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ERISA: Health Resources for States
Table of Contents
NCSL Contact
Updated: July 2011
ERISA, which stands for the Employee Retirement Income Security Act, shields so-called "self-funded insuring" businesses from state and local regulation of the benefits they offer workers, including health insurance. Without the law, national companies in particular could achieve less uniformity in their benefit plans. But that uniformity comes at a cost: The law limits the abilities of state legislatures to regulate many types of health insurance, it restricts the kinds of remedies that states can authorize (such as a patient's right to independent appeal of denials or to see specialists) and it can limit the ability of states to experiment with novel ideas for health care solutions.
The federal health reform law (PPACA) made some fundamental changes in the relationship between the federal and state governments regarding health insurance and health benefits. However, most of those changes were in new statutes rather than direct amendments to or repeal of the existing ERISA statute. It is anticipated that future interpretations and possible litigation will clarify the role of ERISA effective 2014 and beyond. See "Potential Impact of PPACA" cited below
The following are resources, analyses and commentary on ERISA and the states. Several items are recently published; others are archive items but still of use for background research.
Online Resources
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The Potential Impact of PPACA on ERISA Preemption - Presentation slides provided by American Health Lawyers Association, May 2011. [40 slides, PDF format]
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ERISA Regulation of Health Plans: Fact Sheet- CRS Report, 2/6/03.
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U.S. Supreme Court Rules on ERISA Preemption of State Law Claims - The U.S. Supreme Court issued a much anticipated opinion for Aetna Health Inc. v. Davila and Cigna Healthcare of Texas, Inc. v. Calad June 21, 2004; both cases concerning preemption of state authority related to ERISA-governed health benefit plans. Analysis by NCSL Federal Affairs staff. Posted 4/07.
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"ERISA Preemption and State Health Reform"- By Jay E. Shushelsky, AARP Foundation Litigation, 9/19/07.
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"State and city health care reforms collide with a U.S. law" - Christian Science Monitor, 9/27/07.
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"ERISA Pre-emption: Implications for Health Reform and Coverage" - EBRI, 2/08.
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State Health Plans Challeneged by ERISA- NCSL, 8/31/08.
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Including Employer Financing in State Health Reform Initiatives: Implications of Recent Court Decisions- NASHP, 1/09.
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The Critical Role of ERISA in State Health Reform- Health Affairs, 1994
Back to: Health Insurance Resources at NCSL
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