UnitedHealth Group Incorporated, et al., Appellants,

This opinion is nonprecedential except as provided by
Minn. R. Civ. App. P. 136.01, subd. 1(c).

STATE OF MINNESOTA
IN COURT OF APPEALS
A25-1398

UnitedHealth Group Incorporated, et al.,
Appellants,

vs.

State of Minnesota, et al.,
Respondents.

Filed May 26, 2026
Affirmed
Larkin, Judge
Concurring specially, Ross, Judge

Ramsey County District Court
File No. 62-CV-24-4764

Aaron D. Van Oort, Peter C. Magnuson, Berglind Halldorsdottir Birkland, John L.
Rockenbach, Josiah D. Young, Matthew R. Goldammer, Faegre Drinker Biddle & Reath
LLP, Minneapolis, Minnesota (for appellants)

Keith Ellison, Attorney General, Liz Kramer, Solicitor General, Peter J. Farrell, Deputy
Solicitor General, Emily B. Anderson, Scott H. Ikeda, Brandon Boese, Assistant Attorneys
General, St. Paul, Minnesota (for respondents)

Charles N. Nauen, David J. Zoll, Rachel A. Kitze Collins, R. David Hahn, Lockridge
Grindal Nauen PLLP, Minneapolis, Minnesota (for amicus curiae Minnesota House DFL
Caucus and Minnesota Senate DFL Caucus)

Matthew K. Entenza, Entenza Law Firm PLLC, St. Paul, Minnesota (for amicus curiae
Minnesota Council of Health Plans)

Considered and decided by Larkin, Presiding Judge; Ross, Judge; and Smith, John,
Judge.

 Retired judge of the Minnesota Court of Appeals, serving by appointment pursuant to
Minn. Const. art. VI, § 10.
2
NONPRECEDENTIAL OPINION
LARKIN, Judge
Appellants challenge the district court’s summary-judgment dismissal of their
constitutional challenge to a law passed during Minnesota’s 2024 legislative session.
Appellants argue that the law violates the Single -Subject Clause of the Minnesota
Constitution. The district court concluded that appellants ’ constitutional challenge was
justiciable based on two groups of provisions in the law: those restricting the state’s ability
to contract with for -profit health maintenance organizations and those regarding
misclassification of employees as independent contractors. We conclude that appellants’
constitutional challenge based on the misclassification provisions was not justiciable. As
to appellants’ challenge based on the health-maintenance-organization provisions, we
apply the most recent supreme court precedent regarding the Single -Subject Clause and
conclude that appellants’ challenge fails because th e health-maintenance-organization
provisions are germane to the subject of the law as identified in its title. We therefore
affirm the district court’s summary dismissal of appellant’s single-subject challenge.
FACTS
On the final day of Minnesota’s 2024 legislative session, the legislature passed a
combined omnibus bill (the bill).1 The resulting law (the Law) fills an entire session-law

1 “A bill is proposed legislation that has not completely made its way through the legislative
process.” Associated Builders & Contractors v. Ventura , 610 N.W.2d 293, 312 (Minn.
2000) (Anderson, J., concurring in part and dissenting in part ). “Laws are bills that have
been enacted by the legislature and then signed by the governor, enacted after three days
of gubernatorial inaction, or passed by a legislative override of the governor ’s veto.” Id.
3
volume. 2024 Minn. Laws ch. 127, at 2753-3858. The title of the Law begins: “An act
relating to the operation and financing of state government . . . .” Id. at 2753. The title
continues at length, describing all the subjects addressed in the Law:
modifying trunk highway bonds, transportation policy,
combative sports, construction codes and licensing, the Bureau
of Mediation Services, the Public Employee Labor Relations
Act, employee misclassification, earned sick and safe time,
University of Minnesota collective bargaining, broadband and
pipeline safety, housing policy, and transportation network
companies; expediting rental assistance; establishing
registration for transfer care specialists; establishing
licensure for behavior analysts; establishin g licensure for
veterinary technicians and a veterinary institutional license;
modifying provisions of veterinary supervision; modifying
specialty dentist licensure and dental assistant licensure by
credentials; removing additional collaboration requiremen ts
for physician assistants to provide certain psychiatric
treatment; modifying social worker provisional licensure;
establishing guest licensure for marriage and family
therapists; modifying pharmacy provisions for certain
reporting requirements and chang e of ownership or
relocation; modifying higher education policy provisions;
amending the definition of trigger activator; increasing
penalties for transferring firearms to certain persons who are
ineligible to possess firearms; amending agriculture policy
provisions; establishing and modifying agriculture programs;
providing broadband appropriation transfer authority;
requiring an application for federal broadband aid; adding
and modifying provisions governing energy policy;
establishing the Minnesota Energ y Infrastructure Permitting
Act; modifying provisions related to disability services, aging
services, substance use disorder treatment services, priority
admissions to state-operated programs and civil commitment,
and Direct Care and Treatment; modifying p rovisions related
to licensing of assisted living facilities; modifying provisions
governing the Department of Human Services, human services
health care policy, health care finance, and licensing policy;

“Statutes are enacted laws that are codified, organized, and assembled by the revisor of
statutes.” Id. We use the terms “bill” and “law” in accordance with these principles.
4
modifying provisions governing the Department of Health,
health policy, health insurance, and health care; modifying
provisions governing pharmacy practice and behavioral
health; establishing an Office of Emergency Medical Services
and making conforming changes; modifying individual income
taxes, minerals taxes, tax -forfeited property, and
miscellaneous tax provisions; modifying state employee
compensation; modifying paid leave provisions; imposing
penalties; authorizing administrative rulemaking; making
technical changes; requiring reports; appropriating
money; . . . .

Id. at 2753-54. The remainder of the title lists the coded and uncoded laws that the Law
added, amended, or repealed. Id. at 2754-58.
Appellants UnitedHealth Group Incorporated, et al. (UH) includes three entities that
are parties to the underlying action: UnitedHealth Group Incorporated (UHGI),
UnitedHealthcare of Illinois Inc. (UHI), and UnitedHealthcare Life Insurance Company
(UHLI). UH sued respondents State of Minnesota, et. al (the state), seeking a declaratory
judgment that the Law violates the Single-Subject Clause of the Minnesota Constitution,
which provides: “No law shall embrace more than one subject , which shall be expressed
in its title.” Minn. Const. art. IV, § 17 (emphasis added).
The state moved the district court to dismiss for lack of jurisdiction, alleging that
UH presented nonjusticiable claims, and for failure to state a claim upon which relief could
be granted. In the alternative, the state moved for summary judgment. UH responded with
its own motion for summary judgment.
The district court denied the state’s motion to dismiss in part, concluding that UH’s
challenge was justiciable based on two sets of provisions in the Law. The first set regards
state contracting with health maintenance organizations (HMOs) and effectively prohibits
5
the state from contracting with for -profit HMOs and prohibits for-profit HMOs from
participating in state -run medical programs or providing healthcare benefits to state
employees (the HMO-contracting provisions). See 2024 Minn. Laws ch. 127, art. 57, §§ 1,
10, 55, 67, at 3529, 3534, 3561, 3565 -66. The second set of provisions regards
misclassification of employees as independent contractors and increases the penalties for
employers that unlawfully classify employees as independent contractors (the employee-
misclassification provisions). See id., art. 10, §§ 5-7, at 2894-2897.
The district court concluded that UHGI did not have standing to challenge the Law
because it was merely a corporate parent and had not suffered an injury-in-fact. The district
court therefore dismissed UHGI from the action.2 But the district court reasoned that UHI
had standing based on the HMO-contracting provisions and that UHLI had standing based
on the employee-misclassification provisions, though the court expressed some misgivings
regarding whether UHLI’s challenge was ripe. As to the competing motions for summary
judgment, the district court granted summary judgment for the state and dismissed the suit
with prejudice, concluding that the Law does not violate the Single-Subject Clause.
UHI and UHLI appeal. We refer to UHI and UHLI , individually and collectively,
as UH throughout the remainder of this opinion.

2 The district court’s determination that UHGI lacked standing is not challenged on appeal.
6
DECISION
UH contends that the district court erred in ruling that the Law does not violate the
Single-Subject Clause. In response, the state contends that UH’s single-subject challenge
is not justiciable . Because the state’s justiciability arguments present a challenge to the
district court’s exercise of jurisdiction, we address those arguments before turning to the
merits of the district court’s single-subject ruling. See Stone v. Invitation Homes, Inc., 986
N.W.2d 237, 246-47 (Minn. App. 2023) (“Standing is a jurisdictional doctrine, and the lack
of standing bars consideration of the claim by the district court.” (quotation omitted)), aff’d,
4 N.W.3d 489 (Minn. 2024).
I.
The state contends that the district court erred by denying, in part, its motion to
dismiss. The state moved the district court to dismiss for lack of jurisdiction, alleging that
UH presented nonjusticiable claims, and for failure to state a claim upon which relief could
be granted. See Minn. R. Civ. P. 12.02(a), (e). “We review de novo whether a complaint
sets forth a legally sufficient claim for relief, accepting all the facts alleged in the complaint
as true and construing all reasonable inferences in favor of the nonmoving party.” Walsh
v. U.S. Bank, N.A., 851 N.W.2d 598, 606 (Minn. 2014); see Forslund v. State, 924 N.W.2d
25, 30 (Minn. App. 2019) (reviewing dismissals under both rule 12.02(a) and rule 12.02(e)
de novo).
The state argues that UH’s single -subject challenge is not justiciable for two
reasons. First, the state argues that the challenge presents a nonjusticiable political
question. Second, the state argues that UH lacks standing to challenge the employee -
7
misclassification provisions and that its challenge is not ripe.3 We address each argument
in turn, de novo. See McCaughtry v. City of Red Wing, 808 N.W.2d 331, 337 (Minn. 2011)
(“Justiciability is an issue of law that we review de novo.”) (McCaughtry I).
Political-Question Doctrine
The state asserts that all constitutional challenges based on the Single-Subject
Clause present nonjusticiable political questions. A political question is one that is not
‘“appropriate or suitable for adjudication by a court.’” Cruz-Guzman v. State, 916 N.W.2d
1, 7 (Minn. 2018) (quoting Black’s Law Dictionary (10th ed. 2014)). A political question
presents “a matter which is to be exercised by the people in their primary political capacity”
or a matter that “has been specifically delegated to some other department or particular
officer of the government, with discretionary power to act.” In re McConaughy, 119 N.W.
408, 417 (Minn. 1909). Under separation -of-powers principles, the judiciary cannot
“exercise any of the powers properly belonging” to the legislature unless “expressly
provided” in the Minnesota Constitution. Minn. Const. art. III, § 1.
The state argues:
Single-subject claims present quintessential political
process questions that should be beyond the reach of the
judiciary. To be sure, Minnesota courts have long heard cases
arising under the single-subject clause. But in the modern era,
Minnesota courts have not considered whether the political
question doctrine should bar consideration of single -subject
claims. The time to do so is now: constitutional text and
structure, history, and prudential considerations all favor
holding single-subject claims non-justiciable.

3 The state does not dispute that UH has standing based on the HMO-contracting provisions
or that its challenge is ripe.
8
(Quotation and citation omitted.)

Again, the state acknowledges that “Minnesota courts have long heard cases arising
under the single -subject clause .” Indeed, in its most recent consideration of a Single-
Subject-Clause challenge, the supreme court stated: “We remain firmly committed to our
constitutional duty to prohibit infringements by either the legislative or executive branch
of the government of the constitutional rights vested in the people.” Otto v. Wright County,
910 N.W.2d 446, 459 (Minn. 2018) (quotation omitted). The state also acknowledges that
this court does not have authority to abolish supreme court precedent. See State v. M.L.A.,
785 N.W.2d 763, 767 (Minn. App. 2010) (stating that this court is bound by supreme court
precedent), rev. denied (Minn. Sept. 21, 2010). The state explains that it has raised the
political-question issue only to preserve it for further review.
We are “an error -correcting court,” and “it is not the role of this court to abolish
established judicial precedent.” State v. Adkins , 706 N.W.2d 59, 63 (Minn. App. 2005) .
Thus, the state is correct that “[b]ecause the Minnesota Supreme Court has long treated
single-subject claims as justiciable, the State’s political question argument is ultimately for
the Minnesota Supreme Court,” and not this court. We therefore do not address the merits
of the state’s political-question argument.
Standing and Ripeness
The state also asserts that the district court erred in determining that UH’s single-
subject challenge is justiciable based on the employee-misclassification provisions. The
state argues that the district court erred because UH lacks standing to challenge those
provisions and because the challenge is not ripe.
9
A court cannot exercise jurisdiction over a claim unless a justiciable controversy
exists. Growe v. Simon, 2 N.W.3d 490, 499 (Minn. 2024). Justiciability is a threshold for
judicial action. State ex rel. Sviggum v. Hanson, 732 N.W.2d 312, 321 (Minn. App. 2007).
It requires “adverse interests and concrete assertions of rights ” and “ a controversy that
allows for specific relief by a decree or judgment of a specific character as distinguished
from an advisory opinion predicated on hypothetical facts.” Id. If a lawsuit presents no
redressable injury, it “must be dismissed for lack of justiciability.” Id.
The underlying action was brought under Minnesota’s Uniform Declaratory
Judgments Act, which empowers courts to “declare rights, status, and other legal relations
whether or not further relief is or could be claimed .” Minn. Stat. § 555.01 (2024); see
Minn. Stat. § 555.16 (2024) (stating that the chapter may be cited as the “ Uniform
Declaratory Judgements Act”). “An action under the Uniform Declaratory Judgments Act
must present a justiciable controversy or a district court has no jurisdiction to declare rights
under the act.” Minn. Laws. Mut. Ins. Co. v. Bradshaw & Bryant L. Off. PLLC, 19 N.W.3d
206, 213 (Minn. App. 2025) (quotation omitted), rev. denied (Minn. June 17, 2025). A
court “will not issue declarations upon remote contingencies or as to matters where the
plaintiff’s interest is merely contingent upon the happening of some event in the future.”
Sviggum, 732 N.W.2d at 321-22 (quotation omitted). “An injury that is merely possible or
hypothetical is not enough to establish justiciability.” McCaughtry I, 808 N.W.2d at 338
(quotation omitted).
In sum, courts do not issue advisory opinions; we decide only actual controversies.
State v. Arens, 586 N.W.2d 131, 132 (Minn. 1998).
10
The requirements of standing and ripeness are encompassed within the doctrine of
justiciability. “Standing is a legal requirement that a party have a sufficient stake in a
justiciable controversy to seek relief from a court,” whereas ripeness focuses on when a
party with standing may bring suit. McCaughtry I, 808 N.W.2d at 338 (quotation omitted).
The Minnesota Supreme Court has explained:
In Minnesota, a party has standing if it has suffered an
injury-in-fact. For a party to establish an injury-in-fact, it must
demonstrate that it suffered a concrete and particularized
invasion of a legally protected interest . An allegation of a
merely possible or hypothetical injury is inadequate. A litigant
challenging the constitutionality of a law need only
demonstrate that the litigant has a legally cognizable interest
that has suffered because of the State’s action.

Minn. Sands, LLC v. County of Winona , 940 N.W.2d 183, 192 (Minn. 2020) (footnote
omitted) (quotations and citations omitted).
To have standing to seek a declaratory judgment regarding the constitutionality of
a statute, “[a] citizen must have sustained or be in immediate danger of sustaining some
direct injury from the enforcement of the challenged statute and not suffering in some
indefinite way in common with people generally.” Rukavina v. Pawlenty , 684 N.W.2d
525, 531 (Minn. App. 2004).
[I]t is an elementary doctrine of constitutional law that one who
invokes the power of the court to declare a statute to be
unconstitutional must be able to show not only that the statute
is invalid but that he has sustained or is in immediate danger
of sustaining some direct injury resulting from its enforcement
and not merely that he suffers in some indefinite way in
common with people generally. The power of the court to
declare a law unconstitutional is to be exercised only when
absolutely necessary in a particular case.

11
Lott v. Davidson, 109 N.W.2d 336, 345 (Minn. 1961) (emphasis added).
As to ripeness, the necessary showing is similar . “A party challenging the
constitutionality of a law must show that the Law is, or is about to be, applied to his
disadvantage.” McCaughtry I, 808 N.W.2d at 338 (quotation omitted). That is, the party
must show that it “has sustained or is immediately in danger of sustaining some direct
injury.” State ex re l. Smith v. Haveland , 25 N.W.2d 474, 478 (Minn. 1946) (quotation
omitted). “Issues which have no existence other than in the realm of future possibility are
purely hypothetical and are not justiciable.” McCaughtry I, 808 N.W.2d at 339 (quotation
omitted).
UH argues that it has a “direct and not hypothetical” interest in the Law’s employee-
misclassification provisions because UH uses independent contractors and therefore faces
the threat of new penalties and liabilities. But the possibility of enforcement of the
employee-misclassification provisions and imposition of increased penalties falls short of
the necessary direct injury. See Baertsch v. Minn. Dep’t of Revenue , 518 N.W.2d 21, 25
(Minn. 1994) (finding imminent injury where the state, “by letter, expr essed its intent to
enforce the statute against [the plaintiffs]”).
McCaughtry I is instructive. That case involved a challenge to the constitutionality
of a rental-property inspection ordinance, and the supreme court was asked to “clarify the
standing requirements applicable to declaratory judgment actions.” McCaughtry I, 808
N.W.2d at 333-34, 338. The supreme court determined that the claimants had presented a
justiciable controversy and provided two reasons for its determination. Id. at 339-40. The
first reason was that the claimants had “opposed three separate applications for
12
administrative warrants to inspect their properties.” Id. at 339. The second reason was that
the “case present[ed] a purely legal question that [did] not require the development of a
factual record” and “there [was] no reason to delay resolution of the constitutional
questions.” Id. at 339-40.
The supreme court explained:
The constitutional issue that the landlords and tenants
have raised is neither hypothetical nor abstract. The City has
actually begun enforcing the rental inspection ordinance
against appellants. The City has sought not just one but three
separate administrative warrants over a four -year period to
inspect their properties, which appellants have been forced to
defend. And the City has indicated that it will continue to seek
administrative warrant s to inspect appellants’ properties.
Accordingly, the claim s here are based on an actual
controversy . . . .

Id. at 340 (emphasis added).
Despite the well-established direct-injury requirement, UH argues that its single-
subject challenge is justiciable even though the state has neither attempted to enforce nor
threatened to enforce the employee-misclassification provisions against UH. UH argues
that it need not show a direct injury and that its challenge to the Law is justiciable solely
because it presents a purely legal issue and the factual record is adequately developed. As
support, UH quotes the following line from the supreme court’s post -remand decision in
McCaughtry II out of context: “In McCaughtry I, we held that appellants’ claim was ripe
because their facial challenge presented ‘a purely legal question that does not require the
development of a factual record.’” McCaughtry v. City of Red Wing, 831 N.W.2d 518, 523
(Minn. 2013) (McCaughtry II) (quoting McCaughtry I, 808 N.W.2d at 339).
13
The entire passage from McCaughtry II states:
[W]e held that appellants ’ claim was ripe because their facial
challenge presented “a purely legal question that does not
require the development of a factual record. ” Because their
challenge raised a “constitutional issue that . . . is neither
hypothetical nor abstract,” we concluded that “there [wa]s no
reason to delay resolution of the constitutional question[].”

Id. (alteration in original) (emphasis added) (citation omitted) (quoting McCaughtry I, 808
N.W.2d at 339 -40). Thus, t he entire passage reflects the two reasons for the supreme
court’s justiciability determination in McCaughtry I. Again, the constitutional issue was
“neither hypothetical nor abstract” because the city had “actually begun enforcing the
rental inspection ordinance against appellants.” McCaughtry I, 808 N.W.2d at 340.
Moreover, the issue in McCaughtry II was not justiciability; the issue was the merits
of the constitutional challenge. 831 N.W.2d at 524. In fact, the only reason t he supreme
court quoted the passage from McCaughtry I in McCaughtry II was to explain why
McCaughtry I was not dispositive regarding the merits of the constitutional challenge. See
id. at 5 23-24 (explaining that “McCaughtry I dealt with the specific issue of whether
appellants’ claims were unripe” and that “[t]he present appeal is the first time that we have
examined the merits of the facial challenge”).
In sum, UH’s challenge to the employee -misclassification provisions is not
justiciable unless it can show that it has sustained or is in immediate danger of sustaining
a direct injury from enforcement of those provisions. As to that issue, UH’s final, amended
complaint alleges that UH “works with independent contractors, including for the sale of
commercial insurance products,” that “[a] number of these independent contractors based
14
in Minnesota have executed contracts that contain arbitration clauses with [UH],” and that
the employee-misclassification provisions “threaten to undercut the arbitration rights that
[UH] has bargained for in its contracts with these independent contractors, harming [UH’s]
expectations in its contracts.”
As the state notes, the allegation that the employee -misclassification provisions
threaten to undercut UH’s contractual expectations is specious because those provisions do
not change the test for determining whether a worker is classified as an employee or an
independent contractor. And, UH has not alleged any facts to show that it has sustained or
is in immediate danger of sustaining a direct injury from enforcement of the employee -
misclassification provisions. UH’s claim of a direct-injury stemming from the employee-
misclassification provisions stands in stark contrast to its direct-injury claim based on the
HMO-contracting provisions. As the district court reasoned, “the for -profit HMO is no
longer able to submit proposals to the Minnesota Department of Human Services nor is it
able to offer healthcare plans to state employees or Minnesotans who rely on Medicaid or
MinnesotaCare. . . . [T]his is an injury-in-fact.” UH does not allege a comparable injury
stemming from the employee-misclassification provisions.
In sum, UH makes no factual assertion suggesting that the state has enforced, has
attempted to enforce, or is about to enforce the newly enacted employee -misclassification
provisions against UH. UH has articulated an injury that is merely possible or hypothetical,
which is insufficient to establish a justiciable claim. Because UH’s challenge to the Law
based on the employee-misclassification provisions is nonjusticiable, we affirm the district
court’s award of summary judgment regarding those provisions on that ground , without
15
addressing those provisions in the constitutional analysis that follows . See Doe v.
Archdiocese of St. Paul, 817 N.W.2d 150, 163 (Minn. 2012) (stating that an appellate court
“need not adopt the reasoning of the district court ” and “may affirm a grant of summary
judgment if it can be sustained on any grounds”).
II.
We now turn to the merits of UH’s constitutional challenge and its argument that
the Law violates the Single-Subject Clause. The issue comes before us on appeal from the
district court’s grant of summary judgment. A district court must grant summary judgment
“if the movant shows that there is no genuine issue as to any material fact and the movant
is entitled to judgment as a matter of law.” Minn. R. Civ. P. 56.01. “In an appeal from a
summary judgment where there is no dispute of material fact our review is limited to
determining whether the lower court erred in its application of the law .” Associated
Builders, 610 N.W.2d at 298. And because “the constitutionality of a statute is at issue our
review is de novo.” Id.
We presume that Minnesota statutes are constitutional and exercise our authority to
declare a statute unconstitutional with extreme caution. Id. at 299. A constitutional
challenger must meet a “very heavy burden of demonstrating beyond a reasonable doubt
that the statute is unconstitutional.” Id.
The Single-Subject Clause
Again, the Single-Subject Clause provides , “No law shall embrace more than one
subject, which shall be expressed in its title.” Minn. Const. art. IV, § 17 (emphasis added).
The clause serves two purposes: (1) “to prevent log-rolling, a legislative process by which
16
a number of different and disconnected subjects are united in one bill” and (2) “to prevent
surprise and fraud upon the people and the legislature by failing to provide notice of the
nature of the proposed legislation and the interests likely to be affected by the legislation.”
Otto, 910 N.W.2d at 456 (quotations omitted). The clause is interpreted liberally and is
not violated so long as a law is “germane to one general subject.” Associated Builders, 610
N.W.2d at 299. The Single-Subject Clause does not prevent the legislature “from
embracing in one act all matters properly connected with one general subject.” Id.
(quotation omitted).
All that is necessary is that the act should embrace one general
subject; and [this means], merely, that all matters . . . should
fall under . . . one general idea, be so connected with or related
to each other, either logically or in popular understanding, as
to be parts of, or germane to, one general subject.

Id. (quotation omitted).
In determining that the Law did not violate the Single -Subject Clause, the district
court explained that “seven ‘modern era’ cases” instruct a court how to determine whether
there is a violation of the title4 and single-subject rule and that the framework is as follows:
• First, one must identify the challenged provision or
provisions of the [law];
• Second, review the title of the [law];
• Third, determine whether the title gives reasonable notice
of the challenged provision of the [law];
• Fourth, determine whether the challenged provision is
germane to the title of the [law]; and
• Fifth, strike the challenged provision of the [law], if there
was not reasonable notice as to the contents of the [law] in

4 “The single subject and title provisions of Section 17 are often discussed together, but the
title provision serves a different purpose and requires a somewhat different analysis.”
Associated Builders, 610 N.W.2d at 304. The title provision is not at issue here.
17
the title and/or the challenged provision is not germane to
the title.

Applying that framework, the district court concluded that UH did not meet the
extraordinary burden of persuasion necessary to overcome the general presumption of
constitutional validity, that the Law gave reasonable notice of its contents in its title ,5 and
that the HMO-contracting provisions are germane to the title of the law. The district court
explained: “Here, the core of the challenged provisions directly relate to the operation of
state agencies. The HMO Contracting Provision[s] . . . are policies that instruct state
agencies as to who they may contract with for health care for state employees and
government programs . . . .”
UH asserts that the district court erred by looking only at the title of the Law and
determining that the HMO-contracting provisions were germane to the title. UH argues
that under supreme court precedent, “a court must first determine whether a law has a
common theme defined by the great weight of its provisions before the court can decide
whether the provisions at issue ar e constitutionally valid.” The state counters that UH’s
proposed approach is inconsistent with the supreme court’s approach in Otto and that we
must follow Otto.
The Otto Approach
In Otto, the supreme court considered and rejected a single-subject challenge to a
law that allowed counties to choose between the state auditor and a private accounting firm

5 UH does not challenge the district court’s ruling regarding the adequacy of the Law’s
title.

18
for a statutorily required annual audit. 910 N.W.2d at 4 48-49. The Otto court stated:
“Laws passed by the Legislature will comply with [the Single -Subject] constitutional
requirement when all of the provisions fall under one general idea. In other words, all
provisions need to be so connected or related to each other that they are all parts of, or
germane to, one general subject. ” Id. at 456 (quotations and citation omitted). The
supreme court cited its decision in Associated Builders and included a parenthetical stating,
‘“Where the common theme of the law is clearly defined by its other provisions, a provision
that does not have any relation to that common theme is not germane, is void, and may be
severed.’” Id. (quoting Associated Builders, 610 N.W.2d at 307).
Despite language in Otto and Associated Builders indicating that a court should look
to the provisions of a law to determine whether the law has one general subject or common
theme, the Otto court did not use that approach. Instead of determining whether the law’s
provisions revealed a common theme, the supreme court looked to the title of the law,
which began, “ an act relating to the operation of state government.” Id. (quotation
omitted). The Otto court referred to its approach as an application of the “well-established”
germaneness test and concluded that the test was satisfied based on its comparison of the
challenged provision to the purpose of the law, as stated in the law’s title. Id. at 457. The
supreme court explained:
A provision that allows counties to choose between the State
Auditor and a private CPA firm for the annual audit required
by statute, overseen by the State Auditor and subject to the
State Auditor’s review and further audit, is clearly germane to
the subject of state government operations. . . .

19
We reach this conclusion even though other provisions
of the bill may not be germane to the subject “the operation of
state government.” Those provisions are not before us in this
constitutional challenge, and we will not strike down a
germane provision of a law simply because other provisions in
the law are not germane. To do so would undermine the
presumption of constitutionality that we afford to legislation
and risk overstepping our judicial bounds.

Id. at 457-58 (quotation omitted).

UH argues that Otto is not on point because the existence of one general subject was
not disputed in that case. But the Otto court considered and rejected the following
arguments from the state auditor: (1) the law contained a “wide variety of topics,”
including appropriations, adoption of a symbol to honor members of the military, railroad-
condemnation powers, and regulation of cosmetologists; (2) the law was the “epitome” of
a “garbage bill”; and (3) the law’s numerous disparate provisions did not “share a common
meaningful thread.” Id. at 455-56 (quotations omitted). Those arguments indicate that the
existence of one general subject was disputed in Otto. And Otto indicates that the existence
of such disparate provisions in a law is tolerable, so long as the challenged provision is
germane to the purpose of the law, as set forth in its title.
UH also argues that “ unquestioning reliance on a bill’s title to identify its
subject . . . fails to recognize that a title may violate the constitution by naming multiple
subjects, or an overbroad single subject.” UH notes that the Otto court recognized that a
subject can be “too broad to comply with the constitution.” 910 N.W.2d at 451. Indeed,
the Otto court considered and rejected the state auditor’s a rgument that the subject of
“government operations ” was “too broad to be a single subject that connect s the many
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disparate provisions” of the challenged law. Id. at 456-57. As support, the supreme court
relied on its earlier cases that defined “subject” with a “broad and extended meaning.” Id.
at 457 (quotation omitted).
UH also notes that in State v. Women’s & Children’s Hospital , the supreme court
declared an entire law void under the Single -Subject Clause because the law’s title
addressed two subjects. 173 N.W. 402, 402 (Minn. 1919). The supreme court invalidated
the law because its title contained “two distinct objects ,” and the latter was “in no way
germane to the former,” explaining:
The validity of the act depends upon whether it
embraces more than one subject. We hold that it does. The
body of the act, as well as its title, provides: First, for the
protection and care of homeless children and for the regulation
of societies receiving and placing them in suitable homes;
second, for the regulation or control of parties or hospitals
receiving and caring for women during confinement. The
former has to do only with homeless and abandoned children
as a class, a very creditable object, and one that should receive
full protection from the law. The latter, which is in no way
germane to the former, has to do with places where mothers
from almost every walk of life are received and cared for
during confinement. The rule is well settled that where the title
to an act actually indicates, and the act itself actually includes,
two distinct objects where the Constitution declares it shall
embrace but one, the whole act must be treated as void.

Id. (emphasis added).

Thus, Women’s & Children’s Hospital indicates that a single-subject violation may
result from a two-topic title if the two topics are distinct and not “germane” to each other.
Id. Unlike the two distinct title subjects in Women’s & Children’s Hospital, the subjects
of government operations and financing are adequately “connected with or related to each
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other, either logically or in popular understanding, as to be parts of, or germane to, one
general subject.” See Otto, 910 N.W.2d at 45 8 n.11 (quotation omitted) (discussing the
concept of germaneness) . Again, “subject” is defined with a “broad and extended
meaning.” Id. at 457 (quotations omitted). Women’s & Children’s Hospital is therefore
distinguishable and not dispositive.
Finally, UH argues that if “the operation of state government” is interpreted
“broadly enough to extend outside the state government’s internal operations, the subject
is constitutionally overbroad .” That argument is inconsistent with the supreme court’s
caselaw defining “subject” with a “broad and extended meaning.” Id. (quotations omitted).
Given the supreme court precedent, we are not persuaded that the subject “the operation
and financing of state government” is too broad to pass constitutional muster.
Application of Otto
Were it not for Otto, it would not be difficult to conclude that the Law violates the
Single-Subject Clause because all its provisions do not “fall under one general idea.” Id.
at 456 (quotation omitted). Nor are all of its provisions “ so connected or related to each
other that they are all parts of, or germane to, one general subject.” Id. (quotations omitted).
As UH notes, “a conference committee took the roughly 40 -page tax omnibus bill and
folded in eight other omnibus bills.” And the nine aggregated omnibus bills contain 73
articles identifying at least thirteen subjects: transportation (articles 1-3, 17), labor (articles
4, 6, 8 -11), combative sports ( article 5), state employees ( articles 12, 72 -73), housing
(articles 14-16), health occupations and licensing (articles 18-33, 61, 65), higher education
(articles 34-35), firearms (article 36), agriculture ( articles 37-38), energy (articles 13, 39-
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45, 58), human services ( articles 46-55, 62-64, 66-67), healthcare (articles 56-57, 59-60),
and taxes (articles 68-71).
The Law’s provisions address abortion, assisted living facilities, binary triggers,
bonds for the Iron Range, a child tax credit, college admissions, combat sports, emissions,
grid-enhancing technologies, HIV prevention medication, homeowners’ associations,
licensure compacts, motorcycles, natural organic reduction, paid family and medical leave,
property forfeiture, rental assistance, state building codes, state patrol headquarters, straw
purchasing of firearms, student parents, traffic cameras, Uber and Lyft driver pay, vaccines,
and veterinary licensing.
UH argues that the Law “embraces the very same subjects Minnesota courts have
previously declared too unrelated to pass constitutional muster.” For example, in Unity
Church of St. Paul v. State , we held that a law that addressed both natural resources and
handgun permitting contained “two disparate subjects . . . lack[ing] a legitimate connection
to one another.” 694 N.W.2d 585, 595 (Minn. App. 2005). The Law in this case includes
both of those subjects. See 2024 Minn. Laws ch. 127, art. 36, at 3203 (concerning
firearms); 2024 Minn. Laws ch. 127, art. 42, §§ 1, 50, at 3259, 3304 (concerning energy
policy, specifically, water permits and a study on carbon dioxide pipelines). And in
Associated Builders, the supreme court held that a wage amendment was not germane to
the subject of tax relief. 610 N.W.2d at 295, 302. Once again, the Law in this case includes
both of those subjects . See 2024 Minn. Laws ch. 127, art. 17, § 4, at 2986 (concerning
minimum compensation for a transportation -network-company driver); 2024 Minn. Laws
ch. 127, art. 68-70, at 3786-3814 (concerning taxation and tax forfeiture).
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Finally, UH argues that the challenged HMO -contracting provisions and the
employee-misclassification provisions are themselves unrelated, explaining:
The Employee Classification Provisions change the scope of
sanctionable conduct and remedies available to individuals and
the State when private employers misclassify workers as
independent contractors. This has nothing to do with whether
for-profit HMOs can compete to provide services to
Minnesotans who rely on Medicaid or Minnesota Care. Those
two sets of unrelated provisions are also unrelated to scores of
other provisions in the Omnibus Bill. They have nothing to do
with the ban on binary firearm triggers (Art. 36, § 2), the
codified living standards for assisted living facilities (Art. 47,
§§ 3-4), the traffic rules for motorcyclists (Art. 3, § 61), or
countless other provisions. These subjects are not connected
by any general idea, contrary to the constitution.

(Quotation omitted.)

In short, the numerous provisions in the Law do not readily reveal one general
subject or common theme. Indeed, the state does not directly argue that the Law has one.
Instead, the state argues that “many” of the Law’s provisions relate to “the operation and
financing of state government.” Under Otto, that seems to be good enough.
Although the Otto court stated that it remain ed “firmly committed” to its
“constitutional duty to prohibit infringements by either the legislative or executive branch
of the government of the constitutional rights vested in the people,” it concluded that a law
containing disparate provisions d id not violate the Single -Subject Clause because the
challenged provision was germane to the subject identified in the Law’s title. 910 N.W.2d
at 459 (quotation omitted). We are bound by that precedent. See Minn. Const. art. VI, § 2
(“The court of appeals shall have appellate jurisdiction over all courts, except the supreme
court . . . .” (emphasis added)); State v. Curtis, 921 N.W.2d 342, 346 (Minn. 2018) (“The
24
court of appeals is bound by supreme court precedent, as it has repeatedly
acknowledged.”); State v. Final Exit Network, Inc. , 889 N.W.2d 296, 303 (Minn. App.
2016) (“We are bound by Minnesota Supreme Court precedent.”), rev. denied (Minn. Mar.
14, 2017).
We are also bound by the principles that statutes are presumed constitutional, that
we are to exercise our authority to declare a statute unconstitutional with extreme caution,
and that a constitutional challenger has a very heavy burden to demonstrate beyond a
reasonable doubt that a statute is unconstitutional. Applying the approach from Otto and
those principles, we conclude that the challenged HMO -contracting provisions are
germane to the operation and financing of state government and that UH has not met its
heavy burden to overcome the presumption of constitutionality. We therefore affirm the
district court’s rejection of UH’s single -subject challenge and its award of summary
judgment to the state.
Affirmed.

CS-1
ROSS, Judge (concurring specially)
No one could read even the first three pages of the challenged 1,500 -page law we
are considering today —the offspring of nine, multi -topic omnibus bills folded into a
gargantuan mega-omnibus bill—and maintain even a slight impression that she is reading
a law embracing only one subject. I nevertheless concur with the court’s decision because
we are bound by supreme court precedent and today’s opinion faithfully follows the literal
dictates of Otto v. Wright County , 910 N.W.2d 446 (Minn. 2018). I write separ ately only
to mourn the loss of the state constitution’s Single-Subject Clause.
I agree that Otto teaches that we are not to invalidate a law under the Single-Subject
Clause so long as “all of [its] provisions fall under . . . one general idea,” or a “general
subject,” however it might be captioned in the bill’s title, Otto, 910 N.W.2d at 456
(quotation omitted), and that we are so restrained regardless of how numerous or apparently
unrelated to each other its provisions might be. Given the profusion and infinite nuance of
English vocabulary, it is impossible for me to imagi ne any assortment of substantively
divergent laws for which one could not, with moderate creativity, fashion a title broad
enough to cover them all. If not for our duty to apply Otto’s reasoning, I would accept the
logically unassailable arguments that UnitedHealth Group has forwarded and, based on the
letter and spirit of the Single-Subject Clause, reverse.