ERISA: A Bipartisan Problem for the ACA and the AHCA

By Allison K. Hoffman

On Monday, the Supreme Court decided another case that enhances ERISA’s deregulatory impact, Advocate Health Care Network v. Stapleton (holding that pension plans maintained by church-affiliated organizations, including hospitals, are exempt from ERISA’s pension protections as “church plans.”). Justice Sotomayor joined the majority opinion but wrote a concurring opinion lamenting its outcome and suggesting that Congress rethink ERISA — a suggestion Justices Thomas and Ginsburg have also made in the past. Abbe Gluck, Peter Jacobson, and I wrote the following on ERISA’s increasingly outsized influence and how it poses an impediment to health reform in the Health Affairs Blog on June 2, 2017.

From our post:

The Supreme Court has once again been called on to mediate the boundaries of a far-reaching, infamously complex, federal employee benefits law. And once again this law may have an important and unanticipated effect on health care.

The main goal of this law, the Employee Retirement Income Security Act of 1974 (ERISA), was to provide uniform, federal regulation of pensions and employee benefit plans (including health care). But the law has had a far more dramatic impact on health policy beyond what Congress ever contemplated. Because ERISA pushes aside state regulation of these plans, it has impeded the states’ ability to partner with the federal government to achieve key health policy goals. ERISA has also stymied some of Congress’s goals under the Affordable Care Act, and may prove an even greater obstacle to Republican efforts to return more authority over health policy to the states.

ERISA and health reform have not meshed well. For instance, the ACA’s attempt to create greater uniformity of benefits is at odds with the way ERISA creates a special class of protected plans and blocks states efforts to regulate them. When you ask yourself why the ACA’s guarantee of essential health benefits applies to some health plans but not to others, the answer is deference to ERISA. When you ask yourself why some health plans are subject to state-mandated benefit laws but some remain exempt, the answer is ERISA. […]

Read the full post on the Health Affairs Blog!

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.