Wilson v. Centene Mgmt

United States Court of Appeals

for the Fifth Circuit

United States Court of Appeals

Fifth Circuit

FILED

____________

February 19, 2026

No. 24-50044 Lyle W. Cayce

____________ Clerk

Cynthia Wilson; Nicholas Angelo; Erin Angelo,

Plaintiffs—Appellants,

versus

Centene Management Company, L.L.C.; Celtic

Insurance Company; Superior HealthPlan,

Incorporated; Centene Company of Texas, L.P.,

Defendants—Appellees.

______________________________

Appeal from the United States District Court

for the Western District of Texas

USDC No. 1:20-CV-484

______________________________

Before Dennis, Southwick, and Engelhardt, Circuit Judges.

Leslie H. Southwick, Circuit Judge:

We withdraw the prior opinion, 144 F.4th 780 (5th Cir. 2025), and

substitute the following.

The Plaintiffs in this case asserted breach-of-contract claims against

the Defendant insurance companies, alleging the provider lists were

materially inaccurate, thereby causing the Plaintiffs and proposed class

members to pay artificially inflated premiums. The district court denied class

No. 24-50044

certification after concluding the Plaintiffs lacked standing because they

failed to establish an injury in fact. Finding error in that standing

determination, we VACATE and REMAND for further proceedings.

FACTUAL AND PROCEDURAL BACKGROUND

The Plaintiffs, who include the proposed class representatives

Cynthia Wilson, Erin Angelo, and Nicholas Angelo, brought suit on behalf of

all individuals residing in Texas who, from January 1, 2014, through

December 31, 2021, purchased a policy under the “Ambetter from Superior

HealthPlan” sold and managed by the Defendants: Centene Management

Company, L.L.C., Celtic Insurance Company, Superior HealthPlan Inc., and

Centene Company of Texas, L.P. (collectively, “Superior”). The Plaintiffs

entered health insurance contracts under the Ambetter plan through the

Texas Health Insurance Exchange, Texas’s Affordable Care Act (“ACA”)

marketplace website.

After obtaining coverage under the policy, each Plaintiff was unable to

obtain certain healthcare providers listed by Ambetter in its in-network

provider directory. The Plaintiffs allege Superior’s list of available providers

supplied via the Ambetter plan was materially inaccurate, containing

thousands of names of providers who were not, in fact, available to provide

medical care. As a result, the Plaintiffs and proposed class members were

overcharged when they paid artificially inflated premiums for access to

providers who were not available.

As an insurance provider under the ACA, Superior is regulated by

both Texas and federal law. Network adequacy is a federal requirement,

meaning the network must be “sufficient in number and types of providers.”

45 C.F.R. § 156.230(a)(1)(ii) (2026). Additionally, federal regulations

require Superior to provide consumers with access to an “up-to-date,

accurate, and complete provider directory” that is “easily accessible,” a

2

No. 24-50044

requirement that is met when “all of the current providers for a plan” are

listed “in the provider directory on the issuer’s public Web site.”

§ 156.230(b)(2). The Texas Department of Insurance is responsible for

overseeing and regulating the Ambetter plan and ensuring Superior’s

adherence to pertinent rules and regulations.

Superior’s Ambetter plan is an Exclusive Provider Organization

policy, which requires policyholders to use in-network healthcare providers.

The marketplace website provides information including monthly prices, co-

pay amounts, deductibles, and out-of-pocket maximums; it does not,

however, supply in-network provider lists for any given plan. Instead, it

provides links to an individual plan’s provider directory. Ambetter uses a

provider search engine, which allows users to access a subset of Ambetter

providers based on the criteria a user puts into the search engine. At a

minimum, these criteria include desired provider specialty and location.

Superior’s brief on appeal states that users do not have a means to view a

comprehensive list of Ambetter’s in-network providers because the results

are always limited by the search criteria.

The Plaintiffs allege that Ambetter’s provider directories were

materially inaccurate. As a result, they allegedly paid artificially inflated

premiums for access to providers who were not available to them. We

examine the details for two of the Plaintiffs.

Plaintiff Cynthia Wilson, a breast cancer patient, purchased the

Ambetter plan in January 2017 after reviewing the directory of in-network

providers. Shortly thereafter, Ambetter assigned her a primary-care

provider. Later that year, Wilson developed shingles and was referred to her

Ambetter-assigned physician. The assigned physician, unhelpfully, was a

pediatrician. Trying to identify a physician who could assist her, Wilson

contacted nine physicians on Ambetter’s provider list — none of whom

3

No. 24-50044

accepted the Ambetter policy. Ultimately, Wilson consulted an out-of-

network physician to receive care for her medical condition and switched

insurance policies. She was never able to use her Ambetter policy to see a

healthcare provider.

Plaintiffs Erin and Nicholas Angelo also reviewed the Ambetter

provider directory prior to purchasing their policy in December 2016. At the

time, Erin was pregnant with twins in a single amniotic sac, which was a high-

risk pregnancy, requiring the care of a maternal-fetal medicine specialist.

One reason the Angelos selected the Ambetter policy was that Erin’s

obstetrician with a specialty in maternal-fetal medicine was listed as an in-

network provider. Shortly after purchasing the policy, Erin discovered the

obstetrician had stopped accepting Ambetter insurance due to Ambetter’s

poor payment record. The Angelos searched for another in-network

obstetrician with the same specialty but found none nearby. Ambetter

offered a maternal-fetal medicine specialist in Houston, which was a four-

hour drive from the Angelos’ home in Pflugerville. Without an in-network

specialist nearby, the Angelos used their own funds to pay Erin’s original

obstetrician.

As the time for delivery approached, Ambetter referred Erin to a clinic

and then refused to pay the bill. The clinic refused to deliver her babies.

Ambetter then referred her to an obstetrician at a free clinic who delivered

the twins at an in-network hospital. The premature twins required care in

the hospital’s neonatal intensive care unit, which resulted in a bill for just

over $20,000. Again, Ambetter refused to pay. The Angelos spent the next

two years disputing the bill and ultimately negotiated a settlement, requiring

them to pay $1,500.

The Plaintiffs filed this class action, asserting breach of contract,

breach of warranty, and claims under the Texas Deceptive Trade Practices

4

No. 24-50044

Act. Upon Superior’s motion to dismiss, the magistrate judge recommended

dismissing the breach-of-warranty and Deceptive Trade Practices Act

claims. He concluded the Plaintiffs adequately pled a breach-of-contract

claim, referring to the “specific promises and obligations Defendants made

to Plaintiffs in the Ambetter Contract in exchange for their premium

payments.” These “promises include[d] providing insureds with an

accurate list of network providers; BNc]omplete medical coverage that meets

[their] medical needs and contains all of the Essential Health Benefits;’ a

[Qualified Health Plan] that [Superior] has certified meets ACA’s network

adequacy requirements; and adequate access to physicians and medical

practitioners and treatments or services.” The alleged breach of these

promises resulted in the Plaintiffs’ damages. The district court agreed, and

the breach-of-contract claim survived.

The Plaintiffs moved for class certification, arguing the Plaintiffs and

the class had Article III standing. Relying on their expert’s report, the

Plaintiffs alleged that Ambetter’s provider directory “contains on average

49% of practitioners who are in fact not active network participants.”

Further, a “portion of every Ambetter policyholder’s premium represents

payment for the availability of the providers published” such that “every 1%

change in network size is associated with a 0.29% change in policy premium.”

They alleged that each policy holder had been overcharged “[t]o the extent

th[e] published list is inaccurate.”

Superior opposed the motion, contending the Plaintiffs’ class-wide

injury theory of overpayment based on an overstated provider list was invalid

because Superior never promised “a specific number of providers.” Because

the Plaintiffs’ “damages model [was] based solely on this invalid theory,”

Superior asserted the Plaintiffs failed to establish the concrete injury in fact

required to establish Article III standing.

5

No. 24-50044

Superior also moved to strike the testimony of the Plaintiffs’ damages

expert. Among its arguments was that the expert’s class-wide damages

model neither “fit the facts” nor the Plaintiffs’ theory of liability. Superior

maintained the model did not fit the facts because it was based on the

counterfactual assumption “that Superior promised its customers a certain

network Bbreadth’ — defined as the number of in-network providers in

proportion to the number of providers in the area — but Superior [] never

made any such promise.” Relatedly, Superior argued the model did not fit

the Plaintiffs’ theory of liability — breach of a contractual promise to provide

a current directory — because a current directory is not synonymous with a

directory of a certain breadth, and the expert failed to measure damages from

an inaccurate directory.

The district court referred both motions to a different magistrate

judge. The magistrate judge denied Superior’s motion to strike because

Superior “contest[ed] the basis of the [expert’s] opinion,” which should “go

to the weight of and not admissibility of [the expert’s] testimony.” He

further recommended denying the Plaintiffs’ motion for class certification.

Characterizing the Plaintiffs’ injury argument as an “overcharge-by-fraud

theory,” the magistrate judge concluded that “Plaintiffs have not pleaded

facts sufficient to show that they had reasonable expectations with respect to

the size of the provider network such that the prices paid for access to the

network were inflated.”

In reaching this conclusion, the magistrate judge faulted the Plaintiffs’

expert opinion, stating: “The assumption underlying Plaintiffs’ overcharge

theory is that network size meaningfully accounts for higher premiums,” but

the Plaintiffs’ expert model only showed “correlation, not causation.”

Because the model failed to account for other factors which impact the cost

of premiums, the Plaintiffs failed to “adequately establish[] that the value of

the service for which they paid is measured primarily by network size, and

6

No. 24-50044

that the premiums they paid were inflated as a result of the alleged

discrepancy between promised network size and actual network size.”

Accordingly, the magistrate judge concluded the Plaintiffs had not “plausibly

pleaded an injury in fact” and therefore lacked standing to bring their claim.

Because the suit did not “present a justiciable case or controversy under

Article III,” the magistrate judge did not reach the class-certification

question. The Plaintiffs objected to the Report and Recommendations.

The district court adopted the Report and Recommendations and

denied the Plaintiffs’ motion for class certification. The Plaintiffs timely

petitioned for leave to appeal under Federal Rule of Civil Procedure 23(f),

which this court granted. The district court stayed the case pending the

resolution of this appeal.

DISCUSSION

The Plaintiffs contend the district court erred in determining they

lacked standing because (1) the court applied an incorrect legal standard to

the causation element of standing, (2) the court wrongly characterized their

injury theory as relying on the promise of a network of a particular size,

(3) they pled sufficient facts to show injury in fact, and (4) the court

improperly engaged in a merits-based evaluation of their expert testimony,

impermissibly choosing a side in the “battle of the experts.” We address

these issues in order.

I. Individual Standing

Generally, appeals under Rule 23(f) only permit consideration of the

issue of class certification, but because the district court’s denial of the

Plaintiffs’ motion for class certification was premised on their lack of

individual standing, we must address standing. See Bertulli v. Indep. Ass’n of

Cont’l Pilots, 242 F.3d 290, 294 (5th Cir. 2001) (“Standing is an inherent

prerequisite to the class certification inquiry.”). Standing is a question of law

7

No. 24-50044

that we review de novo, while any fact-finding is reviewed for clear error.

Chavez v. Plan Benefit Servs., Inc., 108 F.4th 297, 305–06 (5th Cir.), cert.

denied, 145 S. Ct. 774 (2024). Whether a plaintiff has standing “is the

threshold question in every federal case.” Warth v. Seldin, 422 U.S. 490, 498

(1975).

To establish standing, the plaintiff bears the burden of showing

“(i) that he suffered an injury in fact that is concrete, particularized, and

actual or imminent; (ii) that the injury was likely caused by the Defendant;

and (iii) that the injury would likely be redressed by judicial relief.”

TransUnion, LLC v. Ramirez, 594 U.S. 413, 423 (2021).

In the class-action context, the class representative must establish his

standing as an individual before he may represent a class of other allegedly

injured persons. See Angell v. GEICO Advantage Ins. Co., 67 F.4th 727, 733–

34 (5th Cir. 2023); Flecha v. Medicredit, Inc., 946 F.3d 762, 769 (5th Cir.

2020). “After all, if the class representative lacks standing, then there is no

Article III suit to begin with — class certification or otherwise.” Flecha, 946

F.3d at 769. Accordingly, if the class representative lacks individual standing,

as the district court concluded here, that issue must be addressed before

determining whether he has standing to represent the class and deciding class

certification. See id.; Angell, 67 F.4th at 733–34.

Appeals under Federal Rule of Civil Procedure 23(f) are limited and

do not permit a general inquiry into the merits of the plaintiff’s claims;

nevertheless, we “must[] review the merits of the district court’s theory of

liability insofar as they also concern issues relevant to class certification.”

Regents of Univ. of Cal. v. Credit Suisse First Bos. (USA), Inc., 482 F.3d 372,

381 (5th Cir. 2007). It logically follows that we have jurisdiction to review

the merits of the district court’s theory of liability insofar as the denial of class

certification was based on its conclusion that the Plaintiffs, including the

8

No. 24-50044

named Plaintiffs, lacked Article III standing. See Bertulli, 242 F.3d at 294–95

(considering merits of defendants’ contention regarding standing).

A. Forfeiture

As a threshold matter, Superior contends the Plaintiffs forfeited any

challenge to the district court’s determination that the Plaintiffs failed to

provide sufficient evidence of injury in fact. Superior urges our court to

affirm on that basis.

The Plaintiffs challenge the legal standard employed by the district

court regarding the causation element of standing. They argue the court

employed a causation standard more rigorous than the “fairly traceable”

standard when it stated that the “Plaintiffs have not adequately established

that the value of the service for which they paid is measured primarily by

network size, and that the premiums they paid were inflated as a result of the

alleged discrepancy between promised network size and actual network

size.” As further evidence, the Plaintiffs note the district court’s observation

that their expert’s report, which modeled the relationship between network

size and policy premiums, merely demonstrated “correlation, not

causation.” According to the Plaintiffs, the appropriate legal standard is that

the injury (the premium overcharge) must be fairly traceable to Superior’s

conduct. See Lujan v. Defs. of Wildlife, 504 U.S. 555, 560 (1992).

The Plaintiffs misconstrue the district court’s analysis here. Although

the district court uses language that appears to invoke the causation element,

ultimately its point was not whether the overcharge was fairly traceable to

Superior, but instead whether the Plaintiffs were overcharged at all. In other

words, as Superior correctly states, the challenged analysis relates to whether

there was any injury in fact.

Superior contends that because the Plaintiffs erroneously challenge

the district court’s determination with arguments about causation, they

9

No. 24-50044

inadequately brief any challenge to the existence of an injury in fact, resulting

in forfeiture of the issue. We see far more in the briefing than Superior does.

The Plaintiffs devoted an entire section of their brief to challenging the

court’s injury-in-fact determination. “To be adequate, a brief must address

the district court’s analysis and explain how it erred.” Smith v. Sch. Bd. of

Concordia Par., 88 F.4th 588, 594 (5th Cir. 2023) (quoting Guillot ex rel.

T.A.G. v. Russell, 59 F.4th 743, 751 (5th Cir. 2023)). Considering the

Plaintiffs’ brief includes the standard of review, discusses applicable law, and

explains their position regarding how the district court erred in reaching its

injury-in-fact determination, the Plaintiffs did not forfeit the issue. See id.

To the extent Superior’s forfeiture argument is based on the

Plaintiffs’ failure to make the specific argument that their expert’s model was

sufficient evidence of injury in fact, we will later explain why the Plaintiffs

were not required to do so. In any event, the Plaintiffs do make this argument.

The remainder of the Plaintiffs’ issues relate to the degree of evidence

required to prove injury in fact at this stage of litigation.

B. Adequacy of Evidence

To review, the Plaintiffs’ remaining issues are as follows: the district

court erroneously concluded that the Plaintiffs failed to plead facts necessary

to establish an injury in fact; erroneously characterized the Plaintiffs’ injury

theory; and impermissibly chose a side in the “battle of the experts.”

Although the district court used some language to suggest its standing

determination stemmed from inadequate pleadings, the better read is that its

determination was based on insufficient evidence. We will proceed under the

understanding that the court faulted the sufficiency of the evidence inasmuch

as the court had already addressed the adequacy of the pleadings at the Rule

12(b)(6) stage.

10

No. 24-50044

In the district court, Superior asserted that the Plaintiffs’ breach-of-

contract claim was based on Superior’s alleged promise to provide a network

with a particular number of in-network providers. In opposing the Plaintiffs’

motion for class certification, Superior challenged standing for the first time,

focusing on the injury-in-fact prong. In relevant part, Superior contended

the Plaintiffs could not demonstrate an injury in fact because: (1) their class-

wide theory of injury was based on a promise of a network of a certain size

and Superior made no such promise; and, relatedly, (2) their expert’s

damages model hinged on this promise that was not made and, accordingly,

did not fit the facts of the case.

Apparently adopting Superior’s characterization of the Plaintiffs’

theory, the district court stated, “Plaintiffs’ theory of their overcharge injury

rests on the counterfactual assumptions that insureds were promised (or that

Defendants represented) that a provider network of a certain size would be

available and that provider network size, in any event, is static.”

Consequently, the court concluded the Plaintiffs did not “plead[] any facts

supporting the claim that they had reasonable expectations of network size.”

We disagree with this characterization of the Plaintiffs’ theory. They

do not claim that Superior promised access to a particular number of

providers. Instead, they claim that the network was falsely represented as

accurate, adequate, and up-to-date. As a result, each policyholder was

overcharged to the extent the network was inaccurate. The size of the

network is certainly relevant in determining the extent to which

policyholders were overcharged, but the extent of any injury is beyond the

scope of the standing inquiry. Insofar as the district court reached its

standing determination by characterizing the Plaintiffs’ injury theory as

11

No. 24-50044

resting on a “counterfactual” promise of a network of a particular size, that

was error.

Turning to evidentiary matters, the district court concluded:

“Plaintiffs [had] not adequately established that the value of the service for

which they paid is measured primarily by network size, and that the

premiums they paid were inflated as a result of the alleged discrepancy

between promised network size and actual network size.” Put simply, the

court did not find the Plaintiffs’ expert’s damages model convincing.

“A +'$)/$!!(0./ (*)./-/ ./)$)"Bwith the manner and degree

of evidence required at the successive stages of the litigation.’” TransUnion,

594 U.S. at 431 (quoting Lujan, 504 U.S. at 561). Thus, while general factual

allegations of injury may suffice for a motion to dismiss, by the time a court

reaches the summary-judgment stage, for example, the plaintiff “must set

forth by affidavit or other evidence specific facts, which for purposes of the

summary judgment motion will be taken to be true.” Lujan, 504 U.S. at 561

(quotation marks and citation omitted). This appeal arises at the class-

certification stage — beyond the motion-to-dismiss stage but before a motion

for summary judgment.

In considering a plaintiff’s Article III standing in the Rule 23 context,

courts accept arguendo the merits of the plaintiff’s legal claim. Cole v. Gen.

Motors Corp., 484 F.3d 717, 723 (5th Cir. 2007) (citing Parker v. District of

Columbia, 478 F.3d 370, 377 (D.C. Cir. 2007)); see Warth, 422 U.S. at 501–

02. Because the Plaintiffs’ ability to recover for a claim “under governing

law is a separate question” from standing, “it is sufficient for standing

purposes that the Plaintiffs seek recovery for an economic harm that they

allege they have suffered.” Cole, 484 F.3d at 723. A court is generally “free

to weigh the evidence and resolve factual disputes in order to satisfy itself

that it has the power to hear the case.” Krim v. pcOrder.com, Inc., 402 F.3d

12

No. 24-50044

489, 494 (5th Cir. 2005) (quoting Montez v. Dep’t of Navy, 392 F.3d 147, 149

(5th Cir. 2004)). We agree with an earlier panel of this court that caution

should be exercised when assessing evidence of standing at the class-

certification stage, especially when “some elements of standing might be said

to be intertwined with the merits” that are still to be decided. Robertson v.

Monsanto Co., 287 F. App’x 354, 360 (5th Cir. 2008) (unpublished); see also

13B Charles Alan Wright, Arthur R. Miller & Edward H.

Cooper, Federal Practice and Procedure § 3531.15 (3d ed.

2025). In Robertson, a panel of this court held that where there is “substantial

overlap between” standing and the merits of a plaintiff’s claim, “the better

course” is to treat the attack on standing “as an attack on the merits — and

therefore outside the scope of [this court’s] Rule 23(f) review of class

certification decisions — rather than as a question of standing.” 287

F. App’x at 360. We endorse that analysis.

Here, despite concluding the Plaintiffs’ expert opinion was admissible

and questions about the “basis” of the expert opinion or whether its

assumptions “go to the weight of and not admissibility” of the opinion, the

district court used the expert opinion to conclude the Plaintiffs failed to

establish a sufficient connection between network size and price. 1 The court

characterized the Plaintiff’s injury argument as an “overcharge-by-fraud

theory,” under which the Plaintiffs “seek[] to recover for a purported

economic injury rather than any risk of physical injury.” Cf. Earl v. Boeing

Co., 53 F.4th 897, 902 (5th Cir. 2022). In noting that overcharge injuries

typically require plaintiffs to “plead facts sufficient to demonstrate plausible

expectations or affirmative misrepresentations as the basis of their injury,”

the district court stated that the Plaintiffs did not plead facts sufficient to

_____________________

1

We need not, and do not, take a position on the admissibility of the expert opinion.

13

No. 24-50044

show “they had reasonable expectations with respect to the size of the

provider network such that the prices paid for access to the network were

inflated.”

Superior maintains the Plaintiffs’ evidence — specifically, their

expert report — was insufficient to prove injury in fact.2 In so doing,

Superior contends the Plaintiffs were required to prove that their premiums

would have been lower but for the alleged inaccuracies in the provider list. In

other words, the appropriate way to determine whether overpayments

occurred is to compare real-world transactions to those in “a hypothetical

world where the [alleged] fraud didn’t happen.” Earl, 53 F.4th at 903.

In Earl, the plaintiffs alleged that they paid inflated prices for airline

tickets because the actual value of those tickets for most passengers was zero

where the defendants concealed defects in the MAX 8 plane that posed

serious risks of injury or death. Id. at 902. The plaintiffs claimed that had

the public known about the defects, demand for tickets would have dropped

and the airlines would have been forced to lower their prices. Id. Earl

presents superficial similarities to the instant case in that it involved a

question of standing at the class-certification stage, as well as an expert

report, but this is where the similarities end. Id.

_____________________

2 Superior initially contends that the Plaintiffs provided no evidence to support

their injury in fact, which, according to Superior, they were required to do by Ford v.

NYLCare Health Plans, 301 F.3d 329, 332 (5th Cir. 2002) (requiring plaintiff to

affirmatively prove elements of standing with record evidence at summary-judgment stage)

and Menchaca v. Chrysler Credit Corp., 613 F.2d 507, 511 (5th Cir. 1980) (factual attack

challenging subject-matter jurisdiction requires plaintiff to show jurisdiction does in fact

exist). The Plaintiffs clearly provided evidence of injury in fact, including affidavits from

the named Plaintiffs, the disputed contract, and most importantly, their expert report (a

report that the district court deemed admissible).

14

No. 24-50044

In concluding the plaintiffs in Earl had not suffered an injury in fact

(and thereby failed to establish standing), we found that the plaintiffs’ injury

theory was untenable. Id. at 903. The plaintiffs’ theory relied “on two

unsupportable inferences”: (1) airlines “would have continued offering the

same MAX 8 flights” even in the face of widespread public knowledge of the

defect; and (2) “the FAA would have permitted airlines to fly the MAX 8

even with full knowledge of the . . . defect.” Id. Although we referenced the

plaintiffs’ expert report in Earl, our holding was not based on the damages

model’s inability to measure damages relative to the injury alleged. Id. at

902–03. Instead, our holding was based on the premise of the effect of the

wrongful conduct itself. We concluded it was an unsupportable inference to

assume airline ticket prices would decrease had the defect been widely known

to the public. Id. at 903. In fact, it was more likely that ticket prices would

increase because of the shortage of available flights. Id.

In contrast, it is not an unsupportable inference to assume that the

Plaintiffs in this case would have expected to pay less for access to an

inaccurate and inadequate provider network, or, more likely, that the

Plaintiffs would not have purchased the Ambetter policy at all. Moreover,

unlike the plaintiffs in Earl, the Plaintiffs here had a contract with Superior,

which promised to provide insureds with, inter alia: an accurate list of

network providers; complete medical coverage that meets their essential

medical needs and contains all of the Essential Health Benefits; a Qualified

Health Plan that Superior has certified meets ACA’s network adequacy

requirements; and adequate access to physicians and medical practitioners

and treatments or services. In short, this case is distinguishable from Earl.

The district court concluded the Plaintiffs failed to establish injury in

fact because their expert report did not prove a causal connection between

the size of the network and premium price, which is what the Plaintiffs would

have to prove to prevail on the merits of their breach-of-contract claim. This

15

No. 24-50044

merits-based evaluation of an expert report to determine standing at the

class-certification stage is $(+-*+ -9DNO*0-/.- )*//*$).$./0+*)B//' 

of the experts’ at the certification stage.” Unger v. Amedisys Inc., 401 F.3d

316, 323 n.6 (5th Cir. 2005). In analogous scenarios, we have held that it is

improper for the district court to resolve factual disputes when “the subject-

matter jurisdiction and merits questions are coterminous.” See Pickett v.

Texas Tech Univ. Health Scis. Ctr., 37 F.4th 1013, 1030 (5th Cir. 2022).

Contrary to Superior’s assertion that the injury-in-fact question is not

“coterminous” with the underlying merits, it is. See id.

This case is more analogous to those in which we have held the

plaintiffs had standing. See, e.g., Mims v. Stewart Title Guar. Co., 590 F.3d

298, 302 (5th Cir. 2009); Cole, 484 F.3d at 723. In Mims, the defendant

alleged error in the district court’s “certifying the plaintiffs’ proposed []

class when the named plaintiffs lack[ed] standing to assert a claim.” 590 F.3d

at 302. We concluded that although the defendant framed the issue as one of

standing, “the substance of its argument is that the plaintiffs fail to state a

claim . . . on the merits.” Id. Along that line, we held “there [was] no serious

question that the plaintiffs [had] standing to bring this claim. They [] alleged

an injury-in-fact (overpayment of premiums for title insurance issued upon

refinancing their mortgage), causation (the defendants overbilled for the

premiums) and redressability (if plaintiffs are successful, they will be

refunded the overpayment).” Id.

Similarly, the Plaintiffs have alleged and provided evidence for an

injury in fact (overcharges for a health insurance policy that contained

materially inaccurate and insufficient provider lists), causation (the amount

of overcharge is fairly traceable to the discrepancy between the promised

network size and the actual network size), and redressability (if the Plaintiffs

are successful, they will be refunded their overpayment). See id.; Cole, 484

F.3d at 723 (standing found at class-certification stage under overcharge

16

No. 24-50044

theory where “Plaintiffs s[ought] recovery for their actual economic harm

(e.g., overpayment, loss in value, or loss of usefulness) emanating from the

loss of their benefit of the bargain”). The district court’s standing

determination was, in substance, a determination on the merits of the

“overcharge-by-fraud” theory. 3

Superior contends that any merits-based evaluations were proper in

this context, relying on Unger and Prantil v. Arkema Inc., 986 F.3d 570 (5th

Cir. 2021). Both cases pertain to evidentiary evaluations of expert opinions

at the class-certification stage. In Prantil, we held that plaintiffs must show

that their evidence satisfies Daubert “when the cementing of relationships

among proffered class members of liability or damages or both turns on

scientific evidence.” Prantil, 986 F.3d at 575 (referencing trial-admissibility

standard for expert testimony set forth in Daubert v. Merrell Dow Pharms.,

Inc., 509 U.S. 579 (1993)). In other words, “when scientific evidence is

relevant to the decision to certify,” the “metric of admissibility” is the same

for both certification and trial. Id. At this stage, however, the Daubert inquiry

should be limited to the relevance and reliability of the expert’s testimony as

it relates to class certification under Rule 23. See Unger, 401 F.3d at 323 n.6.

_____________________

3 Notably, the district court seemed to suggest that the named Plaintiffs have

individual standing, despite ultimately concluding that they did not. Instead of dismissing

the Plaintiffs’ case, as would be the appropriate course of action if the named Plaintiffs truly

lacked Article III standing, the district court denied class certification and set a summary

judgment briefing schedule that was later stayed by stipulation pending resolution of this

appeal. See Earl, 53 F.4th at 903 (“They have offered no plausible theory of economic harm

. . . . [P]laintiffs have suffered no injury in fact and lack Article III standing. Their case

therefore must be dismissed.”); 1 William B. Rubenstein, Newberg and

Rubenstein on Class Actions § 2:6 (6th ed. 2022) (“Because individual standing

requirements constitute a threshold inquiry, the proper procedure when the class plaintiff

lacks individual standing is to dismiss the complaint, not to deny class certification.”).

17

No. 24-50044

The district court’s evaluation of the Plaintiffs’ expert report did not

remain within those limits. The expert opinion was not relevant to the

district court’s decision whether to certify, as the court did not reach the

certification question due to its standing determination. Moreover, even

assuming the district court ventured into a certification analysis when it

evaluated the Plaintiffs’ expert’s damages model, none of the purported

deficiencies were related to the relationships among class members to the

alleged liability or damages. See Prantil, 986 F.3d at 575. As the district court

stated, because “exclusion is limited to an inquiry as to relevance to class

certification requirements, [the expert’s] testimony should not be

excluded.” This shows that any qualms the district court had with the

Plaintiffs’ expert testimony were merits-based.

To repeat, it is improper for the district court to resolve factual

disputes when “the subject-matter jurisdiction and merits questions are

coterminous.” Pickett, 37 F.4th at 1030. Although the Plaintiffs will

ultimately have to prove whether and to what extent they were overcharged

based on the inadequacy of the network, they do not need to prove how to

measure that injury in dollars at the class-certification stage. The Plaintiffs,

including the named Plaintiffs, have therefore established individual

standing.

II. Class Standing

If a named plaintiff lacks individual standing, as the district court here

concluded, it is unnecessary to address whether the plaintiff has standing to

represent the class. See Angell, 67 F.4th at 733–34. We have determined,

however, that all the Plaintiffs have individual standing. Consequently, we

next evaluate class standing.

There are two competing approaches to class standing: the “more

!*-"$1$)" B'..  -/$!$/$*)C ++-*#CE ) D(*-  $)/ ).$1  B./)$)"

18

No. 24-50044

approach.’” Id. (quoting 1 William B. Rubenstein, Newberg and

Rubenstein on Class Actions § 2:6 (6th ed. 2022)); see Chavez, 108

F.4th at 312. The class-certification approach analyzes only a named

plaintiff’s individual standing; “if that is satisfied, any remaining analysis is

considered a matter of class certification under Rule 23.” Angell, 67 F.4th at

734 (citations omitted). By contrast, the standing approach compares “the

injuries or interests of the named plaintiff with those of the putative class and

will hold that the named plaintiff lacks standing for the class claims if his or

her harms are not sufficiently analogous to those suffered by the rest of the

class.” Id.

There is a circuit split regarding which of these is the appropriate test,

and this court has so far declined to determine the correct approach. See id.

at 733–35. We continue to decline. Like two prior panels of this court, we

analyze the Plaintiffs’ claims under both the class certification approach and

the standing approach. See Chavez, 108 F.4th at 312; Angell, 67 F.4th at 733–

34. If the Plaintiffs have demonstrated standing under each, we need not

decide between the two. See Chavez, 108 F.4th at 312; Angell, 67 F.4th at 735.

The Plaintiffs’ injury theory — namely, that each policyholder was

overcharged to the extent the network was inaccurate — applies equally to

the named Plaintiffs and all other Plaintiffs. It thus satisfies the class-

certification approach and the standing approach.

Therefore, on remand the district court should proceed to the Rule 23

class-certification analysis, which it did not reach after determining that the

Plaintiffs lacked standing as a threshold matter. 4 We thus do not address

_____________________

4

We take no position on the proper outcome of the class-certification analysis.

19

No. 24-50044

Superior’s alternative contentions regarding the Plaintiffs’ inability to satisfy

class-certification requirements.

CONCLUSION

We VACATE the district court’s order denying the Plaintiffs’

motion for class certification and REMAND for further proceedings

consistent with this opinion.

20