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law superseded state law in Vermont, those that were hoping to shy away from the transition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