Topic Paper #4

Topic Paper #4

Adam Ingram

MSAH 6500

Prof. Paul Longenecker

15 March, 2016

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Topic Paper #4

Affordable Care Act: Turning Reporting Requirements Into An Effective Strategy

As of 1 March, 2016, the Supreme Court has declared that “a Vermont law that requires health

insurers to report a broad variety of statistics violates the federal statue governing employee

benefit plans” under the Employment Retirement Income Security Act of 1974 (ERISA) (Fisher,

2016). This Supreme Court decision will go out and effect 17 other states, and may lead back to

the Affordable Care Act (ACA) soon- the ACA has a key provision that includes strategies for

quality measures reporting and reimbursement (Hader, 2015). As statistical reporting, be it

broad or specific to states or insurance companies, was deemed unconstitutional and federal

law superseded state law in Vermont, those that were hoping to shy away from the transition

to quality of care versus volume of care may have just found their new mark to do so. The

Supreme Court acknowledged that ERISA’s language is broad preempting “any and all State

laws insofar as they may now or hereafter relate to any employee benefit plan;” however,

Vermont argued its scheme wasn’t preempted because it had different objectives- those

intended to track spending and financial solvency of plans, not to limit pre-emption of insurers-

as preemption means, the purchase of goods or shares by one person or party before the

opportunity is offered to others (Fisher, 2016). An interesting note to this, however, is that

there are doubts whether ERISA’s preemption clause, the one that was ruled upon in Vermont,

is actually valid- “… the provision of Article I authorizes Congress to prohibit States from

applying a host of generally applicable civil laws to ERISA plans. Just because Congress can

regulate some aspects of ERISA plans pursuant to the Commerce Clause does not mean that

Congress can exempt ERISA plans from state regulations that have nothing to do with interstate

commerce (Hader, 2015; Fisher, 2016).”

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Topic Paper #4

References

Fisher, D. (2016, March 1). Vermont Healthcare- Reporting Law Violates ERISA, Supreme

Court Says. Forbes.

Hader, A. L. (2015). Affordable Care Act: Turning Reporting Requirements Into an Effective

Strategy. AORN Journal, 101(2), 270-273 4p. doi:10.1016/j.aorn.2014.11.005

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