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Esparza v. University Medical Center Management Corp.

United States District Court, E.D. Louisiana

October 24, 2017

KIMBERLY ESPARZA
v.
UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION ET AL.

         SECTION I

          AMENDED ORDER AND REASONS

          LANCE M. AFRICK UNITED STATES DISTRICT JUDGE

         Before the Court are two motions to dismiss. The first motion[1] to dismiss was filed by the Board of Supervisors of Louisiana State University and Agricultural and Mechanical College (“the LSU Board”). The LSU Board argues that sovereign immunity bars the Court from hearing Esparza's claim against it under § 1557 of the Patient Protection and Affordable Care Act (“ACA”). As for Esparza's claims against the LSU Board under § 504 of the Rehabilitation Act of 1973, the LSU Board argues that Esparza has failed to state a claim upon which the Court can grant relief.

         University Medical Center Management Corporation (“UMC”)[2] and Louisiana Children's Medical Center (“LCMC”) also filed a motion[3] to dismiss. They argue that Esparza's state law claims against them are premature and as such should be dismissed. They also argue that Esparza has failed to state claims for compensatory damages under § 1557 of the ACA and § 504 of the Rehabilitation Act. Finally, UMC and LCMC ask the Court to stay the case while Esparza submits her state law claims to the requisite state administrative process.

         Esparza opposes[4] both motions. For the following reasons, the Court denies the motions.

         I.

         Kimberly Esparza is a deaf individual whose primary mode of communication is American Sign Language (“ASL”).[5] UMC operates University Medical Center New Orleans (“the hospital”), a full-service medical facility allegedly owned by the LSU Board.[6] LCMC is UMC's sole member.[7]

         From October 2016 through March 2017, Esparza visited the hospital on a number of occasions to receive medical care, including treatment for a broken arm, dental treatment, and lab work.[8] During these visits, the hospital did not provide a qualified in-person sign language interpreter to assist Esparza in communicating with staff and learning healthcare-related information.[9] Instead, the hospital offered Esparza use of a Video Remote Interpreting (“VRI”) machine.[10]

         According to Esparza, the VRI machine-the only accommodation provided by the hospital-was “heavily pixilated.”[11] Moreover, Esparza alleges that use of the VRI machine was not appropriate during certain visits, because she “had limited ability [to] sign with both hands” for a certain period of time “as a result of her injury” to her right arm.[12] The VRI machine also required “several hours to set up.”[13]

         As a result, Esparza contends that the VRI machine was an ineffective accommodation, and so she had to resort to written English, or the assistance of her mother or boyfriend to communicate with hospital staff. However, Esparza alleges that her proficiency in written English is “limited”;[14] that her mother is not a qualified sign language interpreter;[15] that use of her mother as an interpreter required Esparza to relinquish her medical privacy and “embarrassed” her;[16] and that her boyfriend is also deaf, and he had to attempt to read the lips of hospital staff and then translate his reading of their lips into ASL.[17]

         Esparza requested that the hospital provide her with a qualified in-person sign language interpreter.[18] However, the hospital refused to provide one, informing Esparza that it would not pay for the service.[19]

         Because the hospital did not provide a qualified in-person sign language interpreter to assist her during her visits, Esparza alleges that she was not able to effectively communicate with hospital staff about the “nature, scope, or consequence” of her broken arm or dental treatment, [20] treatment options, [21] the use and side effects of medications, [22] lab work, [23] and women's health issues.[24] Esparza also alleges that she was not able to understand various medical documents.[25]

         In response, Esparza filed the present case against UMC, LCMC, and the LSU Board. Esparza alleges that UMC and LCMC violated her rights under Title III of the Americans with Disabilities Act and the Louisiana Commission on Human Rights Act.[26] Esparza also alleges that all three defendants violated her rights under § 504 of the Rehabilitation Act and § 1557 of the ACA.[27]

         II.

         A.

         Rule 12(b)(1) of the Federal Rules of Civil Procedure provides for the dismissal of an action where the court finds that it does not possess subject matter jurisdiction over the action. Where “a Rule 12(b)(1) motion is filed in conjunction with other Rule 12 motions, the court should consider the Rule 12(b)(1) jurisdictional attack before addressing any attack on the merits.” Ramming v. United States, 281 F.3d 158, 161 (5th Cir. 2001).

         “A case is properly dismissed for lack of subject matter jurisdiction when the court lacks the statutory or constitutional power to adjudicate the case.” Home Builders Ass'n of Miss., Inc. v. City of Madison, Miss., 143 F.3d 1006, 1010 (5th Cir. 1998). Courts may dismiss for lack of subject matter jurisdiction on any one of three different bases: (1) the complaint alone; (2) the complaint supplemented by undisputed facts in the record; or (3) the complaint supplemented by undisputed facts plus the court's resolution of disputed facts.” Clark v. Tarrant County, 798 F.2d 736, 741 (5th Cir. 1986) (citing Williamson v. Tucker, 645 F.2d 404, 413 (5th Cir. 1981)). Where the defendant has questioned the court's subject matter jurisdiction, the plaintiff has the burden of “proving by a preponderance of the evidence that the trial court does” possess the requisite jurisdiction to hear the case. Patterson v. Weinberger, 644 F.2d 521, 523 (5th Cir. 1981).

         B.

         Under Rule 12(b)(6) of the Federal Rules of Civil Procedure, a district court may dismiss a complaint, or any part of it, where a plaintiff has not set forth well-pleaded factual allegations that would entitle him to relief. See Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (2007); Cuvillier v. Taylor, 503 F.3d 397, 401 (5th Cir. 2007). A plaintiff's factual allegations must “raise a right to relief above the speculative level.” Twombly, 550 U.S. at 555. In other words, a complaint “must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.'” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S. at 570)).

         A facially plausible claim is one where “the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. If the well-pleaded factual allegations “do not permit the court to infer more than the mere possibility of misconduct, ” then “the complaint has alleged-but it has not ‘show[n]'-‘that the pleader is entitled to relief.'” Id. at 679 (quoting Fed.R.Civ.P. 8(a)(2)) (alteration in original).

         On a Rule 12(b)(6) motion to dismiss, a court limits its review “to the complaint, any documents attached to the complaint, and any documents attached to the motion to dismiss that are central to the claim and referenced by the complaint.” Lone Star Fund V (U.S.), L.P. v. Barclays Bank PLC, 594 F.3d 383, 387 (5th Cir. 2010); see also Spivey v. Robertson, 197 F.3d 772, 774 (5th Cir. 1999). In assessing the complaint, the Court must accept all well-pleaded factual allegations as true and liberally construe all such allegations in the light most favorable to the plaintiff. Spivey, 197 F.3d at 774; Lowrey v. Tex. A&M Univ. Sys., 117 F.3d 242, 247 (5th Cir. 1997). Where “the complaint ‘on its face show[s] a bar to relief, '” then dismissal is the appropriate course. Cutrer v. McMillan, 308 Fed. App'x. 819, 820 (5th Cir. 2009) (quoting Clark v. Amoco Prod. Co., 794 F.2d 967, 970 (5th Cir. 1986)).

         III.

         A.

         The LSU Board first moves to dismiss Esparza's claim under § 1557 of the ACA for lack of subject matter jurisdiction, contending that sovereign immunity bars the Court from adjudicating Esparza's § 1557 claim against it.[28] However, the LSU Board's position assumes that Esparza has the right to bring an individual claim under § 1557. The Court will first address that question.

         i.

Section 1557 of the ACA provides:
Except as otherwise provided for in this title (or an amendment made by this title), an individual shall not, on the ground prohibited under title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), the Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.), or section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity, any part of which is receiving Federal financial assistance, including credits, subsidies, or contracts of insurance, or under any program or activity that is administered by an Executive Agency or any entity established under this title (or amendments). The enforcement mechanisms provided for and available under such title VI, title IX, section 504, or such Age Discrimination Act shall apply for purposes of violations of this subsection.

42 U.S.C. § 18116(a). The ACA does not provide an express private right of action under § 1557. As such, the Court must consider whether the ACA provides an implied one.

         The existence of an implied private right of action is determined by reference to the four-factor test first articulated by the U.S. Supreme Court in Cort v. Ash, 422 U.S. 66 (1975):

(1) Is this plaintiff a member of the class for whose “especial” benefit the statute was passed? In other words, does the statute create a federal right for this plaintiff?
(2) Is there any evidence of legislative intent, either explicit or implicit, to create or deny a private remedy?
(3) Is it consistent with the legislative scheme to imply a private remedy?
(4) Is the cause of action one traditionally relegated to state law so that implying a federal right of action would be inappropriate?

Lundeen v. Mineta, 291 F.3d 300, 311 (5th Cir. 2002) (quoting Louisiana Landmarks Society, Inc., v. City of New Orleans, 85 F.3d 1119, 1122-23 (5th Cir. 1996)). When analyzing a federal statute under Cort v. Ash, a court should “begin with the familiar presumption that Congress did not intend to create a private right of action.” Louisiana Landmarks Society, 85 F.3d at 1123 (internal quotation marks omitted). The plaintiff carries the burden of showing “that Congress affirmatively contemplated private enforcement when it passed the relevant statute.” Id. (quoting Victorian v. Miller, 813 F.2d 718, 721 (5th Cir. 1987) (en banc)).

         Other courts have concluded that § 1557 is indeed enforceable via an implied private right of action. See Se. Penn. Trans. Auth. v. Gilead Sci., Inc., 102 F.Supp.3d 688, 697-99 (E.D. Penn. 2015); Rumble v. Fairview Health Serv., No. 14-2037, 2015 WL 1197415, at *7 n.3 (D. Minn. Mar. 16, 2015) (Nelson, J.); Callum v. CVS Health Corp., 137 F.Supp.3d 817, 845-48 (D.S.C. 2015). Unsurprisingly, Esparza agrees with these courts.[29] UMC and LCMC likewise acknowledge that “the Court would not be remiss in recognizing an implied private right of action under § 1557” given the lack of case law to the contrary.[30] The LSU Board did not provide guidance as to this issue, [31] despite the Court's order to do so.[32]

         Applying the Cort v. Ash test to § 1557, the Court agrees with its sister courts and concludes that § 1557 is enforceable via an implied private right of action. Section 1557 “expressly identifies” classes of individuals that “Congress intended to benefit”-namely, the individuals protected by the four federal nondiscrimination statutes explicitly referenced and incorporated. Lundeen, 291 F.3d at 311 (quoting Cannon v. University of Chicago, 441 U.S. 677, 690 (1979)); see also Franciscan Alliance, Inc. v. Burwell, 227 F.Supp.3d 660, 671 (N.D. Tex. 2016). Section 1557 also mirrors the rights-creating language used in those statutes. Se. Penn. Trans. Auth., 102 F.Supp.3d at 698; Callum, 137 F.Supp.3d at 847. “The cross-reference to these statutes and the use of similar rights-creating terms manifest Congressional intent to create a private right.” Se. Penn. Trans. Auth., 102 F.Supp.3d at 698.

         Further, subsection (a) of § 1557 provides that the “enforcement mechanisms provided for and available under” the other four statutes “shall apply for purposes of violations of” § 1557. Those statutes all permit private rights of action. See Alexander v. Sandoval, 532 U.S. 275, 279-80 (2001) (noting that Title VI and Title IX provided private rights of action); Frame v. City of Arlington, 657 F.3d 215, 223 (5th Cir. 2011) (en banc) (noting that § 504 is enforceable through an implied private right of action); Parker v. Bd. of Super. Univ. of La.-Lafayette, 296 Fed. App'x 414, 417 (5th Cir. 2008) (treating the Age Discrimination Act as providing a private right of action and specifying the statutory prerequisites to bringing a claim under it). As one court observed, “[b]ecause Section 1557 states that the enforcement mechanisms available under those four statutes apply to violations of Section 1557, Section 1557 necessarily also permits private causes of action.” Rumble, 2015 WL 1197415, at *7 n.3; cf. Se. Penn. Trans. Auth., 102 F.Supp.3d at 698 (“[S]uch express incorporation of the enforcement mechanisms from those statutes is probative of Congressional intent to provide both a private right and a private remedy for violations of Section 1557.”).

         Recognition of an implied private right of action to enforce § 1557 then is not merely “consistent with the legislative scheme, ” Lundeen, 291 F.3d at 311, but it is in fact explicitly contemplated by the scheme. Moreover, as the recognition of an implied private right of action to enforce § 504 illustrates well, see Frame, 657 F.3d at 223, a right of action to enforce a federal nondiscrimination provision does not unduly step on the toes of state law.

         It seems abundantly clear to the Court that Congress intended to create a private right of action to enforce § 1557-and congressional intent is the “touchstone” of the Cort v. Ash analysis. Lundeen, 291 F.3d at 312 (quoting Louisiana Landmarks Soc'y, 85 F.3d at 1123). Section 1557 is enforceable via an implied private right of action. With that question settled, the Court can now address whether sovereign immunity bars an individual, such as Esparza, from asserting a § 1557 claim against the LSU Board in federal court.

         ii.

         The Eleventh Amendment provides that “[t]he Judicial power of the United States shall not be construed to extend to any suit in law or equity, commenced or prosecuted against one of the United States by Citizens of another State, or by Citizens or Subjects of any Foreign State.” Despite the Eleventh Amendment's language targeting discrete categories of Article III diversity jurisdiction, the U.S. Supreme Court has fashioned a doctrine of Eleventh Amendment sovereign immunity defined by reference to “the Constitution's structure, its history, and the authoritative interpretations by this Court.” Alden v. Maine, 527 U.S. 706, 713 (1999); see also Hans v. Louisiana, 134 U.S. 1, 13 (1890); cf. Meyers ex rel. Benzing v. Tex., 410 F.3d 236, 240-41 (5th Cir. 2005) (“‘Eleventh Amendment immunity' is a misnomer, . . . because that immunity is really an aspect of the Supreme Court's concept of state sovereign immunity and is neither derived from nor limited by the Eleventh Amendment.”).

         Sovereign immunity operates as “a constitutional limitation on the federal judicial power.” Pennhurst State School & Hosp. v. Halderman, 465 U.S. 89, 98 (1984). However, unlike other aspects of the federal courts' subject matter jurisdiction, sovereign immunity is waivable: “a State may consent to suit against it in federal court.” Id. at 99. To effectuate waiver, “the State's consent [must] be unequivocally expressed.” Id. A court “will find waiver only where stated ‘by the most express language or by such overwhelming implications from the text as (will) leave no room for any other reasonable construction.'” Edelman v. Jordan, 415 U.S. 651, 673 (1974) (quoting Murray v. Wilson Distilling Co., 213 U.S. 151, 171 (1909)). For example, “[t]he mere fact that a State participates in a program through which the Federal Government provides assistance for the operation by the State of a system of public aid is not sufficient to establish consent on the part of the State to be sued in the federal courts.” Id.

         In addition, Congress may abrogate a state's sovereign immunity when exercising at least some of its constitutional powers. See Fitzpatrick v. Bitzer, 427 U.S. 445, 456 (1976) (holding that Congress has the power to abrogate state sovereign immunity under section 5 of the Fourteenth Amendment); but see Seminole Tribe of Fla. V. Fla., 517 U.S. 44, 72 (1996) (holding that Congress does not have the power to abrogate state sovereign immunity under the Indian Commerce Clause). However, as with a state's voluntary waiver of sovereign immunity, abrogation requires “an unequivocal expression of congressional intent to ‘overturn the constitutionally guaranteed immunity of the several States.'” Pennhurst, 465 U.S. at 99; see also Atascadero State Hosp. v. Scanlon, 473 U.S. 234, 243 (1985) (“[I]t is incumbent upon the federal courts to be certain of Congress' intent before finding that federal law overrides the guarantees of the Eleventh Amendment.”), superseded by An Act to Extend and Improve the Rehabilitation Act of 1973, Pub. L. 99-506, 100 Stat. 1807 (1986). “A general authorization for suit in federal court is not the kind of unequivocal statutory language sufficient to abrogate the Eleventh Amendment.” Id. at 246. “When Congress chooses to subject the States to federal jurisdiction, it must do so specifically.” Id.

         Besides waiver and abrogation, the U.S. Supreme Court has also recognized- as a means “to promote the vindication of federal rights, ” Pennhurst, 465 U.S. at 105-that an individual may bring certain kinds of federal claims directly against state officers in their individual capacities and avoid running up against the sovereign immunity bar. See Ex parte Young, 209 U.S. 123, 155-56 (1908); see also Edelman, 415 U.S. at 676 (limiting Ex parte Young actions to claims seeking prospective injunctive relief); Seminole Tribe, 517 U.S. at 75-76 (concluding Ex parte Young actions are not available where Congress has established a remedial scheme to settle a particular claim, even if that scheme is inoperable). However, the Fifth Circuit has concluded that “the LSU Board is an arm of the state and is immune from suit under the Eleventh Amendment.” Raj v. La. St. Univ., 714 F.3d 322, 328 (5th Cir. 2013). Unless Congress has validly abrogated Louisiana's sovereign immunity with respect to § 1557 claims or Louisiana has unambiguously waived its sovereign immunity with respect to § 1557 claims, plaintiff cannot assert such claims against the LSU Board in this Court. See Pennhurst, 465 U.S. at 98.

         iii.

         As the Court previously explained, § 1557 provides that “an individual shall not, on the ground prohibited under [certain federal laws], be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity, any part of which is receiving Federal financial assistance, including credits, subsidies, or contracts of insurance.” 42 U.S.C. § 18116(a) (emphasis added).[33] No provision of the ACA purports to abrogate state sovereign immunity. Moreover, as a general matter, “Louisiana has expressly declined to waive its sovereign immunity under the Eleventh Amendment.” Raj, 714 F.3d at 328 (citing La. R.S. § 13:5106(A) and Richardson v. S. Univ., 118 F.3d 450, 453 (5th Cir. 1997)).

However, Title 42, United States Code, § 2000d-7 provides that:
A State shall not be immune under the Eleventh Amendment of the Constitution of the United States from suit in Federal court for a violation of section 504 of the Rehabilitation Act of 1973 [29 U.S.C.A. § 794], title IX of the Education Amendments of 1972 [20 U.S.C.A. § 1681 et seq.], the Age Discrimination Act of 1975 [42 U.S.C.A. § 6101 et seq.], title VI of the Civil Rights Act of 1964 [42 U.S.C.A. § 2000d et seq.], or the provisions of any other Federal statute prohibiting discrimination by recipients of Federal financial assistance.

42 U.S.C. § 2000d-7(a)(1) (emphasis added). With § 2000d-7, Congress struck a bargain with the states: if a federal statute prohibits discrimination on a certain basis by recipients of federal money, then a state entity that receives federal money is subject to suit in federal court for violations of that nondiscrimination provision.

         This case is far from the first in this Circuit to consider § 2000d-7. The Fifth Circuit comprehensively addressed § 2000d-7's validity in Pace v. Bogalusa City School Bd., 403 F.3d 272 (5th Cir. 2005) (en banc), which involved analyzing the impact of § 2000d-7 on claims brought under § 504 and the Individuals with Disabilities Education Act. Remarkably, the LSU Board does not even cite Pace-let alone discuss its holding and reasoning-in a supplemental brief that this Court ordered specifically respecting the applicability of § 2000d-7 to § 1557.[34] Such a significant oversight on the part of the LSU Board cannot help but call into question the rigor with which the LSU Board considered the issue.

         As the Fifth Circuit explained in Pace, “congressional spending programs that are enacted in pursuit of the general welfare and unambiguously condition a state's acceptance of federal funds on reasonably related requirements are constitutional unless they are either (1) independently prohibited or (2) coercive.” 403 F.3d at 279 (analyzing South Dakota v. Dole, 483 U.S. 203 (1987)). “When the condition requires a state to waive its Eleventh Amendment immunity, . . . an unambiguous statement of the condition and its proscription on coercive inducements serve a dual role because they ensure . . . that waiver of Eleventh Amendment immunity must be (a) knowing and (b) voluntary.” Id.

         According to the Pace court, § 2000d-7 adequately put Louisiana “on notice that, by accepting federal money, it was waiving its Eleventh Amendment immunity.” Id. at 284. Moreover, § 2000d-7 is not unconstitutionally coercive, as a state entity can simply decline federal money if it wants to avoid being hauled into federal court by an individual alleging that the state entity violated a covered federal nondiscrimination law. See Id. at 287. Based on these considerations, the Fifth Circuit held that “the waiver condition set forth in § 2000d-7 is a constitutionally permissible exercise of Congress' spending power.” Bennett-Nelson v. La. Bd. of Regents, 431 F.3d 448, 453 (5th Cir. 2005) (discussing Pace, 403 F.3d at 280-87).

         iv.

         The holding and reasoning in Pace governs the outcome of the Court's § 1557 sovereign immunity analysis. In addition to the four federal nondiscrimination statutes that are explicitly referenced-the same four referenced in and incorporated into § 1557-§ 2000d-7 applies to “provisions of . . . Federal statute[s] prohibiting discrimination by recipients of Federal financial assistance.” Section 1557 is a federal nondiscrimination provision, the applicability of which turns on being a “health program or activity” that “receiv[es] Federal financial assistance.” Cf. 29 U.S.C. § 794(a) (codifying § 504 of the Rehabilitation Act of 1973, which provides that “[n]o otherwise qualified individual with a disability . . . shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance”). If a state entity meets § 1557's requirements, then-pursuant to the terms of § 2000d-7-that entity has waived its immunity against individual § 1557 claims in federal court. Cf. Pace, 403 F.3d at 285-87 (holding that Louisiana, as a recipient of federal funds, knowingly and voluntarily waived its sovereign immunity with respect to § 504 claims under the terms of § 2000d-7); Bennett-Nelson, 431 F.3d at 453 (concluding that Louisiana Tech University was “an intended recipient of federal financial assistance” and so falls within § 504 and § 2000d-7, because the University ultimately benefited from federal student financial aid in the form of tuition payments and other expenses).

         In its supplemental brief addressing § 2000d-7's impact on the § 1557 sovereign immunity question-which, again, does not acknowledge Pace-the LSU Board argues that “the ultimate aim of Congress under Section 1557 was to the ‘health program or activity' and not to the ‘recipient of Federal financial assistance.'”[35] To support this argument, the LSU Board points to McGarry v. Univ. of Miss. Med. Ctr., 355 Fed. App'x 853 (5th Cir. 2009), [36] which itself points to another Fifth Circuit panel decision that concluded that “[t]he [Age Discrimination in Employment Act (ADEA)] prohibits age discrimination by ‘employers, ' not by those who receive federal financial assistance.” 355 Fed. App'x at 856 (quoting Sullivan v. Univ. of Tex. Health Sci. Ctr. at Houston Dental Branch, 217 Fed. App'x 391, 395 (5th Cir. 2007)).

         For starters, McGarry's discussion of the ADEA nondiscrimination provision is irrelevant to the Court's § 1557 sovereign immunity analysis. The ADEA provision does not target recipients of federal financial assistance, but rather targets employers. See 29 U.S.C. § 623(a). In contrast, § 1557 unambiguously targets recipients of federal financial assistance. Hence, § 1557 falls squarely within the terms of § 2000d-7, whereas the ADEA provision does not. See Sullivan, 217 Fed. App'x at 395 (observing that the applicability of § 2000d-7 to a federal nondiscrimination provision turns on whether the provision targets “recipients of Federal financial assistance” (quoting 42 U.S.C. § 2000d-7(a)(1)).

         As to the LSU Board's unreasoned suggestion that Congress intended the federal courts to essentially ignore the words “Federal financial assistance” in § 1557, the Court unequivocally rejects it. If Congress did not intend § 1557 to turn on the receipt of federal financial assistance, then all Congress had to do was delete those words from the statute. Yet Congress passed, and the President signed, those words into law. The Court is bound to honor their choice by giving those words their appropriate weight. See United States v. Ramirez-Carcamo, 559 F.3d 384, 387 (5th Cir. 2009) (“An important statutory construction principle is ‘that a statute ought, upon the whole, to be so construed that, if it can be prevented, no clause, sentence, or word shall be superfluous, void, or insignificant.'” (quoting TRW v. Andrews, 534 U.S. 19, 31 (2001))).

         The LSU Board also argues that “there can be no doubt that Congress is fully aware of how to draft an effective waiver of sovereign immunity, and there is also no doubt that Congress did not do so in drafting” § 1557.[37] The LSU Board seems confused: § 2000d-7 is an example of a valid waiver of state sovereign immunity, seePace, 403 F.3d at 287, and the plain text of ยง 1557 fits within the four corners ...


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