ERISA and the States

Updated May 2008.

ERISA, which stands for the Employee Retirement Income Security Act, shields 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 sue an HMO) and it can limit the ability of states to experiment with novel ideas for health care solutions.

The following are resources, analyses and commentary on ERISA and the states. Several items are newly published; others are archive items written in the late 1990's but still of use for background research.

On-Line Resources
ERISA and state preemption - includes history of managed care "right to sue" state laws and links to general ERISA-state analyses. (2007 update) ERISA and State Health Insurance Regulation Maryland's Fair Share Health Care Fund Act Overturned in ERISA Challenge Maryland: an ERISA Case Study 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.
Health Insurance Resources at NCSL (2007)
Links to Additional Resources "ERISA Pre-emption: Implications for Health Reform and Coverage" - EBRI, February 2008. "ERISA Preemption and State Health Reform" by Jay E. Shushelsky, AARP Foundation Litigation (9/19/07) "State and city health care reforms collide with a U.S. law" - Christian Science Monitor, 9/27/07)
HIPAA (Health Insurance Portability & Accountability Act) Law summary by NCSL Health Committee. Published 1996; still mostly applicable in 2007)
What Next from Washington? HIPAA and the Prospect for Managed Care Reform (1999)

Note: Some material was first produced as an audioconference that took place in March 1999, titled ERISA 101: Running the Federal Roadblock to State Insurance Reform.

Return to Health Menu Page

ERISA and the States

On-Line Resources