Kristen Giovanni v. United States Department of Na , 906 F.3d 94 ( 2018 )


Menu:
  •                               PRECEDENTIAL
    UNITED STATES COURT OF APPEALS
    FOR THE THIRD CIRCUIT
    _____________
    Nos. 17-2473 & 17-3196
    _____________
    KRISTEN GIOVANNI, Individually and as parent and
    natural guardian of V.G., a minor, and D.G., a minor;
    CHARLES GIOVANNI, Individually and as parent and
    natural guardian of V.G., a minor and D.G., a minor;
    ANTHONY GIOVANNI,
    Appellants in No. 17-2473
    v.
    UNITED STATES DEPARTMENT OF THE NAVY
    DOROTHY PALMER; GEORGE PALMER,
    Appellants in No. 17-3196
    v.
    UNITED STATES DEPARTMENT OF THE NAVY
    _____________
    On Appeal from the United States District Court
    for the Eastern District of Pennsylvania
    (D.C. Nos. 2-16-cv-04873 and 2-17-cv-00765)
    District Judge: Hon. Gerald J. Pappert
    _______________
    Argued
    April 26, 2018
    Before: JORDAN, BIBAS, and SCIRICA, Circuit Judges
    (Opinion Filed: October 2, 2018)
    _______________
    Mark R. Cuker             [ARGUED]
    Amy Montemarano
    Cuker Law
    2005 Market Street – Ste. 1300
    Philadelphia, PA 19103
    Counsel for Appellants Kristen Giovanni, Charles
    Giovanni and Anthony Giovanni.
    Steven E. Angstreich      [ARGUED]
    Amy R. Brandt
    Weir & Partners
    1339 Chestnut Street – Ste. 500
    Philadelphia, PA 19107
    Counsel for Appellants Dorothy Palmer
    and George Palmer
    Jeffrey H. Wood
    Eric Grant
    Chloe H. Kolman
    Sonya J. Shea
    Thomas J. Alford
    Brian C. Toth
    Jeffrey S. Beelaert       [ARGUED]
    United States Department of Justice
    Environment & Natural Resources Division
    2
    P.O. Box 7611
    Ben Franklin Station
    Washington, DC 20044
    Counsel for Appellee
    Deanna K. Tanner
    Delaware Riverkeeper Network
    925 Canal Street – Ste. 3701
    Bristol, PA 19007
    Counsel for Amicus Appellants Delaware
    Riverkeeper and Delaware Riverkeeper Network
    Suzanne I. Novak
    Earthjustice
    48 Wall Street – 19th Fl.
    New York, NY 10005
    Counsel for Amicus Appellants Brendan Boyle, Lori
    Cervera, Renee Frugoli, Hope Grosse, Yvonne Love,
    Minda Ruch, Joanne Stanton and Jacquelyn Rose
    Wiest
    Kevin S. Hannon
    1641 Downing Street
    Denver, CO 80218
    Counsel for Amicus Appellant Toxics Action Center
    _______________
    OPINION OF THE COURT
    _______________
    JORDAN, Circuit Judge.
    3
    The Giovanni family and the Palmer family live in
    neighborhoods close to contaminated federal facilities that
    were owned and operated for decades by the United States
    Navy. The families filed separate suits in state court under
    the Pennsylvania Hazardous Sites Cleanup Act (“HSCA”), 
    35 Pa. Cons. Stat. §§ 6020.101
    -.1305, seeking orders requiring
    the Navy to pay for medical monitoring and to conduct a
    health assessment or health effects study that would include
    blood testing for themselves and others exposed to the
    hazardous substances released at the contaminated facilities.
    The Navy removed the cases to the United States District
    Court for the Eastern District of Pennsylvania, which
    concluded that the claims fell within the ambit of the
    Comprehensive Environmental Response, Compensation and
    Liability Act (“CERCLA” or “the Act”), 
    42 U.S.C. §§ 9601
    -
    9675, and were challenges under that Act to ongoing cleanup
    efforts at the facilities. Based on that, the Court further
    decided that it lacked subject matter jurisdiction over the
    cases and dismissed them. The Giovannis and Palmers now
    appeal those orders of dismissal.
    We will affirm in part. In our view, the claim for a
    health assessment or health effects study is barred, as the
    District Court said, because it challenges ongoing cleanup
    efforts. But we will vacate and remand in part because we
    conclude that the medical monitoring claim is not a challenge
    under CERCLA and that it is not barred by sovereign
    immunity.
    4
    I.     BACKGROUND FACTS1
    The Navy owns a number of properties in
    Pennsylvania, including the Willow Grove Naval Air and Air
    Reserve Station in Horsham Township and the Naval Air
    Development Center in Warminster Township (collectively,
    “the Naval Facilities”). Because of the Navy’s activities, both
    facilities are contaminated with hazardous substances.
    Among the contaminants are perfluorinated compounds
    (“PFCs”), including perfluorooctanoic acid (“PFOA”) and
    perfluorooctanesulfonic acid (“PFOS”).
    Studies have identified the toxic effects that PFCs have
    on people, including increased risk of kidney cancer,
    testicular cancer, thyroid disease, ulcerative colitis,
    pregnancy-induced hypertension, and high cholesterol. And
    1
    The parties do not dispute any material facts bearing
    on the issue of subject matter jurisdiction, which makes the
    Navy’s attack on the complaints under Rule 12(b)(1) a facial
    challenge rather than a factual one. See Hartig Drug Co. Inc.
    v. Senju Pharm. Co. Ltd., 
    836 F.3d 261
    , 268 (3d Cir. 2016)
    (“A facial 12(b)(1) challenge … attacks the complaint on its
    face without contesting its alleged facts[.]”). Thus, because
    we address a facial challenge, the facts set forth here come
    from the Giovannis’ and Palmers’ complaints and documents
    referenced therein, and are taken in the light most favorable to
    them. See Schuchardt v. President of the U.S., 
    839 F.3d 336
    ,
    343 (3d Cir. 2016) (“In a facial attack, we review only ‘the
    allegations of the complaint and documents referenced therein
    and attached thereto, in the light most favorable to the
    plaintiff.’” (quoting Gould Elecs. v. United States, 
    220 F.3d 169
    , 176 (3d Cir. 2000)).
    5
    the Environmental Protection Agency (“EPA”) has
    specifically warned that drinking water containing PFOA and
    PFOS above certain thresholds poses health risks. It issued a
    non-binding provisional health advisory recommending a
    maximum combined PFOA/PFOS concentration in public
    drinking water of 70 parts per trillion (0.07 µg/L).
    Groundwater sampling at both the Naval Facilities
    revealed that the PFOA and the PFOS levels exceeded the
    health advisory levels. Those facilities, being in need of
    further investigation to determine the nature and extent of the
    public health and environmental risks associated with
    chemical contamination, have been added to the National
    Priorities List (“NPL”), which is also sometimes called the
    Superfund List.2 The Navy has begun environmental cleanup
    efforts, and the parties do not dispute that those efforts are
    ongoing in both places.
    Kristen Giovanni, along with her husband Charles
    Giovanni, her son Anthony Giovanni, and two other minor
    children V.G. and D.G., lives across the street from the
    Willow Grove facility. The water from their private well had
    a combined PFOA/PFOS level of 2.88 µg/L, which exceeds
    the concentration exposure threshold recommended by the
    2
    The NPL is a list, compiled by the EPA, of facilities
    throughout the United States and its territories that are
    considered “national priorities” among all the facilities known
    to have involved releases, or that threaten releases, of
    hazardous substances, pollutants, and contaminants.
    Superfund:          National      Priorities   List       (NPL),
    https://www.epa.gov/superfund/superfund-national-priorities-
    list-npl (last visited June 25, 2018).
    6
    EPA. The Navy provided the Giovannis with bottled water
    for several months before it connected them to the
    Warrington Township public water supply. But even that
    public water supply is contaminated with PFCs.
    Dorothy Palmer, along with her son George Palmer,
    has lived less than one mile from the Warminster facility
    since 1981. For years, they used a private well on their
    property, until they learned about the PFOA and PFOS
    contamination in the groundwater. The water from their
    private well had a combined PFOA/PFOS level of 0.62 µg/L,
    which exceeds the combined exposure threshold
    recommended by the EPA. The Navy provided the Palmers
    with bottled water until it connected them to the Warminster
    Municipal Authority’s public water supply. Subsequent
    testing of that supply has revealed PFC contamination there
    too.
    II.   PROCEDURAL HISTORY
    The Giovannis filed a complaint against the Navy in
    the Montgomery County Court of Common Pleas, and the
    Palmers did the same in the Bucks County Court of Common
    Pleas. Both complaints alleged harm from the contaminated
    public and private water sources for residents around the
    Naval Facilities due to the Navy’s allegedly improper
    disposal of hazardous substances. Each complaint included a
    single state law claim under HSCA seeking, among other
    things, the costs of medical monitoring and an order
    compelling the Navy to conduct a health assessment or health
    effects study that would include blood testing for themselves,
    and “others exposed to the contaminants and hazardous
    substances released from the Warminster and Willow Grove
    7
    [f]acilities[.]” (Palmer Appendix (“P.A.”) at 16.) They also
    alleged that the Navy waived its sovereign immunity pursuant
    to § 120(a)(1) of CERCLA, 
    42 U.S.C. § 9620
    (a)(1), and
    § 6001(a) of the Resource Conservation and Recovery Act
    (“RCRA”), 
    42 U.S.C. § 6961
    (a).
    The Navy removed both cases to the District Court
    under 
    28 U.S.C. § 1442
    (a)(1). The Giovannis and Palmers
    then filed motions to remand their cases to state court. The
    Navy responded by moving to dismiss the cases without
    remand, which the Giovannis and Palmers opposed.
    The District Court held a hearing on the competing
    motions in the Giovannis’ case. The parties agreed that
    removal was proper under 
    28 U.S.C. § 1442
    , which prompted
    the Court to deny the motion for remand. Ultimately, the
    Court dismissed the Giovannis’ complaint, and it issued a
    thorough and detailed memorandum opinion to support its
    decision. It concluded that § 113(h) of CERCLA3 deprived it
    3
    Section 113(h), which is codified at 
    42 U.S.C. § 9613
    (h), states:
    (h) Timing of review
    No Federal court shall have jurisdiction under
    Federal law other than under section 1332 of
    Title 28 (relating to diversity of citizenship
    jurisdiction) or under State law which is
    applicable or relevant and appropriate under
    section [121 of the Act] (relating to cleanup
    standards) to review any challenges to removal
    or remedial action selected under section [104
    8
    of the Act], or to review any order issued under
    section [106(a) of the Act], in any action except
    one of the following:
    (1) An action under section [107 of the
    Act] to recover response costs or
    damages or for contribution.
    (2) An action to enforce an order issued
    under section [106(a) of the Act] or to
    recover a penalty for violation of such
    order.
    (3) An action for reimbursement under
    section [106(b)(2) of the Act].
    (4) An action under section [159 of the
    Act] (relating to citizens suits) alleging
    that the removal or remedial action taken
    under section [104 of the Act] or secured
    under section [106 of the Act] was in
    violation of any requirement of this
    chapter. Such an action may not be
    brought with regard to a removal where a
    remedial action is to be undertaken at the
    site.
    (5) An action under section [106 of the
    Act] in which the United States has
    moved to compel a remedial action.
    
    42 U.S.C. § 9613
    (h).
    9
    of jurisdiction to hear a claim that would interfere with an
    ongoing cleanup under CERCLA, and that the Giovannis’
    claims that the Navy should pay for medical monitoring and
    should provide a health study amounted to a challenge to the
    ongoing response actions at the Naval Facilities. The Court
    construed § 113(h) of CERCLA as depriving both it and the
    state courts of jurisdiction, and thus it dismissed the
    Giovannis’ case under the doctrine of derivative jurisdiction,
    without remand.
    The District Court then disposed of the Palmers’
    complaint in a footnote order granting the Navy’s motion to
    dismiss, “consistent with the Court’s Opinion in Giovanni[.]”
    (P.A. at 45.) In that order, the District Court rejected an
    additional argument raised by the Palmers, namely that the
    cleanup activities were initiated under § 120 of CERCLA4
    4
    Section 120 of CERCLA, which is codified at 
    42 U.S.C. § 9620
    , clarifies that the Act applies to federal
    facilities:
    Each department, agency, and instrumentality
    of the United States (including the executive,
    legislative,   and      judicial   branches   of
    government) shall be subject to, and comply
    with, this chapter in the same manner and to the
    same      extent,    both     procedurally   and
    substantively, as any nongovernmental entity,
    including liability under section [107 of the
    Act]. Nothing in this section shall be construed
    to affect the liability of any person or entity
    under sections [106 and 107 of the Act].
    10
    and were therefore not affected by § 113(h)’s jurisdictional
    bar. It concluded that the authority to clean up the Naval
    Facilities derived from § 104 of the Act,5 not § 120.
    The Giovannis and Palmers filed these timely appeals.
    Amicus briefs have been filed in support of the Giovannis and
    Palmers by the following groups: (1) the Delaware
    Riverkeeper Network and Maya van Rossum, also known as
    the Delaware Riverkeeper; (2) the Toxics Action Center; and
    (3) Brendan Boyle, Lori Cervera, Renee Frugoli, Hope
    Grosse, Yvonne Love, Minde Ruch, Joanne Stanton, and
    Jacquelyn Rose Wiest, all of whom currently live or formerly
    lived near the Naval Facilities.6
    
    42 U.S.C. § 9620
    (a)(1).
    5
    Section 104 of CERCLA, which is codified at 
    42 U.S.C. § 9604
    , authorizes the President “to remove or arrange
    for the removal of, and provide for remedial action” which he
    “deems necessary to protect the public health or welfare or
    the environment” whenever “any hazardous substance is
    released or there is a substantial threat of such a release into
    the environment[.]” 
    42 U.S.C. § 9604
    (a)(1).
    6
    We are grateful for the additional insights provided
    by the amici.
    11
    III.   DISCUSSION7
    We will affirm in part and vacate in part the District
    Court’s dismissal of the Giovannis’ and Palmers’ complaints
    and will affirm its decision not to remand to state court.
    Although the requests for a government-led health assessment
    or health effects study are barred under § 113(h) as challenges
    to ongoing response actions, the requests for the costs
    associated with private party medical monitoring are not
    barred by that CERCLA provision because that relief does not
    interfere with or alter the ongoing cleanup efforts. Moreover,
    the relief sought by the Giovannis’ and Palmers’ on their
    medical monitoring claims is best characterized as injunctive
    relief, and the federal government has waived sovereign
    immunity to suits by private parties seeking such relief. We
    will therefore vacate the District Court’s dismissal of the
    7
    Our jurisdiction to review the District Court’s
    rulings is uncontested and is rooted in 
    28 U.S.C. § 1291
    . The
    District Court’s jurisdiction is contested. The Giovannis’ and
    Palmers’ state law claims were properly removed to federal
    court by the Navy under 
    28 U.S.C. § 1442
    (a) because the
    Navy presented colorable federal defenses, including that the
    claims are barred under § 113(h) of CERCLA and that it is
    entitled to sovereign immunity. See Mesa v. California, 
    489 U.S. 121
    , 136 (1989) (noting that removal is proper when a
    defendant demonstrates the presence of a federal question,
    either in the form of a federal claim or a colorable federal
    defense); see also Parker v. Della Rocco, 
    252 F.3d 663
    , 665
    n.2 (2d Cir. 2001) (characterizing sovereign immunity as a
    federal defense when asserted by a federal agency). The
    parties dispute the applicability of those defenses, and we will
    address those disputes herein.
    12
    Giovannis’ and Palmers’ requests for costs associated with
    private party medical monitoring and remand for further
    proceedings on those claims.
    Our review of a district court’s grant of a motion to
    dismiss is plenary. Bell v. Cheswick Generating Station, 
    734 F.3d 188
    , 193 n.5 (3d Cir. 2013). When there is a facial
    attack on subject matter jurisdiction under Federal Rule of
    Civil Procedure 12(b)(1), see supra note 1, “we review only
    ‘the allegations of the complaint and documents referenced
    therein and attached thereto, in the light most favorable to the
    plaintiff.’” Schuchardt v. President of the U.S., 
    839 F.3d 336
    ,
    343 (3d Cir. 2016) (quoting Gould Elecs. v. United States,
    
    220 F.3d 169
    , 176 (3d Cir. 2000)). Furthermore, “we
    exercise plenary review over a district court’s interpretation
    of CERCLA[.]” Agere Sys., Inc. v. Advanced Envtl. Tech.
    Corp., 
    602 F.3d 204
    , 216 (3d Cir. 2010). And our review of a
    “[d]istrict [c]ourt’s interpretation and application of legal
    rules and doctrines” is plenary.            McBride v. Int’l
    Longshoremen’s Ass’n, 
    778 F.3d 453
    , 458 (3d Cir. 2015).
    A.     Lack of Jurisdiction Over “Challenges”
    Under § 113(h)
    The Navy argues that federal courts are without
    jurisdiction to rule on the Giovannis’ and Palmers’ state law
    claims because they are barred under § 113(h) as “challenges”
    to ongoing cleanup efforts at the Naval Facilities. The
    Giovannis and Palmers, of course, disagree because, as they
    see it, their requested relief will not interfere with those
    ongoing efforts. We therefore first address whether state law
    claims seeking compensation to fund private party medical
    monitoring and state law claims seeking a government-led
    13
    health assessment or health effects study are “challenges to
    removal or remedial action” under § 113(h).8 Our conclusion
    is that the latter are challenges but the former are not. To
    understand why, we turn to the pertinent portions of
    CERCLA.
    That complex statute was enacted in 1980 “in response
    to the serious environmental and health risks posed by
    industrial pollution.” Burlington N. & Santa Fe Ry. Co. v.
    United States, 
    556 U.S. 599
    , 602 (2009). It gives “the
    President broad power to command government agencies and
    private parties to clean up hazardous waste sites.” Key Tronic
    Corp. v. United States, 
    511 U.S. 809
    , 814 (1994). CERLCA
    was designed, in part, “to ensure that the costs of such
    cleanup efforts were borne by those responsible for the
    contamination.” Burlington N. & Santa Fe Ry., 
    556 U.S. at 602
     (internal quotation marks and citations omitted).
    Section 113(b) of the Act provides that “the United
    States district courts shall have exclusive original jurisdiction
    8
    Medical monitoring is meant “to compensate
    plaintiffs who have been exposed to various toxic substances”
    by accounting for latent diseases or injuries. In re Paoli R.R.
    Yard PCB Litig., 
    916 F.2d 829
    , 849 (3d Cir. 1990). “[A]n
    action for medical monitoring seeks to recover only the
    quantifiable costs of periodic medical examinations necessary
    to detect the onset of physical harm[.]” 
    Id. at 850
    . Under
    Pennsylvania law, medical monitoring claims are cognizable
    under HSCA and the common law. Redland Soccer Club,
    Inc. v. Dep’t of Army of U.S., 
    55 F.3d 827
    , 849 n.12 (3d Cir.
    1995).
    14
    over all controversies arising under [CERCLA].” 
    42 U.S.C. § 9613
    (b). Pursuant to § 113(h), however, jurisdiction is
    unavailable under federal or state law “to review any
    challenges to removal or remedial action selected under
    section [104][9] …, or to review any order issued under
    section [106(a).][10]” Id. § 9613(h). Courts have described
    9
    Section 104 of CERCLA defines response
    authorities under the Act, including the President’s authority
    to institute removal and remedial actions to clean up
    contaminated facilities; it also sets forth limitations on his
    response authority, and exceptions to those limitations. See
    
    42 U.S.C. § 9604
    (a). It details other cleanup-related matters
    too, including financial constraints, funding, interactions with
    state authorities, information gathering processes, and
    emergency response powers. See generally 
    id.
     § 9604(b)-(k).
    10
    That provision of the Act states:
    In addition to any other action taken by a State
    or local government, when the President
    determines that there may be an imminent and
    substantial endangerment to the public health or
    welfare or the environment because of an actual
    or threatened release of a hazardous substance
    from a facility, he may require the Attorney
    General of the United States to secure such
    relief as may be necessary to abate such danger
    or threat, and the district court of the United
    States in the district in which the threat occurs
    shall have jurisdiction to grant such relief as the
    public interest and the equities of the case may
    require. The President may also, after notice to
    15
    § 113(h) as “a ‘blunt withdrawal of federal jurisdiction.’”
    McClellan Ecological Seepage Situation v. Perry, 
    47 F.3d 325
    , 328 (9th Cir. 1995) (quoting N. Shore Gas Co. v. EPA,
    
    930 F.2d 1239
    , 1244 (7th Cir. 1991)). It applies to “any
    challenges,” not just those brought under CERCLA. 
    Id.
    (emphasis added).
    A well-established body of case law, including our
    own, provides guidance on what it means to “challenge” a
    response action. We have said that § 113(h) “clearly
    preclude[s] jurisdiction to delay or interfere with EPA clean-
    up activities[.]” Boarhead Corp. v. Erickson, 
    923 F.2d 1011
    ,
    1023 (3d Cir. 1991). Other courts have noted that “[a]
    lawsuit challenges a removal action if it ‘calls into question’”
    the removal plan. Cannon v. Gates, 
    538 F.3d 1328
    , 1335
    (10th Cir. 2008) (citation omitted). Put in more concrete
    terms, “a suit challenges a removal action if it ‘interferes with
    the implementation of a CERCLA remedy’ because ‘the relief
    requested will impact the [removal] action selected.’”11 
    Id.
    the affected State, take other action under this
    section including, but not limited to, issuing
    such orders as may be necessary to protect
    public health and welfare and the environment.
    
    42 U.S.C. § 9606
    (a).
    11
    See also El Paso Nat. Gas Co. v. United States, 
    750 F.3d 863
    , 880 (D.C. Cir. 2014) (“[A] claim is a § 113(h)
    ‘challenge’ if it will interfere with a ‘removal’ or a ‘remedial
    action.’”); McClellan, 
    47 F.3d at 330
     (describing the relief as
    a challenge under § 113(h) because it “would clearly interfere
    with the cleanup”); Razore v. Tulalip Tribes of Wash., 66
    16
    (alteration in original) (quoting Broward Gardens Tenants
    Ass’n v. EPA, 
    311 F.3d 1066
    , 1072 (11th Cir. 2002)); see also
    Costner v. URS Consultants, Inc., 
    153 F.3d 667
    , 675 (8th Cir.
    1998) (indicating that a lawsuit is not a “challenge” under
    § 113(h) if it “would not involve altering the terms of [a]
    cleanup order” and “would result only in financial penalties”
    (citation omitted)).
    In some cases, “it may be necessary to assess the nexus
    between the nature of the suit and the CERCLA cleanup: the
    more closely related, the clearer it will be that the suit is a
    ‘challenge.’” El Paso Nat. Gas Co. v. United States, 
    750 F.3d 863
    , 880 (D.C. Cir. 2014). Even though practically any
    lawsuit could “increase[] the cost of a cleanup or divert[]
    resources or personnel from it[,]” that does not mean that
    every suit, or every request for relief within a suit,
    automatically “challenges” the cleanup. McClellan, 
    47 F.3d at 330
    . Enforcement of minimum wage laws, for example,
    would have that effect, but seeking enforcement of such laws
    is too attenuated from the cleanup itself to be considered a
    challenge to the remediation activities. 
    Id.
    A suit challenges a response action if it would, for
    example, “dictate specific remedial actions and … alter the
    method and order for cleanup[.]” Broward Gardens, 
    311 F.3d at 1072
     (first alteration in original) (quoting Razore v.
    Tulalip Tribes of Wash., 
    66 F.3d 236
    , 239 (9th Cir. 1995)).
    Conversely, a lawsuit does not challenge a response action if
    it does not “call into question the selected … remedial or
    removal plan[.]” Id. at 1073.
    F.3d 236, 239 (9th Cir. 1995) (“An action constitutes a
    challenge if it is related to the goals of the cleanup.”).
    17
    To assess whether a suit is a challenge, we must also
    consider the meaning of the terms “removal” and “remedial”
    action as used in § 113(h). The statute defines “response”
    efforts to include “remove, removal, remedy, and remedial
    action[.]” 
    42 U.S.C. § 9601
    (25). Removal actions generally
    include short-term or immediate efforts, while remedial
    actions typically involve longer term activities. Black Horse
    Lane Assoc., L.P. v. Dow Chem. Corp., 
    228 F.3d 275
    , 293 (3d
    Cir. 2000).
    CERCLA defines the term “removal” to mean:
    the cleanup or removal of released hazardous
    substances from the environment, such actions
    as may be necessary taken [sic] in the event of
    the threat of release of hazardous substances
    into the environment, such actions as may be
    necessary to monitor, assess, and evaluate the
    release or threat of release of hazardous
    substances, the disposal of removed material, or
    the taking of such other actions as may be
    necessary to prevent, minimize, or mitigate
    damage to the public health or welfare or to the
    environment, which may otherwise result from
    a release or threat of release. The term
    includes, in addition, without being limited to,
    security fencing or other measures to limit
    access, provision of alternative water supplies,
    temporary evacuation and housing of threatened
    individuals not otherwise provided for, action
    taken under section [104(b) of CERCLA], and
    any emergency assistance which may be
    18
    provided under the Disaster Relief and
    Emergency Assistance Act [
    42 U.S.C.A. § 5121
    et seq.].
    
    42 U.S.C. § 9601
    (23).
    The even lengthier definition of “remedial action” is:
    those actions consistent with permanent remedy
    taken instead of or in addition to removal
    actions in the event of a release or threatened
    release of a hazardous substance into the
    environment, to prevent or minimize the release
    of hazardous substances so that they do not
    migrate to cause substantial danger to present or
    future public health or welfare or the
    environment. The term includes, but is not
    limited to, such actions at the location of the
    release as storage, confinement, perimeter
    protection using dikes, trenches, or ditches, clay
    cover, neutralization, cleanup of released
    hazardous      substances     and      associated
    contaminated materials, recycling or reuse,
    diversion, destruction, segregation of reactive
    wastes, dredging or excavations, repair or
    replacement of leaking containers, collection of
    leachate and runoff, onsite treatment or
    incineration, provision of alternative water
    supplies, and any monitoring reasonably
    required to assure that such actions protect the
    public health and welfare and the environment.
    The term includes the costs of permanent
    relocation of residents and businesses and
    19
    community facilities where the President
    determines that, alone or in combination with
    other measures, such relocation is more cost-
    effective than and environmentally preferable to
    the     transportation,    storage,     treatment,
    destruction, or secure disposition offsite of
    hazardous substances, or may otherwise be
    necessary to protect the public health or
    welfare; the term includes offsite transport and
    offsite storage, treatment, destruction, or secure
    disposition of hazardous substances and
    associated contaminated materials.
    
    42 U.S.C. § 9601
    (24).
    With those definitions in mind, we analyze whether the
    relief requested by the Giovannis and Palmers constitutes a
    challenge under §113(h) to ongoing cleanup efforts at the
    Naval Facilities.      We take a holistic approach that
    encompasses several considerations. One is whether the
    relief can be classified as a “removal” or “remedial” step.
    Another and closely related consideration is the specific form
    of relief requested and whether it would compel the defendant
    to take some action or refrain from taking some action, or
    instead seeks to have the defendant pay for a third party to
    provide services. A further consideration is whether, on the
    whole, there is reason to think that a given request for relief
    will conflict with, impact, or otherwise interfere with the
    ongoing cleanup efforts.12 We address each of those three
    considerations seriatim.
    12
    Our concurring colleague disagrees with our holistic
    approach and advocates a bright line test for determining
    20
    1.     Removal and Remedial Actions
    The provision at issue here – § 113(h) – states, in
    relevant part, that federal courts lack jurisdiction “to review
    whether a claim for relief constitutes a challenge. The
    concurrence relies on the District of Columbia Circuit’s
    opinion in El Paso Natural Gas Company v. United States,
    
    750 F.3d 863
    , 880 (D.C. Cir. 2014), to propose “a single
    framework” for analysis – whether the claim for relief
    interferes with a removal or remedial action. Concur. Slip
    Op. at 2-3. But the analysis is not so simple and El Paso does
    not suggest that it is. The El Paso opinion does provide a
    helpful way to conceptualize what a challenge is, but the
    court acknowledged that there will be situations in which “it
    may be necessary to assess the nexus between the nature of
    the suit and the CERCLA cleanup” before being able to
    determine whether a claim for relief would “interfere” with a
    removal or remedial action. 750 F.3d at 880. It did not
    purport to set forth a single bright line test.
    In laying out our analytical framework, we have relied
    on the collective experience of our own Court and our sister
    courts, including the D.C. Circuit in El Paso, to create an
    approach that we hope is sufficiently flexible to account for
    the myriad circumstances in which CERCLA litigation arises
    and yet clear enough to give useful guidance to district courts.
    We appreciate our colleague’s desire to simplify the
    “challenge” analysis for the benefit of future litigants and
    courts, and we share that desire. But we think that a
    framework that relies on nothing but the word “interfere” to
    inform future litigation – a word that does not appear at all in
    the statutory text but rather emerged through case law – will
    not be as helpful as our colleague believes.
    21
    any challenges to removal or remedial action selected under
    section [104.]” Id. § 9613(h). Thus, if the requested relief
    can be classified as a removal or remedial action, it is
    possible that it will conflict with, impact, or otherwise
    interfere with an ongoing CERCLA cleanup for purposes of
    § 113(h). The question, then, is whether the Giovannis’ and
    Palmers’ requests for relief – private party medical
    monitoring and a government-led health study – fit the
    statutory definitions of removal or remedial action.
    a.       Private Party Medical
    Monitoring
    The text of the statute does not suggest that private
    party medical monitoring is a removal action. The reference
    to “monitor[ing]” in the definition of “removal” refers to
    “monitor[ing], assess[ing], and evaluat[ing] the release or
    threat of release of hazardous substances,” not the monitoring
    of individuals for latent diseases or injuries. 
    42 U.S.C. §9601
    (23). And while the definition of “removal” also
    includes “actions as may be necessary to prevent, minimize,
    or mitigate damage to the public health or welfare or to the
    environment, which may otherwise result from a release or
    threat of release,” when read in context of the other actions
    listed, medical monitoring does not appear to be
    contemplated. 
    Id.
     It is a standard principle of statutory
    construction that “a word [or phrase] is known by the
    company it keeps[.]” Yates v. United States, 
    135 S. Ct. 1074
    ,
    1085 (2015). That principle, known as noscitur a sociis,
    counsels courts “to ‘avoid ascribing to one word [or phrase] a
    meaning so broad that it is inconsistent with its accompanying
    words [or phrases], thus giving unintended breadth to the
    Acts of Congress.” 
    Id.
     (citation omitted). The other actions
    listed in the definition of “removal” refer to activities directly
    22
    related to the physical removal, containment, assessment, or
    evaluation of hazardous waste, not broadly to all potential
    actions taken because of a toxic release. Furthermore,
    because removal actions focus on the short term, it would be
    odd to classify medical monitoring as a “removal” action,
    given that medical monitoring is a way to address problems
    that only emerge over time.
    Nor does the text support classifying private party
    medical monitoring as a remedial action. Although medical
    monitoring is certainly “consistent with [a] permanent
    remedy[,]” it is not taken “to prevent or minimize the release
    of hazardous substances.” 
    42 U.S.C. § 9601
    (24). And while
    the statutory definition of “remedial action” references “any
    monitoring reasonably required to … protect the public health
    and welfare and the environment,” that monitoring expressly
    relates to the previously listed items in the definition,
    showing that the contemplated monitoring is “to assure that
    such actions protect the public health and welfare and the
    environment.” 
    Id.
     (emphasis added). The referenced “such
    actions” all relate to physical remediation efforts, including
    dredging, excavations, diversions, repairs, incineration,
    neutralization, and trenching. See 
    id.
     The text of the statute
    therefore does not easily support classifying private party
    medical monitoring as either a “removal” or a “remedial”
    action, and, consequently, it is not a response action. See 
    42 U.S.C. § 9601
    (25) (defining “response” in terms of “removal”
    and “remedial” actions).
    There is precedent for our interpretation. In Daigle v.
    Shell Oil Co., for example, the United States Court of
    Appeals for the Tenth Circuit held that medical monitoring
    does not meet the statutory definitions for removal and
    23
    remedial actions because both definitions were “directed at
    containing and cleaning up hazardous substance releases[,]”
    not “[l]ongterm health monitoring.” 
    972 F.2d 1527
    , 1535
    (10th Cir. 1992); see also Price v. United States Navy, 
    39 F.3d 1011
    , 1016-17 (9th Cir. 1994) (concluding, in the
    context of a response cost analysis under § 107(a) of
    CERCLA, 
    42 U.S.C. § 9607
    (a), that “medical monitoring”
    does not fit the definition of “removal” or “remedial” action
    as defined under CERCLA); cf. Syms v. Olin Corp., 
    408 F.3d 95
    , 105 (2d Cir. 2005) (same).13
    The District Court distinguished those cases by stating
    that they involved an assessment of whether medical
    monitoring expenses are response costs. It said that the
    reasoning in those cases is “flawed because it assumes that
    ‘response costs’ and ‘response’ mean the same thing under
    CERCLA,” but “[t]hey do not.” (Giovanni Joint Appendix
    (“G.J.A.”) at 114.) The Court determined instead that, while
    13
    See also Ambrogi v. Gould, Inc., 
    750 F. Supp. 1233
    ,
    1244-50 (M.D. Pa. 1991) (concluding that CERCLA’s
    definition of “removal” does not encompass medical
    monitoring); Bolin v. Cessna Aircraft Co., 
    759 F. Supp. 692
    ,
    713-14 (D. Kan. 1991) (same); Lutz v. Chromatex, Inc., 
    718 F. Supp. 413
    , 418 (M.D. Pa. 1989) (determining that the
    definition of “response” did not include medical monitoring);
    Coburn v. Sun Chem. Corp., No. 88-0120, 
    1988 WL 120739
    ,
    at *6 (E.D. Pa. Nov. 9, 1988) (stating that it was “difficult to
    understand how future medical testing and monitoring of
    persons who were exposed to contaminated well water prior
    to the remedial measures currently underway” could
    constitute a “removal” action under CERCLA).
    24
    all “removal and remedial actions” are “responses” under
    CERCLA, not all such actions are “response costs.” (G.J.A.
    at 114-15.) Therefore, it concluded, it “does not follow that
    all ‘response costs’ are necessarily ‘removal and remedial
    actions.’” (G.J.A. at 115.) We disagree with that analysis.
    As the District Court noted, those particular cases cited
    by the Giovannis and Palmers were deciding whether a
    private party could recover the costs of medical monitoring
    under CERCLA, which required an assessment of whether
    medical monitoring expenses were “response costs” under
    § 107(a).14 But the District Court’s heavy reliance on a
    distinction between the terms “response” and “response cost”
    is not sound. It is true that CERCLA defines “response,” but
    not “cost” or “response cost.” See 
    42 U.S.C. § 9601
    ; cf.
    Redland Soccer Club, Inc. v. Dep’t of Army of U.S., 
    55 F.3d 827
    , 849 (3d Cir. 1995) (“The absence of a definition of
    ‘response costs’ has been the source of much litigation since
    CERCLA’s enactment.”). Yet to discount the cases cited by
    the Giovannis and Palmers simply because they speak most
    directly to “response costs” rather than “response” actions, is,
    we believe, to miss their significance. Those cases undertake
    practically identical analyses to determine whether medical
    monitoring is a “removal” or “remedial action,” and thus
    necessarily a “response,” en route to determining whether it is
    14
    Section 107(a), a provision for cost recovery claims,
    is one mechanism CERCLA provides for potentially
    responsible parties to recoup costs expended in cleaning up a
    contaminated site. 
    42 U.S.C. § 9607
    (a); see also Agere Sys.,
    Inc. v. Advanced Envtl. Tech. Corp., 
    602 F.3d 204
    , 216-18
    (3d Cir. 2010) (summarizing the cost recovery mechanisms
    provided under CERCLA, including § 107(a)).
    25
    a “response cost.” See Durfey v. E.I. DuPont de Nemours &
    Co., 
    59 F.3d 121
    , 124-25 (9th Cir. 1995); Yslava v. Hughes
    Aircraft Co., 
    845 F. Supp. 705
    , 708-09 (D. Ariz. 1993).
    Regardless of the relationship between “response” and
    “response cost,” the cases concluded that private party
    medical monitoring is not a “response” action and so, by
    definition, is neither a removal or remedial action. Durfey, 
    59 F.3d at 125
    ; Yslava, 
    845 F. Supp. at 709
    .
    The Navy argues that medical monitoring should
    nevertheless be considered a “removal or remedial action”
    under CERCLA because of that statute’s provisions
    concerning the Agency for Toxic Substances and Disease
    Registry (“ATSDR”). The ATSDR was created when
    CERCLA was enacted in 1980, and its purpose is the
    “compiling [of] health effects information[.]” 2 Susan M.
    Cooke, The Law of Hazardous Waste § 12.04[2][f]. When
    CERCLA was amended by the Superfund Amendments and
    Reauthorization Act of 1986 (“SARA”), Congress recognized
    “that inadequate attention had been given to the health effects
    of contaminants found at Superfund sites[.]” Id. Thus, it
    expanded the role of the ATSDR. Id. § 12.05[2][h].
    The charge given to the agency is to “effectuate and
    implement [CERCLA’s] health related authorities[.]” 
    42 U.S.C. § 9604
    (i)(1). It is expressly authorized to “establish[]
    a health surveillance program[,]” 
    id.,
     and, in some instances,
    the statute requires it to initiate such a program, 
    id.
    § 9604(i)(9). Health surveillance programs must include, but
    are not limited to, “periodic medical testing where appropriate
    of population subgroups to screen for diseases for which the
    population or subgroup is at significant increased risk … [,
    and the programs further include] a mechanism to refer for
    26
    treatment those individuals within such population who are
    screened positive for such diseases.” Id.
    Agreeing with the Navy, the District Court said that,
    because those CERCLA provisions relating to the ATSDR
    provided for a program that included “both periodic medical
    testing … and a mechanism to refer for treatment anyone who
    needs medical attention[,]” the medical monitoring requested
    by the Giovannis was a “removal” or “remedial” action as
    defined by the statute. (G.J.A. at 112 n.6.) The Court did not
    explore the connection, though, between CERCLA’s
    definitions of “removal” or “remedial” action and its
    provisions relating to the ATSDR. We think that connection
    depends on the distinction between private party actors and
    state actors.
    The United States Court of Appeals for the Ninth
    Circuit has thoroughly considered whether the ATSDR’s
    health “surveillance activit[ies] … [are] removal or remedial
    action[s] entitled to the protection of [§ 113(h)].” Hanford
    Downwinders Coalition, Inc. v. Dowdle, 
    71 F.3d 1469
    , 1475
    (9th Cir. 1995). It decided that they are, explaining that the
    pertinent statutory provision – § 104 – was titled “response
    authorities,” and “Congress gave no indication that the
    universe of CERCLA response authorities cannot include
    both the health and non-health related activities found in
    [§ 104.]” Id. at 1475-76. The court noted that other parts of
    § 104 also contemplated actions of public health authorities
    being “response measures,” because the President was
    authorized to “take any other response measure … necessary
    to protect the public health or welfare or environment.” Id. at
    1476 (quoting 
    42 U.S.C. § 9604
    (a)(1)). It thus concluded that
    “Congress’ single reference to ATSDR authorities as ‘health
    27
    related’ should be read narrowly as a means to distinguish
    between different types of response authorities, rather than
    interpreted broadly as an effort to differentiate ATSDR health
    … surveillance activity from response actions protected by
    [§ 113(h)].”15 Id.
    Significantly, the court did not believe that its
    conclusion undermined its previous decisions in Durfey and
    Price, which “held that private party medical monitoring
    activities, initiated and coordinated independently of ongoing
    CERCLA cleanup efforts, were not … removal or remedial
    actions.” Id. at 1477. It said that the reasoning in those cases
    did “not apply to health … surveillance actions engaged in by
    a governmental agency pursuant to explicit CERCLA
    provisions.” Id. (emphasis added). It further said that its
    interpretation was “rooted in the distinction Congress drew
    between public and private efforts to monitor the public
    health.” Id. at 1478. Congress used the ATSDR to “expand
    the role [of] government health … surveillance[,]” but did
    nothing to add back in the personal rights to recovery of
    medical expenses (such as for private party medical
    monitoring) that were intentionally excised from original
    drafts of CERCLA. Id. at 1479.
    15
    The court limited its holding to the specific ATSDR
    activities under review because it noted that not all ATSDR
    activities should qualify “per se [as] removal or remedial
    actions for purposes of CERCLA’s Timing of Review
    provision.” Hanford, 
    71 F.3d at 1476
    . That is because some
    of the agency’s duties would not ordinarily constitute
    response actions, such as the ATSDR’s general duties to
    maintain various health-related registries and inventories. 
    Id.
    at 1476 n.9.
    28
    The court bolstered its conclusion that ATSDR’s
    health surveillance activities are response actions with three
    reasons related to CERCLA’s remedial purposes. 
    Id. at 1481
    .
    First, Congress has made it clear, especially with the
    enactment of SARA, that one of CERCLA’s goals is to
    protect the public health. 
    Id.
     Second, there are many
    instances in which CERCLA privileges governmental efforts
    over private party efforts. 
    Id.
     Finally, recognizing that the
    ATSDR’s activities constitute “removal or remedial action” is
    most consistent with Congress’s effort to integrate the
    agency’s functions into NPL cleanups. 
    Id. at 1474, 1481-82
    .
    The analysis provided by the Ninth Circuit Court in
    Hanford is persuasive. We adopt it, with the conclusion that
    CERCLA distinguishes between private party medical
    monitoring      activities and    government-led      health
    16
    surveillance. Private party medical monitoring falls outside
    of the definition of response action, but government-led
    monitoring does not.17
    16
    The Ninth Circuit also determined “that the ATSDR
    health … surveillance activities [at the specific site in
    question] satisfy the definition of removal action.” Hanford,
    
    71 F.3d at 1477
    . We do not need to, and thus do not, decide
    that here. Although the classification of response actions as
    either removal or remedial actions may have significant legal
    and practical consequences under the Act in other
    circumstances, it is enough here for us to conclude that the
    ATSDR’s health surveillance activities are response actions.
    17
    The concurrence disagrees that the distinction
    between private actors and government actors makes a
    29
    Accordingly, the Giovannis’ and Palmers’ requests for
    an order compelling the Navy to pay for the costs associated
    with private party medical monitoring is relief that falls
    outside of CERCLA’s definition of “removal or remedial
    action.” And that counsels in favor of concluding that their
    requests do not, under § 113(h), constitute a jurisdiction-
    stripping challenge to an ongoing CERCLA response action.
    b.     Health Assessment or Health
    Effects Study
    We turn next to the Giovannis’ and Palmers’ requests
    for a government-led health assessment or health effects
    study. As a general matter, a health study would not fit the
    difference in the analysis of whether a claim for relief
    constitutes a challenge. Concur. Slip Op. at 3-4. Our
    colleague stresses that the statutory language focuses on
    “actions” and not “actors.” Id. We take a different message
    from the existence of the ATSDR provisions, which create a
    framework for government actors to conduct medical
    monitoring and health effect studies. 
    42 U.S.C. § 9604
    (i).
    Those statutory provisions show that Congress has made a
    distinction between government action and private action.
    When a court orders the government to do something –
    particularly something that, like a health effects study
    contemplated by the ATSDR provisions, is already regulated
    by statute – separation-of-powers issues may be implicated
    that would not be when ordering action from a private party.
    That seems a pertinent factor to consider in determining
    whether a claim interferes with the work of the government in
    a cleanup.
    30
    statute’s definition of removal action for the same reasons
    that private party medical monitoring falls outside that
    definition. References to “assess[ing]” or “evaluat[ing]” refer
    to “the release or threat of release of hazardous substances,”
    not the study of the effects of contaminants on human health.
    
    42 U.S.C. § 9601
    (23). And the definition’s inclusion of
    “actions as may be necessary to prevent, minimize, or
    mitigate damage to the public health or welfare” does not
    contemplate a generic health study because such a study does
    not align with the subsequent list of activities directly related
    to the evaluation of hazardous waste in connection with its
    immediate removal. 
    Id.
     Nor does the text of the statute
    support classifying a generic health study as a remedial
    action. Such a study is not taken “to prevent or minimize the
    release of hazardous substances,” and it does not necessarily
    relate to conducting an evaluation or assessment to promote
    environmental remediation efforts. 
    42 U.S.C. § 9601
    (24).
    But the Giovannis and Palmers are not requesting a
    generic health study. They want a government-led health
    assessment or health effects study. One of the things the
    ATSDR is charged with “effectuat[ing] and implement[ing]”
    is the completion of a “health assessment” within one year of
    an EPA proposal to list a site on the NPL.18 
    Id.
     § 9604(i)(1),
    18
    The statute defines the term “health assessment” to
    mean:
    preliminary assessments of the potential risk to
    human health posed by individual sites and
    facilities, based on such factors as the nature
    and extent of contamination, the existence of
    potential pathways of human exposure
    31
    (6)(A). The purpose of that assessment is “to assist in
    determining whether actions … should be taken to reduce
    human exposure to hazardous substances from a facility and
    whether additional information on human exposure and
    associated health risks is needed and should be acquired[.]”
    Id. § 9604(i)(6)(G). Among the ways to acquire that
    information is “conducting epidemiological studies[.]” Id. If
    such a health assessment leads the ATSDR Administrator to
    conclude “that there is a significant increased risk of adverse
    health effects in humans from exposure to hazardous
    substances[,]” then the statute requires the ATSDR to set up a
    health surveillance program for the affected population. Id.
    § 9604(i)(9).
    As discussed above with respect to private party
    medical monitoring, Congress differentiated between
    government-led and private efforts to assess and protect the
    (including     ground    or    surface    water
    contamination, air emissions, and food chain
    contamination), the size and potential
    susceptibility of the community within the
    likely pathways of exposure, the comparison of
    expected human exposure levels to the short-
    term and long-term health effects associated
    with identified hazardous substances and any
    available recommended exposure or tolerance
    limits for such hazardous substances, and the
    comparison of existing morbidity and mortality
    data on diseases that may be associated with the
    observed levels of exposure.
    
    42 U.S.C. § 9604
    (i)(6)(F).
    32
    public health following a release or threat of release of
    hazardous waste. Hanford, 
    71 F.3d at 1478
    . Government-led
    health studies, unlike generic health studies conducted by
    private parties, are response actions deemed by Congress as
    necessary for evaluating the release or threatened release of
    hazardous substances. See 
    id. at 1475, 1477
     (concluding that
    ATSDR health assessment activities are removal or remedial
    actions for purposes of § 113(h)). That conclusion comports
    with Congress’s goal of protecting the public health when it
    enacted SARA, as well as being consistent with CERCLA’s
    favoring of governmental efforts over private party efforts,
    and Congress’s effort to integrate the ATSDR’s functions into
    the cleanups of Superfund sites. Id. at 1481-82.
    Here, unlike their requests for private party medical
    monitoring, the Giovannis’ and Palmers’ requests that the
    District Court order the Navy to conduct a health assessment
    or health effects study, including blood testing, do constitute
    removal or remedial actions for purposes of § 113(h).
    Because the ATSDR has authority to conduct health
    assessments on behalf of the government at contaminated
    facilities, and those activities are response actions under
    CERCLA, the Giovannis’ and Palmers’ demand that another
    agency of the government conduct such a study would, if
    granted, interfere with a response action under CERCLA.
    Therefore, we agree with the District Court’s
    determination that the requested relief mandating that the
    Navy perform a health assessment or health effects study is a
    33
    response action under CERCLA, which suggests that it is a
    challenge under § 113(h).19
    19
    The concurrence would not construe the requests
    for a health effects study as a response action because
    § 107(a)(4)(A) refers to “removal or remedial action” and
    § 107(a)(4)(D) separately refers to “any health assessment or
    healthy effects study carried out under [the ATSDR
    provisions.]” Concur. Slip Op. at 4-6. According to the
    concurrence, § 107(a)(4)(D) would be “superfluous” if a
    health effect study were to be construed as a removal or
    remedial action. Id. at 5. But, as the concurrence itself
    highlights, § 107(a)(4)(D) was grafted onto the statute as part
    of the SARA amendments to CERCLA. Id. The addition of
    § 107(a)(4)(D) suggests that Congress wanted to emphasize
    that CERCLA liability encompassed the costs of government-
    led health effects studies; it does not demonstrate
    unambiguous congressional intent to remove government-led
    health effects studies from the ambit of all remedial or
    removal actions. Cf. Hanford, 
    71 F.3d at 1479
     (“[W]e
    decline to read the failure of Congress to accomplish the
    seamless integration of ATSDR provisions with the other
    response authorities found under sub-section [107(a)(4)] as
    compelling proof of Congress’ intent to distinguish ATSDR
    activities from removal and remedial actions.”).           Had
    Congress enacted § 107(a)(4)(A) and § 107(a)(4)(D) at the
    same time, then the concurrence’s statutory structure
    argument might have more persuasive force. But the timing
    of the SARA amendments significantly undermines the
    position pressed by our colleague. Moreover, the Ninth
    Circuit has been characterizing ATSDR activities as removal
    and remedial actions for nearly a quarter century. Hanford,
    
    71 F.3d at 1479-80
    . If Congress thought that the courts had
    34
    2.     Form of Relief Requested
    When assessing whether a claim challenges an
    ongoing cleanup effort, courts have also distinguished among
    forms of relief as they affect the defending party.20
    Generally, requests for injunctive relief that relate in any way
    to pending response actions are viewed as challenges under
    § 113(h). If a plaintiff demands that a defendant engage in
    activities that could have been a part of the cleanup plan, then
    it is a challenge to the selected response actions. See, e.g.,
    McClellan, 
    47 F.3d at 329-30
     (concluding that injunctive
    relief injecting new requirements into a CERCLA cleanup
    effort would clearly constitute a challenge because it would
    interfere with those ongoing activities). In contrast, requests
    that require little more of the defendant than the expenditure
    of money are generally not considered to be “challenges”
    under § 113(h). See, e.g., Beck v. Atl. Richfield Co., 
    62 F.3d 1240
    , 1242-43 (9th Cir. 1995) (concluding that a request for
    compensatory damages for crop loss, lost profits, and
    property devaluation due to water contamination was not a
    challenge because the damages claim did not interfere with
    the existing remedial plan).
    gotten it wrong, we hope it would have said something by
    now.
    20
    We note again that § 113(h) only applies when the
    response actions at issue were selected under § 104, which
    authorizes the President to take certain actions, or when the
    order implicated was issued under § 106(a), which refers to
    additional actions the President may take.
    35
    But the adjectives “injunctive” and “monetary” are
    descriptors, not by themselves reasoned conclusions. The
    effect that the sought-for relief has on the cleanup is what
    must be determinative, not the label a party or court uses to
    describe the claim for relief. For example, a request that the
    defendant pay damages could constitute a challenge under
    § 113(h) if it directly conflicts with the implementation of the
    cleanup plan. See Pakootas v. Teck Cominco Metals, Ltd.,
    
    646 F.3d 1214
    , 1221-22 (9th Cir. 2011) (construing a private
    plaintiff’s request for civil penalties resulting from the
    defendant’s noncompliance with an EPA administrative order
    as a challenge to an ongoing cleanup because the EPA had
    chosen not to sue to enforce its order and was using the
    leverage of civil penalties to ensure the defendant completed
    the remediation). And, conversely, a request for injunctive
    relief that has no effect on an ongoing cleanup is unlikely to
    constitute a challenge. See ARCO Envtl. Remediation, L.L.C.
    v. Dep’t of Health & Envtl. Quality of Mont., 
    213 F.3d 1108
    ,
    1113, 1115 (9th Cir. 2000) (holding that injunctive relief
    ordering the release of documentation to the public about a
    contaminated site does not challenge a pending cleanup effort
    because access to information “does not alter cleanup
    requirements or environmental standards” and does not
    “terminate or delay the … cleanup”). We must consider the
    form of relief that the plaintiffs request and its impact on the
    defendant to determine whether the requested relief
    challenges an ongoing cleanup.
    a.     Private Party Medical
    Monitoring
    Focusing on the specific relief requested here, payment
    for the costs of a private party medical monitoring program
    36
    does not appear to be a challenge under § 113(h). The prayer
    for relief at the end of each complaint expressly states that the
    Giovannis and Palmers want the Navy to provide “the costs
    of medical monitoring[.]” (G.J.A. at 27; P.A. at 16.) In their
    briefing, the Giovannis and Palmers insist that the relief
    “would simply impose the costs of setting up a medical
    monitoring trust fund on the [Navy.]” (Giovannis’ Opening
    Br. at 10; Palmers’ Reply Br. at 9-10.) Thus, according to
    both the Giovannis’ and Palmers’ characterization of the
    relief that they seek with respect to medical monitoring, the
    Navy need do nothing but fund a trust. That counsels in favor
    of concluding that the relief associated with the Giovannis’
    and Palmers’ medical monitoring claim is not a challenge
    under § 113(h). This is especially so because, as noted
    earlier, the private party medical monitoring program the
    Giovannis’ and Palmers’ want the Navy to fund is not a
    removal or remedial action.
    b.     Health Assessment or Health
    Effects Study
    The government-led health study requested by the
    Giovannis and Palmers, when viewed through the form-of-
    relief lens, appears in contrast to be a challenge under
    § 113(h) to ongoing response efforts at the Naval Facilities.
    That relief amounts to a demand that the Navy take on
    additional efforts related to cleaning up the contamination at
    those Superfund sites. Although the facts in this case differ
    from those in Hanford, which involved an injunction
    compelling the ATSDR to implement a health surveillance
    program, the relief requested here is analogous because the
    government is being asked to conduct a response action that
    the ATSDR may still be contemplating. And like the
    37
    plaintiffs in McClellan, who wanted the court to impose
    additional RCRA reporting and permitting requirements upon
    an ongoing cleanup, the requested injunctive relief here
    would interfere with the ongoing cleanup efforts at the Naval
    Facilities because it would modify or replace the existing
    remedial plan. The request for a government-led health
    assessment or health effects study is therefore effectively a
    request for injunctive relief, which counsels in favor of
    concluding that it is barred as a challenge under § 113(h).
    3.    Impact on Ongoing Cleanup Efforts
    Another consideration is whether, on the whole, there
    is some additional reason to think that a given request for
    relief will conflict with, impact, or otherwise interfere with an
    ongoing cleanup effort. See Boarhead, 
    923 F.2d at 1023
    (indicating that § 113(h) bars lawsuits that will “interfere
    with” ongoing remediation activities); see also Cannon, 
    538 F.3d at 1335
     (stating that § 113(h) precludes lawsuits that will
    “interfere[] with the implementation of a [selected] CERCLA
    remedy” (citation omitted)).
    a.     Private Party Medical
    Monitoring
    It seems unlikely that the Giovannis’ and Palmers’
    requests for the costs of private party medical monitoring will
    conflict with, impact, or otherwise interfere with the ongoing
    cleanup efforts at the Naval Facilities. It will “in no way
    impede[] the progress of the government’s ongoing
    assessment and cleanup” at the contaminated site. Yslava,
    
    845 F. Supp. at 710
    ; see also Durfey, 
    59 F.3d at 126
     (holding
    that the plaintiffs’ claim for private party medical monitoring
    38
    costs under state tort law was not a “challenge” to an ongoing
    CERCLA cleanup under § 113(h)). Moreover, an order
    requiring the Navy to pay a sum of money to fund a private
    party medical monitoring program will “not in any manner …
    interfere with the ongoing activities of the ATSDR.” Boggs
    v. Divested Atomic Corp., No. C-2-90-840, 
    1997 WL 33377790
    , at *6 (S.D. Ohio Mar. 24, 1997). Although any
    money the Navy would provide to fund private party medical
    monitoring could divert funds from the cleanup efforts at the
    Naval Facilities, that is insufficient, standing alone, to render
    such relief a challenge under § 113(h). See, e.g., El Paso Nat.
    Gas, 750 F.3d at 880 (“[E]very action that increases the cost
    of a cleanup or diverts resources or personnel from it does not
    thereby become a ‘challenge’ to the cleanup.” (quoting
    McClellan, 
    47 F.3d at 330
    )).
    The District Court nevertheless held that the medical
    monitoring claims are barred by § 113(h) because they
    challenge the ongoing cleanups at the Naval Facilities. In so
    holding, it relied heavily on our decision in Boarhead. We
    said in that case that “Congress enacted CERCLA so that the
    EPA would have the authority and the funds necessary to
    respond expeditiously to serious hazards without being
    stopped in its tracks by legal entanglement before or during
    the hazard clean-up.” 
    923 F.2d at 1019
    . We also said that the
    jurisdictional bar in § 113(h) was “designed to prevent time-
    consuming litigation from delaying the prompt clean-up of
    these [contaminated] sites.” Id. Notably, we described
    “disputes about who is responsible for a hazardous site, what
    measures actually are necessary to clean-up the site and
    remove the hazard[,] or who is responsible for its costs” as
    lawsuits best left for “after the site has been cleaned up.” Id.
    39
    The District Court here concluded that requiring the
    Navy to pay for medical monitoring would interfere with the
    ongoing cleanup efforts because it “would necessarily entail
    deciding a ‘dispute[] about who is responsible for [the]
    hazardous site’ and ‘who is responsible for its costs.’”
    (G.J.A. at 113 (alterations in original) (internal citations
    omitted).) The Court said that those “are decisions that
    Congress determined ‘should be dealt with after the site has
    been cleaned up.’” (G.J.A. at 113 (quoting Boarhead, 
    923 F.2d at 1019
    ).)
    That reliance on Boarhead is understandable but, in
    this instance, misplaced. The plaintiff in that case was
    “challenging the EPA’s ability to conduct an [environmental]
    study pursuant to § 104 of CERCLA before the EPA
    perform[ed] an appropriate review[.]” Boarhead, 
    923 F.2d at 1018
    . The plaintiff was thus directly interfering with the
    EPA’s ability to conduct a cleanup because it was seeking
    injunctive relief that would certainly have altered the existing
    remedial plans. The facts here are quite different. The
    Giovannis and Palmers want the Navy to fund a trust to cover
    the costs of private party medical monitoring rather than to
    take some additional action. And it is not clear that there
    would be any litigation about who is responsible for the
    contamination or the costs of the cleanup. The Navy freely
    admits that it “generated hazardous waste” and “released
    PFOA and PFOS” contaminants at the Naval Facilities.
    (Answering Br. at 11, 13.)
    Finally, the District Court specifically distinguished
    the conclusions in Durfey and Yslava that private party
    medical monitoring claims are not challenges under § 113(h)
    because, in its view, those cases failed to explain why state
    40
    law medical monitoring claims are not disputes about who is
    responsible and hence, under § 113(h), should be dealt with
    after the cleanup is complete. But we should not expect a
    discussion of “responsibility” for “necessary costs of
    response” and “response actions” in a case in which there has
    already been a determination that the requested remedy is not
    a “response” or “response cost.” Furthermore, Durfey
    involved a government-owned property that was
    contaminated with radioactivity during the development of
    the atomic bomb in the 1940s, so there was likely no dispute
    that the government was responsible for the contamination.
    Thus, the District Court’s conclusion that the Giovannis’ and
    Palmers’ requests for the costs of private party medical
    monitoring were challenges for purposes of § 113(h) is, in our
    estimation, without adequate support.
    b.     Health Assessment or Health
    Effects Study
    The story is different for a government-led health
    study. There is reason to believe that the Giovannis’ and
    Palmers’ requests that the Navy conduct a health assessment
    or health effects study will conflict with, impact, or otherwise
    interfere with the ongoing cleanup efforts at the Naval
    Facilities. That relief “seeks to improve on the CERCLA
    cleanup” by adding work to the removal or remedial action
    already selected by the federal government at those facilities.
    El Paso Nat. Gas, 750 F.3d at 880-81 (quoting McClellan, 
    47 F.3d at 330
    ). Ordering such relief necessarily preempts the
    federal government’s “ability to choose the best remedial
    action among a panoply of remedial alternatives that have
    been analyzed in a completed remedial investigation and
    feasibility study according to criteria articulated in
    41
    CERCLA,” id. at 881, especially with respect to those
    provisions relating to the ATSDR’s powers and obligations.
    Thus, the District Court’s conclusion that the Giovannis’ and
    Palmers’ requests for a government-led health study are
    challenges for purposes of § 113(h) is supported by the case
    law.
    In sum, we conclude that the Giovannis’ and Palmers’
    requests for funds to establish a private party medical
    monitoring program are not challenges for purposes of
    § 113(h),21 but their requests for an order mandating that the
    Navy conduct a health assessment or health effects study are.
    We therefore lack jurisdiction to review those latter requests
    at this time.
    21
    That conclusion is consistent with our decisions in
    the In re Paoli cases. See In re Paoli R.R. Yard PCB Litig.,
    
    916 F.2d 829
     (3d Cir. 1990) (“Paoli I”); In re Paoli R.R. Yard
    PCB Litig., 
    35 F.3d 717
     (3d Cir. 1994) (“Paoli II”); In re
    Paoli R.R. Yard PCB Litig., 
    113 F.3d 444
     (3d Cir. 1997)
    (“Paoli III”). In those cases, despite ongoing cleanup efforts
    by the EPA, we said that the plaintiffs could move forward
    with their state law claims for medical monitoring. See, e.g.,
    Paoli III, 
    113 F.3d at
    449 n.2; Paoli II, 
    35 F.3d at 785-95
    .
    Although we did not discuss § 113(h) in those cases, if we
    had reached a conclusion different than we do here, it would
    have undermined our jurisdiction to have decided them. See
    also Clinton Cty. Comm’rs v. EPA, 
    116 F.3d 1018
    , 1025 (3d
    Cir. 1997) (en banc) (concluding that § 113(h)’s bar to
    challenges of ongoing EPA remedial efforts strips the federal
    courts of subject matter jurisdiction).
    42
    4.    The Palmers’ Argument Under § 120
    of CERCLA
    Notwithstanding any argument under § 113(h), the
    Palmers argue that the cleanup activities at the federal Naval
    Facilities were initiated under § 120 rather than § 104, and
    thus that § 113(h) is inapplicable to bar their state-law claim.
    The Navy counters that § 120 merely describes additional
    procedures unique to federal land, and does not confer any
    authority outside of that already granted in § 104. We agree
    with the Navy.
    Section 113(h), by its plain text, bars “challenges to
    removal or remedial action selected under section [104] of
    [CERCLA.]” 
    42 U.S.C. § 9613
    (h). Section 104 broadly
    prescribes the applicable response authorities available under
    the statutory scheme. See 
    42 U.S.C. § 9604
    . Meanwhile,
    § 120, which is titled “Federal facilities[,]” describes the
    application of CERCLA’s provisions to federal facilities.
    Our analysis of a statute begins, of course, with the
    text. Haberle, 885 F.3d at 178. Section 104 states that “the
    President is authorized to act … to remove or arrange for the
    removal of, and provide for the remedial action relating to …
    [a] hazardous substance, pollutant, or contaminant at any time
    …, or take any other response measure … [he] deems
    necessary to protect the public health or welfare or the
    environment.” 
    42 U.S.C. § 9604
    (a)(1). That authority is
    granted in the broadest terms. There are a number of
    references to a “facility” or “facilities,” but there is no
    indication that Congress meant to distinguish between federal
    and non-federal facilities, or between Superfund and non-
    Superfund sites. Furthermore, § 101(9) provides a definition
    43
    of the term “facility” and also fails to distinguish between the
    federal and non-federal, or the Superfund and non-Superfund,
    nature of a site.22 Thus, the text of § 104 authorizes the
    President to take response actions at any facility with respect
    to any hazardous release, including a federal facility listed on
    the NPL.
    Section 120, which was added to CERCLA in 1986,
    see Pub. L. No. 99-499, 
    100 Stat. 1613
     (1986) (codified at 
    42 U.S.C. § 9601
     et seq.), has ever since been a source of
    confusion because of its imprecise language. It states that
    every “department, agency, and instrumentality of the United
    States … shall be subject to, and comply with, [CERCLA] in
    the same manner and to the same extent, both procedurally
    and substantively, as any nongovernmental entity, including
    liability under section [107] of [the Act].” 
    42 U.S.C. § 9620
    (a)(1). It then provides a number of specific duties and
    22
    Section 101(9) defines “facility” to mean:
    (A) any building, structure, installation,
    equipment, pipe or pipeline (including any pipe
    into a sewer or publicly owned treatment
    works), well, pit, pond, lagoon, impoundment,
    ditch, landfill, storage container, motor vehicle,
    rolling stock, or aircraft, or (B) any site or area
    where a hazardous substance has been
    deposited, stored, disposed of, or placed, or
    otherwise come to be located; but does not
    include any consumer product in consumer use
    or any vessel.
    
    42 U.S.C. § 9601
    (9).
    44
    procedures for the Administrator of the EPA with respect to
    federal facilities. See generally 
    id.
     § 9620. One of the
    subsections of § 120 says that “no authority vested in the
    Administrator under this section may be transferred, by
    executive order of the President or otherwise, to any other
    officer or employee of the United States or to any other
    person.” Id. § 9620(g). While that suggests that some
    authority has been granted to the federal government under
    § 120, that does not mean that the authority is necessarily
    independent from, and did not otherwise already exist in
    some form, under § 104 or some other section of CERCLA.
    Section 120 is best understood as clarifying the application of
    already existing CERCLA authority, like § 104, to federal
    facilities.23
    23
    An executive order from the person authorized to
    act under § 104 – the President of the United States –
    supports that reading. Specifically, Executive Order 12,580
    demonstrates that the President and his staff thought
    CERCLA conferred authority for him to initiate response
    actions under §§ 104, 113, 117, 119, 121, and 126 of that
    statute, because he delegated the functions vested under those
    provisions to various federal departments and agencies.
    Exec. Order No. 12,580, 
    52 Fed. Reg. 2923
    , 2924-25 (Jan. 23,
    1987). He did not distinguish between federal facilities and
    non-federal facilities in that delegation of authority. See 
    id. at 2924
     (delegating CERCLA functions in Section 2(e)(1) of the
    Order). Although the Palmers read Section 2(e)(1) of the
    Order, which is limited to facilities not on the NPL, as
    suggesting that § 104(a) only granted the President authority
    to act with respect to federal facilities not listed on the NPL,
    that is not the most logical reading. A better reading is that
    the President simply did not delegate the full scope of his
    45
    Other courts have similarly concluded that § 120 is not
    an independent and wholly separate grant of authority from
    § 104 for the cleanup of federal facilities. In Werlein v.
    United States, the court held that a remedial action at a
    federal facility was taken “under section [104], subject to the
    requirements of section [120].” 
    746 F. Supp. 887
    , 892 (D.
    Minn. 1990), vacated in part on other grounds, 
    793 F. Supp. 898
     (D. Minn. 1992). It reasoned that § 104(a)(1) grants the
    President response authority, which he delegated in Executive
    Order 12,580 to various agencies, both with respect to private
    land and federal land. Id. at 891. The court then explained
    that § 120 “provides a road map for application of CERCLA
    to federal facilities[,]” and that there would be little reason for
    the President to delegate response authority to the Secretary
    of Defense “[i]f section [104] did not apply to federal
    facilities.” Id. at 891-92. Although it acknowledged that
    some aspects of § 120 could be read to suggest it was
    providing a “separate and distinct” source of cleanup
    authority for federal facilities, the court said it was better to
    consider § 120 as a mere set of “separate procedures for
    federal facility cleanups[.]” Id. at 892; see also Heart of Am.
    Nw. v. Westinghouse Hanford Co., 
    820 F. Supp. 1265
    , 1279
    authority in the Order, since NPL sites presumably deserve
    greater attention at the highest levels of government. That
    reading is supported by Section 2(e)(2) of the Order, which
    reads similarly to Section 2(e)(1), except that it makes no
    reference to whether the federal facility is listed on the NPL.
    See id. at 2924-25. The Order contemplates that § 104
    included authority to act with respect to federal facilities, both
    NPL and non-NPL.
    46
    (E.D. Wash. 1993) (holding that an environmental cleanup at
    a federal facility listed on the NPL was conducted under
    § 104, not § 120).24
    Section 120 does create unnecessary tension with a
    logical reading of § 104, but, as we have indicated on
    numerous occasions, CERCLA is not the Mona Lisa of
    statutes. United States v. Rohm & Hass Co., 
    2 F.3d 1265
    ,
    1270 n.6 (3d Cir. 1993) (“Numerous courts have complained
    about the inartful, confusing, and ambiguous language and
    the absence of useful legislative history [of CERCLA].”),
    overruled on other grounds by United States v. E.I. DuPont
    de Nemours & Co., 
    432 F.3d 161
     (3d Cir. 2005) (en banc);
    Lansford-Coaldale Water Auth. v. Tonolli Corp., 
    4 F.3d 1209
    ,
    1221 (3d Cir. 1993) (“CERCLA … [is] notorious for its lack
    of clarity and poor draftsmanship[.]”); United States v. Alcan
    Aluminum Corp., 
    964 F.2d 252
    , 258 n.5 (3d Cir. 1992)
    (“[T]he statute is riddled with inconsistencies and
    redundancies.”). The tension is not so great as to warrant
    interpreting the statutory scheme in a manner that contravenes
    the likely intent of Congress. Adopting the Palmers’
    interpretation of CERCLA would lead to the odd result that
    litigants could not challenge ongoing cleanup work at private
    24
    We recognize, however, that not every court agrees
    with that conclusion. In Fort Ord Toxics Project, Inc. v.
    California E.P.A., the Ninth Circuit held that, while
    “troubling[,]” it is “most reasonable” to interpret §§ 104 and
    120 as separate grants of authority. 
    189 F.3d 828
    , 832 (9th
    Cir. 1999). We are not persuaded by that interpretation, and
    it is notable that no other circuit court has adopted Ford Ord’s
    reasoning.
    47
    facilities but they could run rampant with challenges to the
    same at federal Superfund sites.
    We therefore agree with the District Court that the
    EPA’s cleanup efforts at the Naval Facilities have been
    undertaken pursuant to § 104, subject to the requirements of
    § 120.25
    B.     Sovereign Immunity
    The Navy argues that even if the Giovannis’ and
    Palmers’ claims are not barred as challenges to ongoing
    response actions that they must nevertheless fail because of
    the government’s sovereign immunity. “As a sovereign, the
    United States is immune from suit unless it consents to be
    sued.” White-Squire v. U.S. Postal Serv., 
    592 F.3d 453
    , 456
    (3d Cir. 2010).       “Its consent to be sued must be
    ‘unequivocally expressed,’ and the terms of such consent
    define the court’s subject matter jurisdiction.” 
    Id.
     (quoting
    25
    The parties dispute whether the District Court was
    required to remand the claims to state court. Because we
    have concluded that § 113(h) does not bar the medical
    monitoring claims, there is federal jurisdiction over those
    claims and remand to state court is unnecessary. Section
    113(h) did not bar filing those claims initially in state court.
    Nor did § 113(b), because the claims arise under state law,
    not CERCLA. We will, however, affirm the District Court’s
    decision to dismiss the demands for a health effects study
    because those demands constitute challenges to the Navy’s
    ongoing cleanup, and thus neither we nor the state courts have
    jurisdiction to consider those claims at this time.
    48
    United States v. Mitchell, 
    445 U.S. 535
    , 538 (1980)).
    Importantly, even when there is a statutory waiver of
    immunity, “[w]e should not take it upon ourselves to extend
    the waiver beyond that which Congress intended.” 
    Id.
    (quoting United States v. Kubrick, 
    444 U.S. 111
    , 117-18
    (1979)). The Giovannis and Palmers contend that the Navy,
    as an agency of the United States, has waived its sovereign
    immunity pursuant to § 6001(a) of RCRA and pursuant to
    § 120(a)(1) of CERCLA. The Navy disagrees, and argues
    that there is no unequivocal waiver of its sovereign immunity.
    We think the Giovannis and Palmers have the better of the
    argument because § 6001(a) of RCRA unequivocally waives
    sovereign immunity to state law claims for injunctive relief.26
    26
    The Navy did not, however, waive its sovereign
    immunity under § 120(a)(1) of CERCLA. That provision
    states that “[e]ach department, agency, and instrumentality of
    the United States … shall be subject to, and comply with,
    [CERCLA] in the same manner and to the same extent, both
    procedurally and substantively, as any nongovernmental
    entity[.]” 
    42 U.S.C. § 9620
    (a)(1). Another subsection,
    however, says that “[s]tate laws concerning removal and
    remedial action, including State laws regarding enforcement,
    shall apply to removal and remedial action at facilities owned
    or operated by a department, agency, or instrumentality of the
    United States or facilities that are the subject of a deferral
    under subsection (h)(3)(C) of this section when such facilities
    are not included on the National Priorities List.” 
    Id.
    § 9620(a)(4) (emphasis added). The Naval Facilities are
    listed on the NPL, and thus the federal government has not
    exposed itself to liability under state law as it relates to its
    response efforts at those sites. See Warminster Twp. Mun.
    Auth. v. United States, 
    903 F. Supp. 847
    , 850 (E.D. Pa. 1995)
    49
    Section 6001(a) of RCRA provides that each
    department or agency of the federal government dealing with
    solid or hazardous wastes “shall be subject to, and comply
    with, all Federal, State, interstate, and local requirements,
    both substantive and procedural[.]” It goes on to state that
    “[t]he Federal, State, interstate, and local substantive and
    procedure requirements referred to in this subsection include,
    but are not limited to, all administrative orders and all civil
    and administrative penalties and fines[.]”         
    42 U.S.C. § 6961
    (a). Moreover, it provides that “[t]he United States
    hereby expressly waives any immunity otherwise applicable
    to the United States with respect to any substantive or
    procedural requirement (including, but not limited to, any
    injunctive relief, administrative order or civil or
    administrative penalty or fine …).” 
    Id.
     That waiver is wordy
    but the upshot is that the United States has surrendered its
    immunity with respect to the enforcement of federal, state,
    and local environmental laws due to contamination at the
    hands of the government, when such enforcement involves
    injunctive relief. 
    Id.
     The RCRA waiver does not, however,
    suggest that the government has waived its sovereign
    immunity for suits by private parties for money damages.
    The question thus becomes whether a medical monitoring
    claim is more appropriately classified as a request for money
    damages or for injunctive relief.
    The Giovannis and Palmers characterize their
    requested relief as an injunction ordering the Navy to fund a
    trust fund that will pay for private party medical monitoring.
    (“[T]he waiver of sovereign immunity described in CERCLA
    cannot operate to expose the Government to liability under
    the HSCA [for facilities on the NPL].”).
    50
    That led the District Court to logically concluded that the
    Giovannis and Palmers lawsuits sought “injunctive relief to
    compel medical monitoring[.]” (G.J.A. at 112.) Although the
    case law on that issue is less than clear, we think the better
    approach on this record is to classify the relief as injunctive.
    The characterization of medical monitoring appears to
    come up most often in mass exposure cases where putative
    class plaintiffs seek certification of an injunctive relief class
    under Federal Rule of Civil Procedure 23(b)(2). See, e.g.,
    Gates v. Rohm & Haas Co., 
    655 F.3d 255
    , 264 (3d Cir. 2011)
    (addressing putative Rule 23(b)(2) class seeking costs for
    medical monitoring); Barnes v. Am. Tobacco Co., 
    161 F.3d 127
    , 142 (3d Cir. 1998) (same). In that context, we have
    acknowledged that “[m]edical monitoring cannot be easily
    categorized as injunctive or monetary relief,” Gates, 655 F.3d
    at 262, but have not squarely resolved the issue, see, e.g., id.
    at 263 (declining to reach issue because the district court
    denied class certification “for reasons unrelated to the
    injunctive or monetary nature of the relief sought”). See also
    Barnes, 
    161 F.3d at 151
     (recognizing that medical monitoring
    claims can be brought “at law or in equity depending on the
    type of relief sought”).
    We have also said that “[i]f plaintiffs seek relief that is
    a disguised request for compensatory damages, then the
    medical monitoring claim can only be characterized as a
    claim for monetary damages.” 
    Id.
     (quoting Arch v. Am.
    Tobacco Co., Inc., 
    175 F.R.D. 469
    , 483 (E.D. Pa. 1997)). “A
    plaintiff cannot transform a claim for damages into an
    equitable action by asking for an injunction that orders the
    payment of money.” Jaffee v. United States, 
    592 F.2d 712
    ,
    715 (3d Cir. 1979). On the other hand, “if plaintiffs seek the
    51
    establishment of a court-supervised medical monitoring
    program through which the class members will receive
    periodic medical examinations, then plaintiffs’ medical
    monitoring claims can properly be characterized as a claim
    seeking injunctive relief.” Barnes, 
    161 F.3d at 151
     (quoting
    Arch, 175 F.R.D. at 483). Under those circumstances, “the
    creation of [an] expense does not necessarily remove a form
    of relief from the category of equitable remedies.” Jaffee,
    
    592 F.2d at 715
    . Therefore, whether a medical monitoring
    claim is a request for a legal remedy or one for equitable
    relief requires a case-specific analysis.
    Here, we are faced with a request for medical
    monitoring under HSCA. We have noted that, in Redland
    Soccer Club, Inc. v. Department of the Army, “[t]he
    Pennsylvania Supreme Court has endorsed awarding medical
    monitoring damages as a trust fund which ‘compensates the
    plaintiff for only the monitoring costs actually incurred.’”
    Gates, 655 F.3d at 263 (quoting Redland Soccer, 
    696 A.2d 137
    , 142 (Pa. 1997)). That Court expressly recognized the
    availability of medical monitoring relief in a claim under
    HSCA. 696 A.2d at 142. It characterized the plaintiffs in that
    case as having “requested equitable relief ... in the form of a
    medical monitoring trust fund[.]” Id. It then explained that
    the relief available for such a claim was the creation of a trust
    fund through its equitable powers, not a lump sum award of
    damages:
    A claim for a medical monitoring trust fund is
    significantly different from a claim for a lump
    sum award of damages.            A trust fund
    compensates the plaintiff for only the
    monitoring costs actually incurred. In contrast,
    52
    a lump sum award of damages is exactly that, a
    monetary award that the plaintiff can spend as
    he or she sees fit.       Various courts have
    advocated the trust fund approach instead of the
    lump sum approach.
    Id. at 142 n.6 (citations omitted).
    That case is not the only one in which a state high
    court concluded that the type of medical monitoring costs
    sought here is best characterized as injunctive relief. The
    New Jersey and Maryland Supreme Courts also agree. See
    Exxon Mobil Corp. v. Albright, 
    71 A.3d 30
    , 80 (Md. 2013)
    (“We note with approval the recent tendency of many courts
    that award medical monitoring costs to do so by establishing
    equitably a court-supervised fund, administered by a trustee,
    at the expense of the defendant.”); Ayers v. Township of
    Jackson, 
    525 A.2d 287
    , 314 (N.J. 1987) (“In our view, the use
    of a court-supervised fund to administer medical-surveillance
    payments in mass exposure cases … is a highly appropriate
    exercise of the Court’s equitable powers.”).
    The United States Supreme Court likewise appears to
    agree that a medical monitoring claim can be something other
    than a claim for money damages. In Metro-North Commuter
    Railroad Company v. Buckley, 
    521 U.S. 424
     (1997), a
    railroad worker had brought suit under the Federal
    Employers’ Liability Act (FELA) as a result of asbestos
    exposure. 
    Id. at 427
    . The worker, who was asymptomatic,
    had sought a lump-sum damages award for negligent
    infliction of emotional distress and for a related medical
    monitoring claim. 
    Id. at 426-27
    . The district court dismissed
    the FELA claim because the worker had not shown evidence
    53
    of actual physical harm, and the court declined to address the
    medical monitoring claim. 
    Id. at 428
    . The Second Circuit
    reversed, permitting the medical monitoring claim to proceed.
    
    Id. at 438-39
    . The Supreme Court granted certiorari and in
    turn reversed the Second Circuit.
    The Supreme Court interpreted the Second Circuit’s
    opinion as adopting the idea “that medical monitoring costs
    themselves represent a separate negligently caused economic
    ‘injury[]’ … permitting (as tort law ordinarily permits) the
    recovery of medical cost damages in the form of a lump
    sum[.]” 
    Id. at 439
    . With no FELA case law on point, the
    Supreme Court “canvassed the state-law cases that have
    considered whether the negligent causation of this kind of
    harm (i.e., causing a plaintiff, through negligent exposure to a
    toxic substance, to incur medical monitoring costs) by itself
    constitutes a sufficient basis for a tort recovery.” 
    Id. at 440
    .
    The Court described that body of law as revealing “that the
    cases authorizing recovery for medical monitoring in the
    absence of physical injury do not endorse a full-blown,
    traditional tort law case of action for lump-sum damages[.]”
    
    Id.
     “Rather,” the Court observed, “those courts, while
    recognizing that medical monitoring costs can amount to a
    harm that justifies a tort remedy, have suggested, or imposed,
    special limitations on that remedy.” 
    Id. at 440-41
    . The Court
    explained that the New Jersey Supreme Court had
    “recommend[ed] in future cases [the] creation of ‘a court-
    supervised fund to administer medical-surveillance
    payments[.]’” 
    Id. at 441
     (quoting Ayers, 525 A.3d at 314).
    The Supreme Court characterized the Second Circuit’s
    adoption of a lump-sum damages award for medical
    monitoring costs as “beyond the bounds of currently evolving
    54
    common law.” Id. at 440 (internal quotation marks and
    citation omitted).
    As it relates to the Giovannis’ and Palmers’ medical
    monitoring claims under HSCA, we now join those courts
    that have characterized that type of relief as primarily
    equitable in nature. The Giovannis’ and Palmers’ medical
    monitoring claims do not seek a lump sum of money to
    compensate them for past harm. Rather, those claims seek an
    order requiring the Navy to fund a trust that will cover a
    prospective private party medical monitoring program. That
    the Navy will have to expend money does not, in itself, make
    the desired relief a demand for money damages. Jaffee, 
    592 F.2d at 715
    . We therefore conclude that the Giovannis’ and
    Palmers’ medical monitoring claims are best understood as
    requests for injunctive relief.27
    Because RCRA waives sovereign immunity to claims
    for injunctive relief, the Navy is not immune from suit for the
    costs of private party medical monitoring. Accordingly, those
    claims may proceed.
    IV.   CONCLUSION
    For the foregoing reasons, we will affirm in part and
    vacate and remand in part the orders of dismissal.
    27
    Our analysis is limited to characterizing claims for
    private party medical monitoring under HSCA for purposes
    of the RCRA waiver of sovereign immunity. We do not
    decide today how to characterize claims for relief outside
    those limited circumstances.
    55
    BIBAS, Circuit Judge, concurring in part and concurring in the
    judgment.
    I agree with the majority that the government took its re-
    sponse actions at Navy facilities under § 9604, so I join part
    III.A.4 of the majority opinion. I also join part III.B because I
    agree with the limited holding that RCRA’s sovereign-immun-
    ity waiver does not bar claims that seek a medical-monitoring
    trust fund. See Maj. Op. at 55 n.27. So I concur in the judgment.
    But I would adopt the D.C. Circuit’s definition of a forbid-
    den “challenge,” limiting it to actions that would interfere with
    a cleanup. At root, I disagree that who does an action bears on
    whether that action meets CERCLA’s definitions of “removal”
    or “remedial.” In other words, I am unpersuaded by the Ninth
    Circuit’s decision in Hanford. While that opinion relies on leg-
    islative history and remedial purpose, I would stick to the stat-
    utory text. At the very least, we should adopt a single workable
    test to determine what are challenges barred by § 9613(h).
    Under the correct test, neither medical monitoring nor
    health assessments qualify as “challenges to removal or reme-
    dial action[s].” 
    42 U.S.C. § 9613
    (h). I agree with the majority
    that private medical monitoring is not a challenge. But my con-
    clusion would not change if the plaintiffs sought medical mon-
    itoring by the government. The same is true for health assess-
    ments.
    I. WE SHOULD ADOPT THE D.C. CIRCUIT’S
    INTERFERENCE TEST
    To determine what a forbidden “challenge” is, the majority
    takes a “holistic approach.” Maj. Op. at 20. It addresses each
    1
    of our sister circuits’ varied tests and applies them all. But
    adopting divergent tests leaves district courts without a work-
    able framework. Instead, we should distill the various tests into
    a single one. The D.C. Circuit has already done that work for
    us in El Paso Natural Gas, 750 F.3d at 880.
    Adopting the other circuits’ differing tests could produce
    divergent results. This case illustrates the point. The Giovan-
    nis’ and Palmers’ health-assessment claims are unlikely to call
    the remedial plan “into question.” Broward, 
    311 F.3d at 1073
    .
    And arguably it would not “interfere with the implementation
    of a CERCLA remedy” by “ ‘impact[ing] the [removal] action
    selected.’ ” Cannon, 
    538 F.3d at 1335
     (quoting Broward, 
    311 F.3d at 1072
    ). At most, health assessments could later prompt
    the EPA to take extra response actions if the health assessment
    revealed a significant risk. 
    42 U.S.C. § 9604
    (i)(11). But layer-
    ing new health measures, or even extra cleanup efforts, on top
    of an existing plan is not the same as challenging the measures
    already selected. On the other hand, a health assessment is “re-
    lated to the goals of cleanup.” Razore, 
    66 F.3d at 239
    . Still, the
    majority relies on all three of those opinions, plus El Paso. Maj.
    Op. at 16-17. I do not know how district courts will untangle
    this web.
    Instead, I would adopt El Paso’s interference test. The D.C.
    Circuit nicely synthesized our sister circuits’ varied tests into a
    single framework: a claim is a challenge under § 9613(h) “if it
    will interfere with a ‘removal’ or a ‘remedial action.’ ” El Paso,
    750 F.3d at 880 (emphasis in original) (discussing Cannon and
    Broward, among other cases). In close cases, courts must
    gauge how closely “the suit [relates to] the CERCLA cleanup:
    2
    the more closely related, the clearer it will be that the suit is a
    ‘challenge.’ ” Id. And the Ninth, Tenth, and D.C. Circuits agree
    that the statutory requirement of a “challenge” means “inter-
    ference” or something very close to it. El Paso, 750 F.3d at
    880; Cannon, 
    538 F.3d at 1335
    ; see also Razore, 
    66 F.3d at 239-40
     (finding “interfere[nce]” because the requested reme-
    dies could have “halted [cleanup efforts] for ‘days or weeks’ ”).
    I would simply add that “interfere” should carry its ordinary
    meaning: to “obstruct[ ] or hind[er].” Interference, Black’s
    Law Dictionary 831 (8th ed. 2004).
    II. MEDICAL MONITORING IS NOT A RESPONSE ACTION
    The majority artfully explains why private medical moni-
    toring is neither a removal nor a remedial action. But I see no
    reason why the quality of the action changes simply because
    the actor is the government.
    The Ninth Circuit’s opinion in Hanford, relied on by the
    majority, is unpersuasive. Maj. Op. at 27-29. There, the Ninth
    Circuit resorted too quickly to CERCLA’s legislative history
    and remedial purpose. 
    71 F.3d at 1478-81
    . But CERCLA does
    not distinguish governmental actors from private ones; the rel-
    evant provisions say nothing about who does the cleanup. As
    the majority notes, the law “gives ‘the President broad power
    to command government agencies and private parties to clean
    up hazardous waste sites.’ ” Maj. Op. at 14 (quoting Key Tronic
    Corp. v. United States, 
    511 U.S. 809
    , 814 (1994)). And the def-
    initions of “removal” and “remedial action[s]” are keyed to ac-
    tions, not actors. 
    42 U.S.C. § 9601
    (23) (listing “actions” that
    may need to be taken to “cleanup or remov[e] released hazard-
    3
    ous substances”) (emphasis added); 
    id.
     § 9601(24) (“[R]eme-
    dial action means those actions consistent with permanent
    remedy taken instead of or in addition to removal actions.”)
    (internal quotation marks omitted and emphases added).
    Given the statutory text’s explicit focus on actions, not ac-
    tors, I find Hanford’s focus on legislative history and purpose
    unpersuasive. So I would hold that § 9613(h) does not bar a suit
    seeking medical monitoring as “challenges to removal or re-
    medial action.”
    III. Nor Are Health Assessments Response Actions
    Nor does government involvement turn health assessments
    into removal or remedial actions. CERCLA explicitly distin-
    guishes health assessments from response actions. The statute
    allows recovery of
    (A) all costs of removal or remedial action in-
    curred by the United States Government or a
    State or an Indian tribe not inconsistent with the
    national contingency plan;
    (B) any other necessary costs of response in-
    curred by any other person consistent with the
    national contingency plan;
    (C) damages for injury to, destruction of, or loss
    of natural resources, including the reasonable
    costs of assessing such injury, destruction, or
    loss resulting from such a release; and
    4
    (D) the costs of any health assessment or health
    effects study carried out under section 9604(i) of
    this title.
    
    42 U.S.C. § 9607
    (a)(4) (emphases added). Since the statute
    enumerates response actions separately from health assess-
    ments, the two are distinct. Any other reading renders
    § 9607(a)(4)(D) superfluous.
    And subparagraph (D) was added later than (A) and (B).
    Superfund Amendments and Reauthorization Act of 1986,
    Pub. L. No. 99-499, § 107, 
    100 Stat. 1613
    . In fact, Congress
    added subparagraph (D) at the same time that it created the
    ATSDR and provided for medical monitoring and health as-
    sessments. 
    Id.
     §§ 107, 110. If health assessments were removal
    or remedial actions, then they would already have been cov-
    ered by § 9607(a)(4)(A) and (B). But health assessments were
    not, so Congress added § 9607(a)(4)(D). I would give full ef-
    fect to that addition.
    True, there is a colorable argument that the definition of a
    health assessment falls within the definition of a removal ac-
    tion. Health assessments examine “the potential risk to human
    health posed by individual sites and facilities.” 
    42 U.S.C. § 9604
    (i)(6)(F). That sounds a lot like “assess[ing], and eval-
    uat[ing] the release” of, hazardous substances. 
    Id.
     § 9601(23)
    (defining removal actions). Still, health assessments are unlike
    the other temporary measures listed in the definition of re-
    moval actions, like providing security fencing or monitoring
    the release of hazardous substances. They are not done at the
    cleanup site itself. And the enumeration of health assessments
    as distinct from removal actions in § 9607(a)(4) resolves any
    5
    doubt. So I would hold that health assessments are neither re-
    moval nor remedial actions.
    Nor would a health assessment interfere with any response
    action. On this record, I do not see how a health assessment
    would obstruct or hinder any ongoing cleanup. Sure, it might
    require the EPA to take more action if the assessment revealed
    a significant risk. Id. § 9604(i)(11). And those extra actions
    might include “provi[ding] alternative water supplies, tempo-
    rary evacuation and housing,” all of which are listed removal
    actions. Id. § 9604(23). But a health assessment is upstream
    from a response action. We lack jurisdiction over challenges to
    response actions only if they have been “selected.” Id.
    § 9613(h). But while an assessment may require new response
    actions, it is not an attack on the response itself.
    *****
    In short, § 9613(h) turns on whether the action would inter-
    fere with a removal or remedial action, not whether the actor
    is the government. Neither medical monitoring nor health as-
    sessments would interfere with an ongoing cleanup. So I would
    hold that neither kind of requested relief turns a suit into a chal-
    lenge.
    I agree with the majority that the court-supervised medical
    monitoring sought here is not a challenge and is not barred by
    sovereign immunity, so I concur in part and in the judgment.
    Because the majority finds that government-led health assess-
    ments are challenges barred by § 9613(h), it does not address
    whether sovereign immunity would bar those claims. So I too
    decline to reach that question.
    6
    

Document Info

Docket Number: 17-2473

Citation Numbers: 906 F.3d 94

Filed Date: 10/2/2018

Precedential Status: Precedential

Modified Date: 1/12/2023

Authorities (43)

Yslava v. Hughes Aircraft Co. , 845 F. Supp. 705 ( 1993 )

Cannon v. Gates , 538 F.3d 1328 ( 2008 )

Broward Gardens Tenants Ass'n v. United States ... , 311 F.3d 1066 ( 2002 )

redland-soccer-club-inc-bretni-brink-a-minor-by-tamara-brink-ryan , 55 F.3d 827 ( 1995 )

eileen-syms-individually-and-as-administrator-of-the-estate-of-john-syms , 408 F.3d 95 ( 2005 )

ira-p-daigle-and-mary-l-daigle-john-beaver-and-mary-winter-donald-e , 972 F.2d 1527 ( 1992 )

White-Squire v. United States Postal Service , 592 F.3d 453 ( 2010 )

Boarhead Corporation v. Edwin B. Erickson, Region ... , 923 F.2d 1011 ( 1991 )

gould-electronics-inc-fka-gould-inc-american-premier-underwriters , 220 F.3d 169 ( 2000 )

Lansford-Coaldale Joint Water Authority, in No. 92-7605 v. ... , 4 F.3d 1209 ( 1993 )

Agere Systems, Inc. v. Advanced Environmental Technology ... , 602 F. Supp. 3d 204 ( 2010 )

stanley-jaffee-and-sharon-blinn-jaffee-individually-and-stanley-jaffee-on , 592 F.2d 712 ( 1979 )

In Re Paoli Railroad Yard Pcb Litigation , 916 F.2d 829 ( 1990 )

in-re-paoli-railroad-yard-pcb-litigation-mabel-brown-individually-and-on , 113 F.3d 444 ( 1997 )

United States v. Rohm and Haas Company Rohm and Haas ... , 2 F.3d 1265 ( 1993 )

Clinton County Commissioners Arrest the Incinerator ... , 116 F.3d 1018 ( 1997 )

prodliabrep-cch-p-15407-william-barnes-ciaran-mcnally-catherine-potts , 161 F.3d 127 ( 1998 )

black-horse-lane-assoc-lp-a-new-jersey-limited-partnership-united , 228 F.3d 275 ( 2000 )

united-states-v-alcan-aluminum-corp-basf-corp-beazer-materials-and , 964 F.2d 252 ( 1992 )

In Re Paoli Railroad Yard PCB Litigation , 35 F.3d 717 ( 1994 )

View All Authorities »