Amicus Brief for O’BRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES;...
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Transcript of Amicus Brief for O’BRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES;...
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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CARVARMPJ @ESCDASZRJ SPMPJIJOP
Eo mccar`mocj xepn Rzdj 27/= ag pnj Gj`jrmd Rzdjs ag Mvvjddmpj Vracj`zrj
mo` @/C/ Cerczep Rzdj 27/=Miece imlj pnj gaddaxeoh `escdaszrjs;
Xaijo Svjml gar Pnjisjdwjs es m vrahrmi ag pnj Cnemrasczra Eospepzpj
m j`zcmpeaomd oaovragep arhmoe{mpeao rjcahoe{j` ms pm~)j~jivp zo`jr sjcpeao
:6=.c%.3% ag pnj Eopjromd Rjwjozj Ca`j/ Pnj Cnemrasczra Gazo`mpeao m vrewmpj
gazo`mpeao rjcahoe{j` ms pm~)j~jivp zo`jr sjcpeao :6=.c%.3% ag pnj Eopjromd
Rjwjozj Ca`j es eps vmrjop carvarmpeao/ Pnjrj es oa vzbdecdu njd` carvarmpeao xepn
m =6 vjrcjop ar hrjmpjr axojrsnev eopjrjsp eo pnj Cnemrasczra Eospepzpj/
Beajpnecs @jgjosj Gzo` mo` Degj Djhmd @jgjosj Gazo`mpeao mrj oaovragep
djhmd mo` j`zcmpeaomd arhmoe{mpeaos/ Pnju nmwj oa vmrjop carvarmpeaos mo` oa
vzbdecdu njd` carvarmpeaos nad` =6 vjrcjop ar iarj ag pnjer spacl/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 2 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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PMBDJ AG CAOPJOPS
CARVARMPJ @ESCDASZRJ SPMPJIJOP ///////////////////////////////////////////////////////// e
PMBDJ AG CAOPJOPS ////////////////////////////////////////////////////////////////////////////////////////// eePMBDJ AG MZPNAREPEJS /////////////////////////////////////////////////////////////////////////////////// ew
EOPJRJSP AG MIECE CZREMJ ///////////////////////////////////////////////////////////////////////////// =
SZIIMRU AG PNJ MRHZIJOP /////////////////////////////////////////////////////////////////////// 3
MRHZIJOP //////////////////////////////////////////////////////////////////////////////////////////////////////////// :
E/ Pnj Imo`mpj es Mrbeprmru mo` Cmvreceazs zo`jr pnj MVM bjcmzsj pnjHawjroijop Joperjdu Gmedj` pa Caose`jr Nehndu Rjdjwmop Jwe`jocj Snaxeohpnmp Nariaomd Caoprmcjvpewjs Sehoegecmopdu Eocrjmsj Xaijos Njmdpn Resls
Eocdz`eoh Cmocjrs Cmr`eawmsczdmr @esjmsj mo` pnj Mc}zesepeao mo`Prmosiesseao ag NEW/ /////////////////////////////////////////////////////////////////////////////////////// :
M/ Sjreazs Njmdpn Resls ag Armd Caoprmcjvpewj Vedds /////////////////////////////////////// 8
=/ Nehnjr resl ag njmrp mppmcl spralj ' cmr`eawmsczdmr caivdecmpeaos //// 8
2/ Nehnjr resl ag brjmsp cmocjr ////////////////////////////////////////////////////////////////// >
3/ Nehnjr resl ag cjrwecmd cmocjr /////////////////////////////////////////////////////////////// 5
0/ Nehnjr resl ag dewjr pziars!cmocjr ////////////////////////////////////////////////////// =6
:/ Hrjmpjr szscjvpebedepu pa sj~zmddu prmosieppj` eogjcpeaos //////////////////// =6
B/ Sjreazs Njmdpn Resls ag Daoh)Mcpeoh Caoprmcjvpewjs /////////////////////////////// ==
EE/ Bjcmzsj pnj Imo`mpj eocdz`js @rzhs pnmp Sehoegecmopdu Eocrjmsj SjreazsNjmdpn Resls pnj Hawjroijop Cmooap Ijjp eps Bzr`jo Zo`jr RGRM ag@jiaosprmpeoh pnmp pnj Imo`mpj Gzrpnjrs Eps Mssjrpj` Eopjrjsp Eo VraiapeohPnj Njmdpn Mo` Xjdd)Bjeoh Ag Xaijo/ ////////////////////////////////////////////////////// =7
M/ Pnj EAI Rjvarp @ajs Oap Szvvarp pnj Hawjroijops Mssjrpeao pnmpEocrjmsj` Zsj ag Caoprmcjvpewjs xedd Vraiapj Xaijo(s Njmdpn/ //////////// =8
B/ Pnj Hawjroijop Nms Gmedj` Pa Snax Pnmp Pnj Imo`mpj Gzrpnjrs EpsMssjrpj` Eopjrjsp Ag Vraiapeoh Hjo`jr J}zepu/ /////////////////////////////////////// 2=
CAOCDZSEAO /////////////////////////////////////////////////////////////////////////////////////////////////////// 27
CJRPEGECMPJ AG CAIVDEMOCJ ////////////////////////////////////////////////////////////////////// 28
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 3 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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WERZS CNJCL CJRPEGECMPEAO /////////////////////////////////////////////////////////////////////// 2>
CJRPEGECMPJ AG SJRWECJ /////////////////////////////////////////////////////////////////////////////// 25
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 0 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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PMBDJ AG MZPNAREPEJS
CMSJSBraxo w/ Jopip Ijrcns/ Msso/$ :70 Z/S/ QQQQQ =3= S/ Cp/ 2825 2835 .26==% // =>Hao{mdjs w/ A Cjopra Jsverepm Bjojgecejopj Zoema `a Wjhjpmd :07 Z/S/ 0=> 03>.2667% ////////////////////////////////////////////////////////////////////////////////////////////////////////////////////// 2=
Iapar Wjnecdj Igrs/ Mss!o ag Z/S/$ Eoc/ w/ Spmpj Gmri Izp/ Mzpa Eos/ Ca/$ 073 Z/S/
25 03 .=5>3% ///////////////////////////////////////////////////////////////////////////////////////////////////////////// 8
Vappjr w/ @esprecp ag Cadzibem ::> G/3` :02 :07 .@/C/ Cer/ 2665% ////////////////////// =7
SPMPZPJSRjdeheazs Grjj`ai Rjsparmpeao Mcp .RGRM% 02 Z/S/C/ 2666bb=.m% //////////////// =7
Rjdeheazs Grjj`ai Rjsparmpeao Mcp .RGRM% 02 Z/S/C/ 2666bb=.b% //////////////// =7
Pnj Vmpejop Vrapjcpeao mo` Mggar`mbdj Cmrj Mcp Vzb/ D/ Oa/ ===)=0> =20 Spmp/==5 .26=6% ///////////////////////////////////////////////////////////////////////////////////////////////////////////////// :
APNJR MZPNAREPEJSBjromcjrrmg B/R/ jp md/ Pnrjj)`eijoseaomd zdprmsazo` `jpjcpeao ag mboarimddudacmpj` eoprmzpjreoj caoprmcjvpewj `jwecjs xnecn mrj m sazrcj ag vjdwec vmeo mo`mboarimd bdjj`eoh/ Zdprmsazo` Abspjp Huojcad2665< 30.=%;==6)==: ///////////////// =2
Bjrpmles L/ @/ R/ M{mre D/ K/ Njdis J/ K/ Cmddmnmo mo` K/ M/ Rabbeos/ 2666/Hjo`jr `eggjrjocjs eo pnj zpede{mpeao ag njmdpn cmrj sjrwecjs/Kazromd ag Gmiedu
Vrmcpecj 05.2%;=08=:2 ////////////////////////////////////////////////////////////////////////////////////////// 23
Brmmpjo L/V/ jp md/ Imdvasepeaoj` EZ@s; Xnjo uaz snazd` eopjrwjoj .mo` xnjouaz snazd` oap%/ ABH Imomhjijop26=2< 20.>%;35)07 /////////////////////////////////////// =2
Cmocjr Spmpespecs bu Cmocjr Puvj Cjopjrs gar @esjmsj Caoprad /////////////////////////////// 5
Cnjo jp md/ Rjcjop armd caoprmcjvpewj zsj mo` m`wjrsj berpn azpcaijs =00Jzravjmo Kazromd ag Abspjprecs ' Huojcadahu mo` Rjvra`zcpewj Beadahu 0603
.Imu 2665% ////////////////////////////////////////////////////////////////////////////////////////////////////////////// 26@addj K jp md/ Resl gmcpars gar prevdj ojhmpewj brjmsp cmocjr eo xaijo zo`jr pnj mhjag 0:/ Cmocjr Jve`jiead Beaimrljrs Vrjw 2665.0%;==:8)7: ////////////////////////////// 5
Grmocjscne S jp md/ Hjoepmd xmrps mo` cjrwecmd ojavdmsem; mo jve`jieadahecmd spz`u/Br K Cmocjr=5>3;72=)2> ////////////////////////////////////////////////////////////////////////////////// ==
Mvvjddmpj Cmsj; =2)33:8 Vmhj; : @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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Rjbjccm Vjcl I/@/ C/C/@/ mo` Cnmrdjs X/ Oarres I/@/ Sehoegecmop Resls agArmd Caoprmcjvpewjs .ACVs% 85.=% Pnj Deomcrj ]zmrpjrdu 0= 02 .Gjbrzmru 26=2%///////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////// =8
Snmn B/ R/ R/ Rjpomlmrmo mo` H/ D/ Baapn/ 266>/ Eocrjmsj` resl ag
cmr`eawmsczdmr `esjmsj eo uazoh xaijo gaddaxeoh hjspmpeaomd `embjpjs ijddepzs/@embjpjs Cmrj 3=.>%;=77>=775 ///////////////////////////////////////////////////////////////////////////// 26
Pmoes BC jp md/ Armd caoprmcjvpewjs mo` pnj resl ag iuacmr`emd eogmrcpeao/Ojx
Johdmo` Kazromd ag Ij`eceoj 266=8)53 ///////////////////////////////////////////////////// >
Zpjreoj Vjrgarmpeao Resl grai Ierjom mwmedmbdj mpnppv;!!xxx/xaijos)njmdpn/ca/zl!zpjreoj)vjrgarmpeao)resl)grai)ierjom/npid //////////////////////////////////////// =3
wmo Nudclmim Wdejh M jp md/ Wjoazs pnraibapec resl ag armd caoprmcjvpewjsjggjcps ag ajsprahjo `ajs mo` vrahjspahjo puvj; rjszdps ag pnj IJHM cmsj)caopradspz`u/BIK2665
Xmoh CC jp md/ Resl ag NEW eogjcpeao eo armd caoprmcjvpewj vedd zsjrs; m ijpm)momdusesKME@S=555 //////////////////////////////////////////////////////////////// ==
[ejimo O Nmpcnjr R/M/ jp md/M Vacljp Hze`j pa Imomheoh Caoprmcjvpeao/ PehjrHM; Bre`heoh pnj Hmv Gazo`mpeao 26=6 mp 38 ////////////////////////////////////////////////////// =2
RJHZDMPEAOSCjrpmeo Vrjwjopewj Sjrwecjs zo`jr pnj Mggar`mbdj Cmrj Mcp .pnj Imo`mpj%geomde{j` mp 88 Gj`/ Rjh/ >82: .Gjb/ =: 26=2% /////////////////////////////////////////////////// 3 20
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 8 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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EOPJRJSP AG MIECE CZREMJ=
Xaijo Svjml gar Pnjisjdwjs m vrahrmi ag pnj oao)vragep Cnemrasczra
Eospepzpj mrasj azp ag mo avjo djppjr sehoj` ms ag pnes xrepeoh bu iarj pnmo 37$666
xaijo/ Ca)`rmgpj` bu mpparojus Njdjo Mdwmr mo` Lei @moejds2 pnj avjo djppjr
vrawe`js eo vmrp;
Pnasj czrrjopdu eowaleoh xaijo(s njmdpn / / / nmwj ojwjrrjsvao`j` pa pnj dmrhj ba`u ag scnadmrdu rjsjmrcn eo`ecmpeoh pnmp
imou garis ag caoprmcjvpeao nmwj sjreazs se`j jggjcps ar pnmp saij
garis mcp mp saij peijs pa `jsprau jibruas ar pnmp hawjroijop
caoprmcjvpewj vrahrmis eojwepmbdu cnmohj pnj sj~ `mpeoh mo`imrremhj imrljps eo xmus pnmp djm` pa iarj jivpu sj~ iarj oao)imrepmd berpns mo` iarj mbarpeaos/ Ep es xaijo xna szggjr`esvravarpeaompjdu xnjo pnjsj pneohs nmvvjo/ Oa aoj svjmls gar mddxaijo ao pnjsj esszjs/ Pnasj xna vzrvarp pa `a sa mrj seivdumppjivpeoh pa `jgdjcp mppjopeao grai pnj sjreazs rjdeheazs debjrpu esszjsczrrjopdu mp spmlj / / / /3
Beajpnecs @jgjosj Gzo` .B@G% mo` Degj Djhmd @jgjosj Gazo`mpeao
.DD@G% mrj pxa oao)vragep vzbdec)eopjrjsp djhmd mo` j`zcmpeaomd arhmoe{mpeaos
xnasj djhmd j~vjrps mo` ij`ecmd m`wesars m``rjss esszjs mp pnj eopjrsjcpeao ag dmx
= Vzrszmop pa Cer/ Rzdj 25 cazosjd cjrpegejs pnmp pnj vmrpejs nmwj caosjopj` pa pnjgedeoh ag pnes brejg mo` gzrpnjr cjrpegejs pnmp oa vmrpu ar vmrpus cazosjd mzpnarj`pnes brejg eo xnadj ar eo vmrp ar caoprebzpj` iaoju pnmp xms eopjo`j` pa gzo` pnj
brejg/2
Njdjo I/ Mdwmr vrjse`jop ag pnj Cnemrasczra Eospepzpj es m dmx vragjssar mpHjarhj Imsao Zoewjrsepu svjcemde{eoh eo pnj mrjms ag gmiedu dmx mo` dmx mo`rjdeheao/ Pnes brejg es ao bjnmdg ag Xaijo Svjml gar Pnjisjdwjs< ep eo oa xmurjvrjsjops pnj wejxs ar aveoeaos ag Hjarhj Imsao Zoewjrsepu ar eps jivdaujjs/Pnj avjo djppjr xms ca)`rmgpj` bu Lei @moejds @erjcpar ag Cmpnadec Waecjs ZSM/3 Pnj gzdd pj~p ag pnj Xaijo Svjml gar Pnjisjdwjs avjo djppjr es mwmedmbdj mpnppv;!!xxx/xaijosvjmlgarpnjisjdwjs/cai/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; > @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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mo` ij`ecmd jpnecs szcn ms pnj ojhmpewj njmdpn eivmcp ao xaijo ag mbarpeao mo`
nzimo jhh `aompeao gar jibruaoec spji cjdd rjsjmrcn ar eo wepra gjrpede{mpeao
vrapjcpeao ag wzdojrmbdj nzimo bjeohs mp pnj bjheooeoh mo` jo` ag degj njmdpncmrj
rehnps ag caoscejocj jo` ag degj ij`ecmd jpnecs mo` pnj rehnp ag eo`ewe`zmds pa dewj
azp pnjer vra)degj mo` rjdeheazs caowecpeaos eo pnj xarlvdmcj/Miece nmwj mo eopjrjsp eo breoheoh pnes Cazrps mppjopeao pa pnj gmcp pnmp eo
vraizdhmpeoh pnj NNS Imo`mpj pnj Hawjroijop joperjdu `esrjhmr`j` eo`jj`
ojwjr jwjo caose`jrj` pnj dmrhj ba`u ag rjdjwmop xe`jdu mwmedmbdj scejopegecmddu
sazo` scnadmrdu rjsjmrcn `aczijopeoh sjreazs njmdpn resls pa xaijo mreseoh grai
pnj zsj ag nariaomd caoprmcjvpewjs0 eocdz`eoh pnj cdmssegecmpeao ag caibeoj` armd
caoprmcjvpewjs bu pnj Xard` Njmdpn Arhmoe{mpeao ms Hrazv =; Cmrceoahjoec pa
Nzimos/
0 Pnj pjri caoprmcjvpewj ms zsj` eo pnes brejg rjgdjcps pjrieoadahu zsj` bu pnjHawjroijop eo pnj NNS Imo`mpj/ Miece naxjwjr mcloaxdj`hj pnj Vdmeopeggsrjdeheazs abkjcpeao pa pnj cmvmcepu ag saij ag pnj sa)cmddj` caoprmcjvpewj `rzhs
mo` `jwecjs pa pjrieompj pnj degj ag m nzimo bjeoh mp pnj jibruaoec spmhj ag`jwjdavijop/ Gar m brejg momduses ag pnj zo`jrdueoh jibruadahu mo`
vnmrimcadahu sjj NNS Caiijop gedj` ao bjnmdg ag @r/ Imzrjjo D/ Cao`ecPnaims Bjrh mo` Kmijs Cmvrjppm mwmedmbdj mpnppv;!!xxx/screb`/cai!`ac!580:6268!Beajpnecs)@jgjosj)Gzo`)Degj)Djhmd)@jgjosj)Gazo`mpeao)Djppjr)pa)NNS)Rjhmr`eoh)Mggar`mbdj)Cmrj)Mcp .dmsp cnjclj`
Oawjibjr =5 26=2%/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 5 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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SZIIMRU AG PNJ MRHZIJOP
Eo caoszdpmpeao xepn ij`ecmd mo` scejocj m`wesars:Miecebreoh pnes Cazrps
mppjopeao pa pnj gmcp pnmp eo vraizdhmpeoh pnj NNS Imo`mpj7
pnj Hawjroijop
joperjdu gmedj` pa caose`jr pnj rabzsp ba`u ag ij`ecmd jwe`jocj eo`ecmpeoh pnmp
nariaomd caoprmcjvpewjs nmwj beadahecmd vravjrpejs pnmp sehoegecmopdu eocrjmsj
xaijos resls ag brjmsp cjrwecmd mo` dewjr cmocjr spralj mo` m nasp ag apnjr
`esjmsjs eocdz`eoh pnj mc}zesepeao mo` prmosiesseao ag nzimo eiizoa`jgecejocu
werzs .NEW%/ Pnjsj resls nmwj bjjo rjcahoe{j` oap aodu bu apnjr mhjocejs ag pnj
Hawjroijop epsjdg bzp mdsa bu rjvzpmbdj ompeaomd mo` eopjrompeaomd ij`ecmd
mzpnarepejs eocdz`eoh pnj Xard` Njmdpn Arhmoe{mpeao/
Ujp pnj Hawjroijop mo` pnj eom`j}zmpj mo` `jgjcpewj Eospepzpj ag Ij`eceoj
rjvarp ao xnecn ep rjdej` caivdjpjdu ehoarj` pnes xe`jdu mwmedmbdj vjjr)rjwejxj`
ij`ecmd rjsjmrcn snaxeoh sehoegecmopdu eocrjmsj` cmocjr mo` apnjr njmdpn resls
: Ij`ecmd mo` scejocj m`wesars xna mssespj` eo pnj caivedmpeao ag spz`ejs vrjsjopj`eo pnes brejg eocdz`j Kano I/ Pnarv$ Kr/$ I/@/ vragjssar xaijos njmdpnrjsjmrcnjr mo` AbHuo `erjcpar ag pnj Zoewjrsepu ag Oarpn Cmradeom mp CnmvjdNedds Xaijos Vreimru Njmdpncmrj< Imru @mwjovarp$ I/@/$abspjprecemo!huojcadahesp mo` vrjse`jop ag MMVDAH< Mohjdm Dmogrmocne$ I/@/$G/M/C/S/ brjmsp szrhecmd aocadahesp mo` ca)gazo`jr ag pnj Brjmsp Cmocjr
Vrjwjopeao Eospepzpj< Imzrjjo D/ Cao`ec$ Vn@$ rjsjmrcn scejopesp mo`jibruadahesp mp pnj Zoewjrsepu ag Zpmn< mo` Kajd Breo`$ Vn@ scejopesp mo`vragjssar mp Bmrzcn Caddjhj eo pnj Cepu Zoewjrsepu ag Ojx Uarl suspji/ Mddzoewjrsepejs mrj despj` gar vzrvasjs ag e`jopegecmpeao aodu< pnes brejg eo oa xmurjvrjsjops pnj wejxs ag pnj omij` zoewjrsepejs oar ag mou ag eps jivdaujjs/7 Cjrpmeo Vrjwjopewj Sjrwecjs zo`jr pnj Mggar`mbdj Cmrj Mcp .pnj Imo`mpj%geomde{j` mp 88 Gj`/ Rjh/ >82: .Gjb/ =: 26=2%/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; =6 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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mssacempj` xepn nariaomd caoprmcjvpewjs ij`ecmd jwe`jocj pnmp pnj Hawjroijop
snazd` nmwj caose`jrj` pa bj m nehndu rjdjwmop msvjcp eo `jpjrieoeoh pnj `rzhs mo`
sjrwecjs pa bj imo`mpj` ms m oa)casp bjojgep pa vraiapj xaijos njmdpn/
Eo gmedeoh pa jwjo mcloaxdj`hj ar bmdmocj pnj nehndu rjdjwmop ij`ecmd
jwe`jocj vrjsjopj` eo pnes brejg pnj Imo`mpj es mrbeprmru mo` cmvreceazs zo`jr
pnj M`ieoesprmpewj Vracj`zrjs Mcp bjcmzsj pnj Hawjroijop joperjdu gmedj` pa
caose`jr mo eivarpmop msvjcp ag pnj vrabdji/ .Sjcpeao E%
Pnj `esrjhmr` ag pnes eivarpmop ij`ecmd jwe`jocj mdsa snaxs pnmp pnj
Hawjroijop cmooap ijjp eps bzr`jo zo`jr RGRM ag `jiaosprmpeoh pnmp mvvdecmpeao
ag pnj NNS Imo`mpj pa m rjdeheazsdu abkjcpeoh jivdaujr es eo gzrpnjrmocj ag m
caivjddeoh hawjroijopmd eopjrjsp vmrpeczdmrdu eps mssjrpj` eopjrjsps ag vraiapeoh
xaijos njmdpn/ .Sjcpeao EE%/
Pnj brejg caocdz`js bu m``rjsseoh nax pnj Eospepzpj ag Ij`eceoj rjvarp `ajs
oap szvvarp pnj Hawjroijops mssjrpeao pnmp eocrjmsj` zsj ag caoprmcjvpewjs xedd
vraiapj pnj njmdpn ag xaijo .Sjcpeao EE/M% oar pnmp ep xedd gzrpnjr pnj mssjrpj`
eopjrjsp eo vraiapeoh hjo`jr j}zepu/ .Sjcpeao EE/B%/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; == @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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MRHZIJOP
E/ Pnj Imo`mpj es Mrbeprmru mo` Cmvreceazs zo`jr pnj MVM bjcmzsjpnj Hawjroijop Joperjdu Gmedj` pa Caose`jr Nehndu Rjdjwmop
Jwe`jocj Snaxeoh pnmp Nariaomd Caoprmcjvpewjs Sehoegecmopdu
Eocrjmsj Xaijos Njmdpn Resls$ Eocdz`eoh Cmocjrs$ Cmr`eawmsczdmr
@esjmsj$ mo` pnj Mc}zesepeao mo` Prmosiesseao ag NEW/
Ao Mzhzsp = 26== vzrszmop pa pnj Mggar`mbdj Cmrj Mcp8 pnj Hawjroijop
mhjocu loaxo ms NRSM .Njmdpn Rjsazrcjs mo` Sjrwecjs M`ieoesprmpeao% m`avpj`
eo gzdd pnj hze`jdeojs> rjcaiijo`j` bu m rjvarp ag pnj Eospepzpj ag Ij`eceoj .EAI%/
Pnmp 26== EAI rjvarp rjcaiijo`j` pnmp vrjwjopewj sjrwecjs gar xaijo eocdz`j
mdd G@M)mvvrawj` caoprmcjvpewj ijpna`s spjrede{mpeao vracj`zrjs mo` vmpejop
j`zcmpeao mo` cazosjdeoh/ G@M)mvvrawj` caoprmcjvpewj ijpna`s eocdz`j
`emvnrmhis armd caoprmcjvpewj vedds eokjcpeaos mo` eivdmops jijrhjocu
caoprmcjvpewj `rzhs mo` eoprmzpjreoj `jwecjs/
5
8 Pnj Vmpejop Vrapjcpeao mo` Mggar`mbdj Cmrj Mcp Vzb/ D/ Oa/ ===)=0> =20 Spmp/==5 .26=6% rj}zerjs mdd hrazv njmdpn vdmos pa vrawe`j cawjrmhj gar cjrpmeo
vrjwjopewj sjrwecjs xepnazp casp)snmreoh eocdz`eoh gar xaijo szcn m``epeaomdvrjwjopewj cmrj mo` scrjjoeohs / / / ms vrawe`j` eo caivrjnjosewj hze`jdeojsszvvarpj` bu \pnj Njmdpn Rjsazrcjs mo` Sjrwecjs M`ieoesprmpeao .NRSM%Y/ 02Z/S/C/ 366hh)=3/> Njmdpn Rjsazrcjs mo` Sjrwecjs M`ieoesprmpeao .NRSM% Xaijos VrjwjopewjSjrwecjs; Rj}zerj` Njmdpn Vdmo Cawjrmhj Hze`jdeojs mwmedmbdj mpnppv;!!xxx/nrsm/haw!xaijoshze`jdeojs!/5 Eospepzpj ag Ij`eceoj Cdeoecmd Vrjwjopewj Sjrwecjs Gar Xaijo; Cdaseoh pnj Hmvs.26==% .26== EAI% mwmedmbdj mpnppv;!!baals/omv/j`z!avjobaal/vnv1rjcar`Qe`9=3=>= .jivnmses m``j`%/
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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Oapmbdu pnj EAI rjvarp caivdjpjdu gmedj` pa caose`jr ar m``rjss pnj
rjdjwmop xe`jdu mwmedmbdj scejopegec rjsjmrcn jspmbdesneoh sehoegecmop eocrjmsj`
njmdpn resls ag nariaomd caoprmcjvpewjs ms sjp garpn bjdax/ Eo ehoareoh pnes nehndu
rjdjwmop ij`ecmd jwe`jocj ep `e` oap jwjo pru pa jspmbdesn pnmp ao bmdmocj pnj
vzpmpewj njmdpn bjojgeps ag nariaomd caoprmcjvpewjs azpxjehnj` pnj sehoegecmopdu
eocrjmsj` njmdpn resls/ Eo`jj` pnj EAI rjvarp `e` oap jwjo ijopeao pnmp pnj Xard`
Njmdpn Arhmoe{mpeao cdmssegejs caibeoj` armd caoprmcjvpewjs ms Hrazv =;
cmrceoahjoec pa nzimos=6 ar pnmp m szbspmopemd ba`u ag jwe`jocj eo`ecmpjs pnmp
nariaomd caoprmcjvpewjs sehoegecmopdu eocrjmsj m xaimos resl ag njmrp mppmcl
bdaa` cdaps spralj brjmsp cmocjr cjrwecmd cmocjr dewjr pziars sj~zmddu
prmosieppj` eogjcpeaos mo` pnj caoprmcpeoh mo` prmosiesseao ag NEW ms sjp garpn
bjdax eo m brejg szrwju ag ij`ecmd depjrmpzrj/
Pnj xe`jdu mwmedmbdj spz`ejs vrjsjopj` bjdax snazd` nmwj bjjo caose`jrj`
mo` bmdmocj` bu pnj Hawjroijop mhmeosp mou vzpmpewj bjojgeps ag caoprmcjvpewjs
jsvjcemddu eo `jpjrieoeoh pnj caopjop ag imo`mpj` vrjwjopewj njmdpn cawjrmhj/
Ujp pnj Hawjroijop mo` pnj EAI rjvarp ao xnecn ep rjdej` caivdjpjdu ehoarj` pa
=6 Caibeoj` armd caoprmcjvpewjs mrj cdmssegej` ms m hrazv = cmrceoahjo gar brjmspcjrwecmd mo` dewjr cmocjrs mccar`eoh pa pnj Xard` Njmdpn Arhmoe{mpeaosEopjrompeaomd Mhjocu ao Rjsjmrcn ag Cmocjr .EMRC%/ EMRC Iaoahrmvns ao pnj
Jwmdzmpeao ag Cmrceoahjoec Resls pa Nzimos 2668< 5=;=80>0 mwmedmbdj mpnppv;!!iaoahrmvns/emrc/gr!JOH!Iaoahrmvns!wad5=!iaoa5=/v`g/ .`esczssj` buLmpndjjo P/ Rz``u I/@/ mp nppv;!!brjmspcmocjrbu`rrz``u/cai!1vmhjQe`92%/
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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pnj `jpreijop ag xaijos njmdpn pnj iazopmeo ag ij`ecmd jwe`jocj pnmp es vmrpemddu
szrwjuj` bjdax/
Pnjrjgarjpnj Imo`mpj es mrbeprmru mo` cmvreceazs zo`jr pnj M`ieoesprmpewj
Vracj`zrjs Mcp .MVM%/ Pnj kz`ecemd spmo`mr` gar rjwejx zo`jr pnj MVM mrbeprmru
mo` cmvreceazs spmo`mr` vrawe`js;
Mo mhjocu rzdj xazd` bj mrbeprmru mo` cmvreceazs eg pnj mhjocu nmsrjdej` ao gmcpars xnecn Caohrjss nms oap eopjo`j` ep pa caose`jrjoperjdu gmedj` pa caose`jr mo eivarpmop msvjcp ag pnj vrabdji aggjrj` mo j~vdmompeao gar eps `jceseao pnmp rzos cazopjr pa pnj
jwe`jocj bjgarj pnj mhjocu ar es sa eivdmzsebdj pnmp ep cazd` oap bjmscrebj` pa m `eggjrjocj eo wejx ar pnj vra`zcp ag mhjocu j~vjrpesj/
Iapar Wjnecdj Igrs/ Mss!o ag Z/S/$ Eoc/ w/ Spmpj Gmri Izp/ Mzpa Eos/ Ca/$ 073 Z/S/25 03 .=5>3%.jivnmses m``j`%/
Njrj pnj NNS Imo`mpj es cdjmrdu mrbeprmru mo` cmvreceazs bu werpzj ag pnj
gmcp pnmp pnj Hawjroijop `e` eo`jj` joperjdu gmed\Y pa caose`jr mo eivarpmop msvjcp
ag pnj vrabdji omijdu pnmp pnj imo`mpj` `rzhs eocrjmsj resl ag `esjmsj rmpnjr
pnmo vrjwjopeoh `esjmsj/
M oao)j~nmzspewj szrwju ag pnj caivdjpjdu ehoarj` bzp nehndu rjdjwmop mo`
xe`jdu mwmedmbdj vjjr)rjwejxj` ij`ecmd spz`ejs `aczijops pnj gaddaxeoh sjreazs
njmdpn resls;
M/ Sjreazs Njmdpn Resls ag Armd Caoprmcjvpewj Vedds
=/ Nehnjr resl ag njmrp mppmcl$ spralj ' cmr`eawmsczdmrcaivdecmpeaos/ Miaoh xaijo xepn oa caowjopeaomd resl gmcpars gar
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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njmrp `esjmsj pnasj xna pmlj armd caoprmcjvpewjs nmwj pxecj pnj resl
ag njmrp mppmcl/== Pnasj xepn nuvjrpjoseao nm` gewj peijs pnj resl/=0wmo Nudclmim Wdejh M jp md/ Wjoazs pnraibapec resl ag armd caoprmcjvpewjsjggjcps ag ajsprahjo `ajs mo` vrahjspahjo puvj; rjszdps ag pnj IJHM cmsj)caopradspz`u/BIK2665
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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caoprmcjvpewjs bjgarj nmweoh m cned`/=7 Eo 2668 pnj Xard` Njmdpn
Arhmoe{mpeaos Eopjrompeaomd Mhjocu ao Rjsjmrcn ag Cmocjr .EMRC%
rjvarpj` pnmp jsprahjo)vrahjspeo caibeompeao `rzhs .pnj Vedd% xjrj m
Hrazv = cmrceoahjo gar brjmsp cjrwecmd mo` dewjr cmocjrs/=8 M 2665
spz`u snaxj` m 326* eocrjmsj resl ag prevdj ojhmpewj brjmsp cmocjr
pnj iasp `eggeczdp mo` `jm`du gari ag brjmsp cmocjr pa prjmp eo xaijo
pmleoh armd caoprmcjvpewjs/=> Mdpnazhn pnj resl ag zpjreoj mo` awmremo
cmocjrs mvvjmrs daxjr gar xaijo pmleoh caoprmcjvpewjs pnjrj es gazr
peijs iarj brjmsp cmocjr eo xaijo pnmo zpjreoj mo` awmremo cmocjrs
caibeoj`/=5
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gazrgad` eocrjmsj resl ag cjrwecmd cmocjr;
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caibeoj` jsprahjo)vrahjspahjo ijoavmzsmd pnjrmvu/ Mwmedmbdj mp;nppv;!!iaoahrmvns/emrc/gr!JOH!Iaoahrmvns!wad5=!iaoa5=/v`g=> @addj K jp md/ Resl gmcpars gar prevdj ojhmpewj brjmsp cmocjr eo xaijo zo`jr pnjmhj ag 0:/ Cmocjr Jve`jiead Beaimrljrs Vrjw 2665.0%;==:8)7:/=5Sjj Cmocjr Spmpespecs bu Cmocjr Puvj Cjopjrs gar @esjmsj Caoprad/ Mwmedmbdj mp;nppv;!!xxx/c`c/haw!cmocjr!`cvc!`mpm!puvjs/npi .dmsp wesepj` Sjvpjibjr 26 26=2%/
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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mssjss pnj mssacempeao bjpxjjo armd caoprmcjvpewj zsj mo`cjrwecmd cmocjr resl miaoh xaijo eogjcpj` xepn pnjnzimo vmveddaimwerzs .NVW%/ Rjsjmrcnjrs gazo` m ojmrdupnrjjgad` eocrjmsj eo resl miaoh xaijo xna nm` zsj` armdcaoprmcjvpewjs gar : pa 5 ujmrs caivmrj` xepn xaijo xnanm` ojwjr zsj` armd caoprmcjvpewjs/ Miaoh xaijo xnanm` zsj` armd caoprmcjvpewjs gar =6 ujmrs ar daohjr pnj resl
ag cjrwecmd cmocjr xms gazr peijs nehnjr/26
0/ Nehnjr resl ag dewjr pziars!cmocjr/ Ms spmpj` eo pnj Hawjroijopsaxo OCE Gmcpsnjjp Armd caoprmcjvpewj zsj es mssacempj` xepn mo
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bdjj`eoh ar rzvpzreoh/ Iarjawjr \sYaij spz`ejs nmwj gazo` pnmp
xaijo xna pmlj armd caoprmcjvpewjs gar iarj pnmo : ujmrs nmwj mo
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cmrceoaim bzp apnjrs nmwj oap/ 2=
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Hrjmpjr szscjvpebedepu pa sj~zmddu prmosieppj` eogjcpeaos/ Xaijo
pmleoh armd caoprmcjvpewjs mrj pxecj ms deljdu pa bj eogjcpj` xepn pnj
hjoepmd nzimo vmveddaimwerzs .NVW% werzs djm`eoh pa cjrwecmd cmocjr
26 Ompeaomd Cmocjr Eospepzpj; Armd Caoprmcjvpewjs mo` Cmocjr Resl .Imrcn 2= 26=2%cepeohIarjoa W Bascn G^ Izoa{ O jp md/ Jggjcp ag armd caoprmcjvpewjs ao reslag cjrwecmd cmocjr eo xaijo xepn nzimo vmveddaimwerzs eogjcpeao; pnj EMRCizdpecjoprec cmsj)caoprad spz`u/Dmocjp2662< 3:5.53=2%;=6>:=652/2=E`/ cepeohDm Wjccnem C Pmwmoe M/ Gjimdj nariaojs mo` bjoeho dewjr pziazrs/@ehjspewj mo` Dewjr @esjmsj 2667< 3>.>%;:3::37/
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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ms xaijo oap pmleoh armd caoprmcjvpewjs/22 Xnedj pnj spz`ejs ao NEW
resl mo` armd caoprmcjvpewjs snax ie~j` rjszdps aoj xjdd)loaxo
spz`u geo`s pnmp xaijo pmleoh pnj vedd mrj 76* iarj deljdu pa bj
eogjcpj` xepn pnj NEW werzs pnmo pnasj xna mrj oap/23 Eo m``epeao pa
vnuseadahecmd cnmohjs cmzsj` bu nariaomd caoprmcjvpewjs djm`eoh pa
eocrjmsj` szscjvpebedepu pa sj~zmddu prmosieppj` eogjcpeaos .SPEs%
rjcjop spz`ejs eo`ecmpj pnmp eocrjmsj` mccjss pa jijrhjocu
caoprmcjvpewjs djm`s pa bjnmwearmd cnmohjs e/j/ eocrjmsj` resl)pmleoh
eo sj~zmd bjnmwear pnmp oap aodu cmocjds azp mou `jcrjmsj eo pnj rmpj
ag zovdmooj` vrjhomocu miaoh m`adjscjops bzp mdsa `rewjs zv pnj
rmpj ag SPEs/20
B/ Sjreazs Njmdpn Resls ag Daoh)Mcpeoh Caoprmcjvpewjs
Ms iehnp bj vrj`ecpj` bu spmo`mr` iecrajcaoaiec pnjaru pnj oa)casp
jdjijop ag pnj NNS Imo`mpj xedd oap aodu eocrjmsj zsj ag dax)casp vedds mo`
jijrhjocu caoprmcjvpewjs ep xedd mdsa eocrjmsj eocjopewjs gar xaijo mo`
m`adjscjops pa cnaasj pnj vrjweazsdu casp)vranebepewj daoh)mcpeoh ijpna`s szcn
22 Grmocjscne S jp md/ Hjoepmd xmrps mo` cjrwecmd ojavdmsem; mo jve`jieadahecmdspz`u/Br K Cmocjr=5>3;72=)2>/23 Xmoh CC jp md/ Resl ag NEW eogjcpeao eo armd caoprmcjvpewj vedd zsjrs; m ijpm)momdusesKME@S=55520 Sjj Herim s/ jp md/ Pnj eivmcp ag jijrhjocu berpn caoprad ao pjjo vrjhomocumo` SPEs/Kazromd ag Njmdpn Jcaoaiecs 36 .26==% 3833>6/
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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ms eokjcpmbdj caoprmcjvpewjs eivdmops mo` eoprmzpjreoj `jwecjs .EZ@s%/ Pnes
`jcrjmsj eo casp rjszdps eo mo eocrjmsj eo j~vaszrj ag xaijo mo` pjjomhjrs pa jwjo
iarj `mohjrazs njmdpn caosj}zjocjs ms snaxo bjdax eocdz`eoh mo mdmrieoh
`azbdj` resl ag NEW gar zsjrs ag eokjcpmbdj caoprmcjvpewjs/
Mccar`eoh paM Vacljp Hze`j paImomheoh Caoprmcjvpeao .IC%2: ijpna`s
ag daoh)mcpeoh caoprmcjvpeao eocdz`j;
.=%VmrmHmr` Eoprmzpjreoj Cavvjr EZ@; Xepn m nehn zvgraop casp ag $08:gar pnj `jwecj mdaoj j~cdzsewj ag pnj ij`ecmd casps ag scrjjoeoh mo`
eosjrpeao pnj cavvjr EZ@ cmo rjszdp eo zpjreoj vjrgarmpeao mo` apnjr
imdvasepeaoeoh pnmp cmo rjszdp eo eocrjmsj` bdjj`eoh ar vmeo mo` eokzru ar
`mimhj pa pnj szrrazo`eoh arhmos/27
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.DOH% eopa pnj zpjreoj joweraoijop/ Eo m``epeao pa resls ag zpjreoj
vjrgarmpeao xnecn xjrj pnj szbkjcp ag m xmroeoh djppjr sjop bu G@M pa pnj
imozgmcpzrjr Bmujr Ierjom nms bjjo deolj` pa awmremo cusps m nehnjrvragedj garvjdwec eogdmiimparu `esjmsj .VE@% mo` errjhzdmr bdjj`eoh/ Mdsa
eo pnj rmrj cmsj eo xnecn m xaimo caocjewjs xnedj zseoh pnj Ierjom m
2: [ejimo O Nmpcnjr R/M/ jp md/ M Vacljp Hze`j pa Imomheoh Caoprmcjvpeao/Pehjr HM; Bre`heoh pnj Hmv Gazo`mpeao 26=6 mp 38/ Imomheoh CaoprmcjvpeaoarICes m cao`josj` wjrseao ag pnj vreimru ij`ecmd pj~pbaal ao caoprmcjvpeao
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bdjj`eoh/ Zdprmsazo` Abspjp Huojcad2665< 30.=%;==6)==:/
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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rjszdpmop dass ag vrjhomocu mo` m vassebdj vjrimojop dass ag gjrpedepu imu
rjszdp/28
.3%Eivdmoao; Pnes `jwecj es m vdmspec eivdmop ra` caopmeoeoh vrahjspahjojpaoahjsprjd xnecn es szrhecmddu eosjrpj` zo`jr pnj sleo ag pnj zvvjr mri< Eprjvdmcj` Oarvdmop xnecn es oa daohjr imrljpj` eo pnj Z/S/ mgpjr awjr
:6666 xaijo gedj` dmxszepseocdz`eoh 86 cdmss mcpeaosawjr sjwjrepu ag
se`j jggjcps/2> Eo m``epeao pa jcpavec vrjhomocu resls pnj imozgmcpzrjr
xmroeoh rjvarps sjreazs pnraibajibadec jwjops eocdz`eoh cmsjs ag
vzdiaomru jibade .saij gmpmd% mo` spraljs eo vmpejops zseoh
EIVDMOAO/25
.0%@jva)Vrawjrm; Pnes es m vavzdmr eokjcpmbdj vrahjspahjo eopjo`j` pa dmspzv pa pnrjj iaopns/ Eo m``epeao pa pnes eokjcpeaos bdmcl ba~ xmroeoh aodass ag baoj ieojrmd `josepu @jva)Vrawjrm zsj nms bjjo snaxo pa rjszdp eo
m `azbdj` resl ag mc}zereoh mo` prmosieppeoh NEW ms `esczssj` bjdax/
Eo Acpabjr 26== pnj Ojx Uarl Peijs hmwj graop)vmhj cawjrmhj pa pnj
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vjjr)rjwejxj` kazromd mgpjr eps vrjsjopmpeao nm` rmesj` mdmri iaopns jmrdejr mp mo
eopjrompeaomd ME@S caogjrjocj/ Pnj Njggrao spz`u rjszdpj` eo caoweoceoh geo`eohs
pnmp eokjcpmbdj caoprmcjvpewjs nmwj beadahecmd vravjrpejs pnmp mvvjmr pa `azbdj
28 Ierjom Dmbjd Xmroeohs mo` Vrjcmzpeaos< Sjj mdsa Zpjreoj Vjrgarmpeao Reslgrai Ierjom mwmedmbdj mp nppv;!!xxx/xaijos)njmdpn/ca/zl!zpjreoj)vjrgarmpeao)
resl)grai)ierjom/npid/2> CPszvrm o/ 3>/25 Eivdmoao Xmroeohs mwmedmbdj mpnppv;!!xxx/eivdmoao)zsm/cai!jo!NCV!djmro)mbazp)ep!hjp)pnj)gmcps!xmroeohs!eo`j~/msv/36 Njggrao R/ jp md/ Zsj ag nariaomd caoprmcjvpewjs mo` resl ag NEW)=prmosiesseao; m vrasvjcpewj canarp spz`u/Dmocjp Eogjcp @es 26=2< =2;=5)27/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 26 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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j~prjijs jwjo pnazhn pnj Hawjroijop epsjdg mcloaxdj`hjs pnjsj resls ao pnj
Ompeaomd Cmocjr Eospepzpj xjbsepjs mo` eo`jj` gzo`s imou ag pnj spz`ejs `esczssj`
mbawj pnrazhn pnj Ompeaomd Eospepzpjs ag Njmdpn/3:
Pnj EAI rjvarp zvao xnecn pnj Hawjroijop j~cdzsewjdu rjdej` mdsa mvvjmrs
abdeweazs pa pnj gmcp pnmp pnj wjru cao`epeaos ep zsjs pa eddzsprmpj xnu saij xaijo
ojj` pa vaspvaoj vrjhomocu .j/h/ `embjpjs abjsepu vzdiaomru nuvjrpjoseao% mo`
pnjrjgarj pa kzspegu eps rjcaiijo`mpeao pa gmcedepmpj mccjss pa caoprmcjvpeao mrj pnj
smij cao`epeaos pnmp vzp xaijo mp hrjmpdu eocrjmsj` resl gar cmr`eawmsczdmr
vrabdjis grai caoprmcjvpewj zsj/
Bjcmzsj ep ehoarj` pnj imou sjreazs njmdpn resls gar xaijo vasj` bu
nariaomd caoprmcjvpewjs pnj 26== EAI rjvarp `e` oap jwjo pru pa vrawj pnmp ao
bmdmocj pnj vzpmpewj njmdpn bjojgeps ag caoprmcjvpewjs azpxjehnj` pnj sehoegecmopdu
eocrjmsj` njmdpn resls/ Bu rjdueoh j~cdzsewjdu ao pnj `jgjcpewj EAI rjvarp pnj
Hawjroijop nms joperjdu gmedj` pa caose`jr mo eivarpmop msvjcp ag pnj vrabdji
zo`jrdueoh pnj Imo`mpj e/j/ vraiapeoh xaijos njmdpn/ Gar pnes rjmsao pnj
@jgjo`mops mcpeao eo vraizdhmpeoh pnj Imo`mpj xms mrbeprmru mo` cmvreceazs eo
weadmpeao ag pnj MVM/
3: Sjj j/h/ Njggrao szvrm xnecn spmpjs; Gzo`eoh; ZS Ompeaomd Eospepzpjs agNjmdpn mo` pnj Bedd ' Ijdeo`m Hmpjs Gazo`mpeao/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 22 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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xjdd)bjeoh bu eocjopewe{eoh .xepn imo`mpj` mwmedmbedepu ag oa)casp cawjrmhj% pnj
zsj ag nariaomd caoprmcjvpewjs pnmp mrj cdmssegej` ms cmrceoahjoec mo` m sazrcj ag
sehoegecmopdu eocrjmsj` resls ag sjreazs `esjmsjs/38
Bjcmzsj ag pnj dmrhj ba`u ag jwe`jocj snaxeoh sehoegecmopdu eocrjmsj`
njmdpn resls ag nariaomd caoprmcjvpewjs mdaoh xepn pnj gmcp pnmp gjrpedepu mo`
vrjhomocu mrj oap `esjmsj spmpjs pnj imo`mpj ag nariaomd caoprmcjvpewjs gmed\sY
pnj iasp eivarpmop pjsp ag vrjwjopewj ij`eceoj; pnju eocrjmsj resl ag `esjmsj
eospjm` ag `jcrjmseoh ep/3> Pnzs pnj Hawjroijops bzr`jo ag snaxeoh pnmp pnj
Imo`mpj gzrpnjrs eps caivjddeoh eopjrjsp eo vzbdec njmdpn es jwjo njmwejr; ep izsp
snax oap kzsp pnmp caoprmcjvpewjs vraiapj xaijos njmdpn bzp pnmp pnju `a sa pa m
`jhrjj pnmp azpxjehns pnjer `aczijopj` m`wjrsj jggjcps ao xaijos njmdpn/
M/ Pnj EAI Rjvarp @ajs Oap Szvvarp pnj Hawjroijops Mssjrpeao pnmp
Eocrjmsj` Zsj ag Caoprmcjvpewjs xedd Vraiapj Xaijo(s Njmdpn/
Zogarpzompjdu gar pnj Hawjroijop eps sadj jwe`jocj ag mou njmdpn bjojgeps
grai caoprmcjvpewjs es pnj 26== Eospepzpj ag Ij`eceoj Rjvarp/ Cepeoh pnes rjvarp35
pnj Hawjroijop mssjrps pnmp bu eocrjmseoh mccjss pa caoprmcjvpewjs pnj Imo`mpj
xedd vraiapj vzbdec njmdpn bu `jcrjmseoh zoeopjo`j` vrjhomocejs vraiapeoh pnj
38Sjj Sjcpeao Eszvrm/3> Rjbjccm Vjcl I/@/ C/C/@/ mo` Cnmrdjs X/ Oarres I/@/ Sehoegecmop Resls agArmd Caoprmcjvpewjs .ACVs% 85.=% Pnj Deomcrj ]zmrpjrdu 0= 02 .Gjbrzmru 26=2%/35 Eospepzpj ag Ij`eceoj Cdeoecmd Vrjwjopewj Sjrwecjs Gar Xaijo; Cdaseoh pnjHmvs .26==% .26== EAI% mwmedmbdj mpnppv;!!baals/omv/j`z!avjobaal/vnv1rjcar`Qe`9=3=>= /
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 20 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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svmceoh ag berpns mo` vrjwjopeoh vrjhomocu eo xaijo xepn cao`epeaos gar xnecn
vrjhomocu es caoprmeo`ecmpj`/ Eo m``epeao pa ehoareoh pnj dmrhj ba`u ag ij`ecmd
jwe`jocj sjp garpn eo pnj sjcpeao mbawj snaxeoh pnj sehoegecmopdu eocrjmsj` resls ag
cmocjrs mo` apnjr sjreazs `esjmsjs06 pnj Hawjroijop nms mdsa gmedj` pa snax pnmp
pnj Imo`mpj xazd` vrjwjop pnj ojhmpewj njmdpn caosj}zjocjs mddjhj`du mssacempj`
xepn zovdmooj` vrjhomocu pnmp ep sjjls pa vrjwjop/ Ojmrdu mdd ag pnj rjsjmrcn es
bmsj` ao carrjdmpeao oap jwe`jocj ag cmzsmpeao mo` iasp ag pnj spz`ejs szggjr grai
sehoegecmop m`ieppj` gdmxs eo ijpna`adahu/Braxo w/ Jopip Ijrcns/ Msso/$ :70
Z/S/ QQQQ =3= S/ Cp/ 2825 2835 .26==% .}zapmpeao imrls aieppj`%/
Pnj EAI m`ieps pnmp gar imou ojhmpewj azpcaijs grai zoeopjo`j`
vrjhomocu rjsjmrcn es deiepj`/0= Pnj EAI cepjs eps =55: rjvarp xnecn seiedmrdu
jivnmse{js pnj gzo`mijopmd `eggeczdpu eo `jgeoeoh xnecn vrjhomocejs mrj
zoeopjo`j` mo` eo `espeohzesneoh bjpxjjo mssacempeao mo` cmzsmpeao eo mssjsseoh
pnj resls ag zoeopjo`j` vrjhomocejs/02
Pnj =55: EAI rjvarp caocj`js pnmp oa cmzsmd deol nms bjjo jspmbdesnj` gar
06 Pnj ij`ecmd jwe`jocj ag pnj cmrceoahjoec eivmcp ag nariaomd caoprmcjvpewjs sjpgarpn eo Sjcpeao E szvrm es eo `erjcp caoprm`ecpeao pa pnj EAI rjvarps bram`
`jgeoepeao ag \vYrjwjopewj sjrwecjs gar xaijo ms pnasj pnmp vrjwjop cao`epeaosnmrigzd pa xaijos njmdpn mo` xjdd)bjeoh/ 26== EAI mp 26/0= 26== EAI mp =63/02 Eospepzpj ag Ij`eceoj Pnj Bjsp Eopjopeaos .=55:% .=55: EAI% mwmedmbdj mpnppv;!!baals/omv/j`z!avjobaal/vnv1rjcar`Qe`90563'vmhj970 .dmsp wesepj`Sjvpjibjr 26 26=2%/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 2: @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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iasp ag eps mddjhj` gmcpars/ Pnes imljs sjosj seocj pnj eopjo`j`ojss ar
zoeopjo`j`ojss ag m vrjhomocu cmooap epsjdg vnuseadahecmddu cnmohj eps njmdpn
jggjcp/ Pnzs m `jdmu eo sjjleoh vrjompmd cmrj gar mo zoeopjo`j` vrjhomocu imu bj
oa daohjr spmpespecmddu sehoegecmop gar xaijo xna mrj oap mdrjm`u `esvasj` pa
`jdmu ar xna nmwj m szvvarp ojpxarl03 )) ms `a pnj Vdmeopeggs eoszrj`
jivdaujjs ms xjdd ms pnj jivdaujjs svazsjs mo` `jvjo`jops/
Pnj EAI rjvarp cepjs pa apnjr bjnmwearmd resl gmcpars deolj` xepn zoeopjo`j`
vrjhomocu eocdz`eoh sialeoh `reoleoh `jvrjsseao mo` `aijspec weadjocj/00
Naxjwjr ep es eivassebdj pa smu mo` pnj EAI rjvarp `ajs oap mppjivp pa vrawj
pnmp zoeopjo`j` vrjhomocu djm`s pa pnjsj ojhmpewj bjnmwears mo` zonjmdpnu
sepzmpeaos/ Rmpnjr pnj deolmhj bjpxjjo pnji mo` zoeopjo`j` vrjhomocu es eo imou
cmsjs deljdu pa bj aoj ag mssacempeao oap cmzsmpeao/
Pnj EAIs szhhjspeao pnmp eocrjmsj` mccjss pa caoprmcjvpewjs xedd rj`zcj
dax berpn xjehnp mo` vrjimpzrepu awjrdaals pnj gmcp pnmp delj apnjr cepj` gmcpars
pnjsj mrj ijrjdu mssacempj` xepn oap cmzsj` bu zoeopjo`j` vrjhomocu .26==
EAI mp =63< =55: EAI mp 86%< pnj EAI epsjdg cepjs spz`ejs snaxeoh oa caoojcpeao
bjpxjjo dax berpn xjehnp mo` vrjhomocu)svmceoh eo pnj Z/S/0:
Oapmbdu pnj 26== EAI rjvarp cdmeis pa cepj m suspjimpec rjwejx ao dax
03E`/ mp 7>/00 26== EAI mp =63/0:=55: EAI mp 86)8=/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 27 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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berpn xjehnp bzp pnj cepmpeao es eocarrjcp/07 Pnj EAI pnjo cepjs pnrjj spz`ejs
snaxeoh mo mssacempeao bjpxjjo dax berpn xjehnp!vrjpjri `jdewjru mo` snarpjr
vrjhomocu eopjrwmds/08 Pnj EAI rjvarp gmeds pa oapj pnmp mdd pnrjj spz`ejs gazo`
pnjsj smij ojhmpewj azpcaijs gar djohpnu vrjhomocu eopjrwmds m cao`epeao deljdu pa
gaddax zvao eocrjmsj` caoprmcjvpewj zsj/
Pnj EAI mdsa gmedj` pa caose`jr pnj resls ag dax berpn xjehnp pnmp mresj grai
caoprmcjvpewj zsj epsjdg; m 2665 Cmom`emo spz`u snaxs pnmp xaijo xna caocjewj
xepneo 36 `mus ag haeoh agg caoprmcjvpewj vedds sehoegecmopdu eocrjmsj pnj resl ag dax
berpn xjehnp mo` wjru dax berpn xjehnp/0>
Geomddu pnj hawjroijops rjdemocj ao pnj svjcemd ojj`s ag saij xaijo
szcn ms pnasj xepn `embjpjs pa mwae` vrjhomocu ehoarjs pnj gmcp pnmp pnjsj xaijo
caivresj m gmr simddjr hrazv pnmo pnj Imo`mpj cawjrs mo` gar pnmp rjmsao pnj
Imo`mpj ms czrrjopdu sprzcpzrj` es oap omrraxdu pmedarj`/ Gaczsj` cmrj pa njdv
xaijo xepn pnjsj cao`epeaos cazd` mcnejwj pnj Imo`mpjs hamds xepn pnj
07 26== EAI mp =63 =77 .cepeoh Snmn jp md/ 266>%/ Pnj Snmn spz`u `ajs oapm``rjss dax berpn xjehnp< ep xms spz`u ag cmr`eawmsczdmr `esjmsj eo uazoh xaijoxepn hjspmpeaomd `embjpjs/ Snmn B/ R/ R/ Rjpomlmrmo mo` H/ D/ Baapn/ 266>/Eocrjmsj` resl ag cmr`eawmsczdmr `esjmsj eo uazoh xaijo gaddaxeoh hjspmpeaomd
`embjpjs ijddepzs/@embjpjs Cmrj 3=.>%;=77>=775/08E`/ mp =63/0> Cnjo jp md/ Rjcjop armd caoprmcjvpewj zsj mo` m`wjrsj berpn azpcaijs =00
Jzravjmo Kazromd ag Abspjprecs ' Huojcadahu mo` Rjvra`zcpewj Beadahu 0603.Imu 2665% mbsprmcp mwmedmbdj mp nppv;!!xxx/jkah/arh!mrpecdj!S636=)2==:.65%66680)>!/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 28 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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hawjroijop epsjdg vrawe`eoh caoprmcjvpewj sjrwecjs eg szcn sjrwecjs xjrj ij`ecmddu
eo`ecmpj`/
Eo szi xnedj pnj Hawjroijops hjojrmd eopjrjsp eo vrjwjopewj sjrwecjs gar
xaijos njmdpn mo` xjdd)bjeoh imu bj wmde` eps mcp ag cajrceoh rjdeheazsdu
abkjcpeoh jivdaujrs pa cawjr `rzhs pnmp sehoegecmopdu eocrjmsj resls pa xaijos
njmdpn xnedj vrawe`eoh `zbeazs njmdpn bjojgeps cjrpmeodu gmeds pa gzrpnjr pnmp
eopjrjsp/ Ms j~vdmeoj` bu pnj Z/S/ Szvrjij Cazrp Xj `a oap `azbp pnj wmde`epu
ag pnjsj eopjrjsps mou iarj pnmo xj `azbp pnj hjojrmd eopjrjsp eo vraiapeoh vzbdec
njmdpn mo` smgjpu/ / /bzp zo`jr RGRM eowacmpeao ag szcn hjojrmd eopjrjsps$
spmo`eoh mdaoj$ es oap joazhn/ Hao{mdjs w/ A Cjopra Jsverepm Bjojgecejopj Zoema
`a Wjhjpmd :07 Z/S/ 0=> 03> .2667%.jivnmses m``j`%/
B/ Pnj Hawjroijop Nms Gmedj` Pa Snax Pnmp Pnj Imo`mpj Gzrpnjrs
Eps Mssjrpj` Eopjrjsp Ag Vraiapeoh Hjo`jr J}zepu/
Pnj Hawjroijop mssjrps moapnjr mddjhj`du caivjddeoh hawjroijopmd eopjrjsp
omijdu vraiapeoh hjo`jr j}zepu bu rjiaweoh pnj zoj}zmd geomocemd bmrrejrs pa
njmdpn cmrj svjcegecmddu vrjwjopewj cmrj pnmp mresj grai nehnjr azp)ag)vacljp casps
gar xaijos hjo`jr)svjcegec cao`epeaos/ Pnj Hawjroijop mssjrps pnmp rjdejweoh
xaijo ag pnes mddjhj` `esvravarpeaompj bzr`jo xedd djm` pa j}zmd mccjss pa njmdpn
cmrj bjppjr njmdpn mo` pnjrjgarj j}zmd avvarpzoepejs pa vmrpecevmpj eo pnj xarlvdmcj
xepn ijo/ Zo`jrdueoh pnes mrhzijop mrj m ozibjr ag vrjiesjs gar xnecn pnj
Hawjroijop nms vrawe`j` deppdj ar oa szvvarpeoh jwe`jocj/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 2> @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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Gersp ms sjp garpn eo pnj vrjcj`eoh sjcpeaos pnj Hawjroijop nms gmedj` pa
snax pnmp pnj Imo`mpj xedd eo gmcp eivrawj xaijos njmdpn/ Eo`jj` pnjrj es
szbspmopemd jwe`jocj pnmp xe`jsvrjm` mo` djohpnu zsj ag caoprmcjvpewjs bu xaijo
nms rjszdpj` mo` xedd rjszdp eo sehoegecmop nmri pa pnjer njmdpn/ Pnes caocdzseao eo
mo` ag epsjdg `esvasjs ag pnj Hawjroijops mddjhj` hjo`jr j}zepu eopjrjsp/ Pnj
Hawjroijop cmo oap mssjrp m caivjddeoh eopjrjsp eo eocrjmseoh mccjss pa mo`
zpede{mpeao ag caoprmcjvpewjs mvmrp grai eps eopjrjsp eo vraiapeoh xaijos njmdpn/
Pnjrj es oa jwe`jocj eo pnj djhesdmpewj rjcar` grai xnecn pnj Hawjroijop cazd`
mrhzj pnmp Caohrjss eopjo`j` pa eocrjmsj mccjss pa caoprmcjvpewjs gar pnj smlj ag
xaijo bjeoh mbdj pa mwae` vrjhomocu mo` cned`bjmreoh sadjdu ms m ijmos ag
mcnejweoh hjo`jr j}zepu/ Rmpnjr pnj djhesdmpewj nesparu snaxs pnmp Caohrjsss
eopjop xms pa rjdejwj xaijo ag pnj eoj}zepmbdj geomocemd bzr`jo pnju gmcj eo
imeopmeoeoh pnjer njmdpn/ Pnzs eg caoprmcjvpewjs `a oap vraiapj xaijos njmdpn
pnju `a oap vraiapj pnj hawjroijops mssjrpj` eopjrjsp eo hjo`jr j}zepu/ Ms sjp
garpn eo Sjcpeao E mo` EE szvrm pnj Hawjroijop nms gmedj` pa snax pnmp
caoprmcjvpewjs vraiapj xaijos njmdpn/
Jwjo msszieoh mrhzjo`a pnmp caoprmcjvpewjs eo saij ijmszrj vraiapj
xaijos njmdpn pnj jwe`jocj vrjsjopj` bu pnj Hawjroijop pa szvvarp eps vrjiesj
pnmp xaijo mrj eoj}zepmbdu bzr`joj` bu pnjer casps es xajgzddu eom`j}zmpj/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 25 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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caose`jreoh eo vmrpeczdmr pnj azp)ag)vacljp j~vjosjs gar caoprmcjvpewjs pnj
jivdaujjs ojj` gar caoprmcjvpewjs eo`ecmpjs saij eopeimpj rjdmpeaosnev xepn m
imo }zepj vassebdu njr nzsbmo`/ Pnj Hawjroijop mvvmrjopdu msszijs xepnazp
vraag pnmp ijo )) xnjpnjr nzsbmo`s raaiimpjs ar saij apnjr radj )) eo eopeimpj
rjdmpeaosnevs xepn xaijo `a oap caoprebzpj pa pnj casps ag xnmpjwjr caoprmcjvpewj
ijpna` es zsj` bu pnj cazvdj/ Bzp xepnazp szcn vraag pnjrj es oa rjmsao pa bjdejwj
pnmp xaijo mrj cmrrueoh mo eoj}zepmbdj bzr`jo xnjo ep caijs pa pnj casps ag
caoprmcjvpewjs/ Mo` xepnazp szcn vraag pnjrj es oa rjmsao pa bjdejwj pnmp pnj
Imo`mpj `ajs moupneoh bzp snegp pnj geomocemd bzr`jo ag caoprmcjvpewjs oap grai
pnj xaimo bzp grai pnj cazvdj aopa pnj jivdaujr )) mhmeo `aeoh oapneoh pa
gzrpnjr pnj mssjrpj` hawjroijopmd eopjrjsp eo vraiapeoh hjo`jr j}zepu/
Eo szi pnj Hawjroijop nms gmedj` pa cmrru eps bzr`jo ag vraweoh pnmp pnj
cajrcewj Imo`mpj eo gmcp oap eo pnjaru gzrpnjrs eps mssjrpj` eopjrjsp eo vraiapeoh
xaijos njmdpn ar hjo`jr j}zepu/
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 32 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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CAOCDZSEAO
Gar pnj garjhaeoh rjmsaos Miece Xaijo Svjml gar Pnjisjdwjs Beajpnecs
@jgjosj Gzo` mo` Degj Djhmd @jgjosj Gazo`mpeao rjsvjcpgzddu zrhj pnes Cazrp pa
hrmop mo ar`jr rjwjrseoh mo` rjimo`eoh pnj kz`hijop bjdax `esiesseoh pnj
Vdmeopeggs cmsj mo` eosprzcpeoh pnj cazrp pa vraivpdu `jce`j pnj vjo`eoh iapeao
gar vrjdeieomru eokzocpeao/
Rjsvjcpgzddu szbieppj`
!s! @areo`m C/ Bar`djjQQQQQQQQQ
Oeladms P/ Oelms M[ Bmr Oa/ 6==62:+@areo`m C/ Bar`djj DM Bmr Oa/ 26==:BEAJPNECS @JGJOSJ GZO@7>== J/ Wadpmerj Mwjozj
Scapps`mdj M[ >:2:0.0>6% 0>3)3:58
Cmpnjreoj X/ Snarp .CM Bmr Oa/ ==8002%DEGJ DJHMD @JGJOSJ GAZO@MPEAOV/A/ Ba~ =3=3Akme CM 53623.>6:% 706)=506DD@GAkmeFcs/cai
+CAZOSJD AG RJCAR@
Mpparojus gar Miece Czremj
@MPJ@; Oawjibjr 26 26=2
Mvvjddmpj Cmsj; =2)33:8 Vmhj; 33 @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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CJRPEGECMPJ AG CAIVDEMOCJ
Vzrszmop pa Rzdj 32.m%.8.C% ag pnj Gj`jrmd Rzdjs ag Mvvjddmpj Vracj`zrj E
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pnmp rzdj/ Pnes brejg caopmeos 0$382 xar`s .j~cdzsewj ag pnj cawjr pmbdj ag caopjops
pmbdj ag mzpnarepejs mo` apnjr graop imppjr%/ E rjdej` ao iu xar` vracjssar
Iecrasagp Xar`;imc 26== pa abpmeo pnj cazop/
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Mvv/ V/ 3:.m%.:% mo` pnj puvj spudj rj}zerjijops ag Gj`/ R/ Mvv/ V/ 32.m%.7%
bjcmzsj pnes brejg nms bjjo vrjvmrj` eo m vravarpeaomddu svmcj` puvjgmcj zseoh
Iecrasagp Xar`;imc 26== eo Peijs Ojx Raimo =0 vp/
@MPJ@; Oawjibjr 26 26=2 !s!@areo`m C/ Bar`djj@areo`m C/ Bar`djj
Cazosjd garMiece Czremj
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WERZS CNJCL CJRPEGECMPEAO
Pnj jdjcpraoec wjrseao ag pnj brejg mo` m``jo`zi nmwj bjjo scmooj` gar werzsjs mo` mrj
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Mvvjddmpj Cmsj; =2)33:8 Vmhj; 3: @mpj Gedj`; ==!26!26=2 Jopru E@; 358755= RJSPRECPJ@
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7/30/2019 Amicus Brief for OBRIEN INDUSTRIAL HOLDINGS, LLC v.U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; KATHLEEN SEBELIUS and others
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CJRPEGECMPJ AG SJRWECJ
E cjrpegu pnmp ao Oawjibjr 26 26=2 E jdjcpraoecmddu gedj` pnj garjhaeoh xepn pnj
Cdjrl ag pnj Cazrp gar pnj Zoepj` Spmpjs Cazrp ag Mvvjmds gar pnj Jehnpn Cerczep bu
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CI!JCG zsjrs mo` pnmp sjrwecj xedd bj mccaivdesnj` bu pnj CI!JCG suspji/
@MPJ@; Oawjibjr 26 26=2 !s!@areo`m C/ Bar`djj@areo`m C/ Bar`djjCazosjd garMiece Czremj