By Lisa Soronen
Certainly not absolutely nothing. But how the U.S. Supreme Court views why states want this information and how they use it will likely determine the outcome of this case.
Vermont and at least 16 other states collect health care claims data. In Gobeille v. Liberty Mutual Insurance Company, the Supreme Court will decide whether the Employee Retirement Income Security Act (ERISA) pre-empts Vermont’s all-payers claims database (APCD) law. The State and Local Legal Center (SLLC) filed an amicus brief arguing against ERISA pre-emption.
ERISA applies to most health insurance plans and requires them to report detailed financial and actuarial information to the Department of Labor (DOL). ERISA pre-empts state laws if they “relate to” the core functions of an ERISA plan. Vermont’s APCD law seeks the following medical claims data: services provided, charges and payments for services, and demographic information about those covered.
The 2nd U.S. Circuit Court of Appeals concluded that ERISA pre-empts Vermont’s law because one of the key functions of ERISA is reporting. Vermont’s law imposes “burdensome, time-consuming, and risky” reporting obligations that are multiplied by other states’ APCD laws.
One judge dissented. He opined that that the ERISA and Vermont reporting requirements are too different to warrant pre-emption and that Vermont’s data collection isn’t burdensome. ERISA requires data reporting focused on asset allocation to avoid the mismanagement of funds or the failure to pay employee benefits. Vermont seeks different information “to fulfill its role of providing health care to its citizens.” Vermont’s law isn’t burdensome because it seeks data that health insurance companies already possess.
The SLLC amicus brief provides examples of how states, consumers, and health insurance companies are using APCD data to reduce the cost and increase the quality of health care. The brief also argues that the 2nd Circuit should have applied the presumption against pre-emption in this case because DOL doesn’t collect the same data as the states. The brief also points out that efforts towards uniformity among state APCD laws minimize the burden of reporting this already-available data.
The National Governors Association, National Conference of State Legislatures, Council of State Governments, National Association of Health Insurance Commissioner, and Association of State and Territorial Health Officials join the SLLC amicus brief which was written by Jennifer McAdams of the National Association of Insurance Commissioners.
This is the first significant pre-emption case the Supreme Court has decided in a while. Last term, the court only decided one pre-emption case, Oneok v. Learjet, holding that the Natural Gas Act does not pre-empt state-law antitrust lawsuits alleging price manipulation.
Lisa Soronen is the executive director of the State and Local Legal Center and writes frequently for the NCSL blog about the U.S. Supreme Court.