs would have begun receiving benefits again on January 1, 1990. That was their expectation at least until December 13, 1989, when the President signed the Repeal Act into law. It is beyond dispute that the elderly in our society must structure their use of medical services to take advantage of any source of financing. Many class members moved into SNFs in 1989 without spending three days in a hospital prior to admission. See Exhibits A and L to Plaintiffs’ Reply to Defendant’s Motion to Dismiss, reprinted in Joint Appendix at 31, 78-81; Exhibit A to Plaintiffs’ Motion for Summary Judgment; Exhibit A to Plaintiffs’ Motion and Memorandum for a Reduction of Time for Defendant to Respond to Complaint of Applicant for Intervention. At least one member of the class spent the requisite three days in a hospital, returned home for over thirty, and then moved to a nursing facility. See Exhibit A to Plaintiffs’ Motion for a Reduction of Time. It appears that another relied on the availability of benefits for the first part of 1990 to trigger a “medigap” insurance policy that would then cover the remainder of the year. See Joint Appendix at 78-81; Brief for Appel-lees at 44.
The abrupt return to the old system certainly upset the planning of these individuals and would inflict a significant hardship on them. Rewriting subsection (1)(C) to exclude these persons would implicate the reliance factor that the majority views as the target of the transition provision. Thus, it is anything but self-evident that Congress would have wanted to deprive them of its benefits.
The majority nevertheless contends that this vision of congressional intent “seems broad in relation to conventional grandfathering goals.” Maj.Op. at 277. Perhaps, then, Congress had broader purposes than the one the majority feels appropriate. Another transition provision, section *283101(b)(l)(D)(ii), suggests that Congress sought to achieve more than “conventional grandfathering” as defined by the majority. Under that provision, the Social Security Act’s inpatient hospital deductible would not apply “for a spell of illness beginning during January 1990, if such a deductible was imposed on the individual for a period of hospitalization that began in December 1989....” Pub.L. No. 101-234, § 101(b)(l)(D)(ii). This transition provision provides generous treatment for individuals who entered a hospital in December 1989, terminated their stay in that month, and then returned to a hospital in January 1990. Such individuals need not pay the annual deductible for 1990. Whatever the objective of that provision, it cannot be to “grandfather” a rule applicable to persons receiving medicare coverage for services at the time of the Repeal Act’s passage.
The majority also derives ambiguity from the legislative history, placing particular reliance on statements from sponsors and cosponsors of various versions of the Repeal Act. Even when clear, however, such statements are unreliable guides to statutory meaning. “While a sponsor’s statements may reveal his understanding and intentions, they hardly provide definitive insights into Congress’ understanding of the meaning of a particular provision.” Overseas Educ. Ass’n, Inc. v. FLRA, 876 F.2d 960, 975 (D.C.Cir.1989) (Buckley and Starr, JJ., concurring) (emphasis in original). As any viewer of C-SPAN knows, such explanations often fall on few, if any, ears.
Finally, the majority seeks support for its holding from a one-page computer printout that purports to give cost estimates of the Congressional Budget Office for the Repeal Act. My colleagues effectively undermine the value of this evidence, Maj.Op. at 279-280, yet they consider it “relevant and somewhat supportive of the Secretary,” id. at 280, simply because appellees did not make the same arguments. I read appellees’ brief, however, as questioning the relevance of the estimate and whether any member of Congress relied on it. See Brief for Appellees at 44-45. In any event, we are not bound, when interpreting a statute, to rely on the arguments put before us by the parties. Indeed, the Secretary makes no claim, for example, that the transition provision serves “conventional grandfathering goals,” yet the panel overturns the district- court based, in part, on that argument.
Having reached the conclusion that Congress could not have meant what it clearly said, the majority has jerry-built the suggestion of a contrary intent out of “evidence” that, on examination, proves to be little more than attenuated inferences and speculation. More is required before a court can presume to rewrite a statute.