In a 6-2 decision in Gobeille v. Liberty Mutual released on March 1, the U.S. Supreme Court has dealt a blow to state all- payer claims databases. By upholding a lower court’s decision, the Court ruled that states may no longer require self funded plans to submit claims data – that action is preempted by ERISA.
NASHP Executive Director Trish Riley published a blog outlining what the decision means for states.
What was at issue?
At issue was whether or not a state can compel a self-insured employer to submit health care claims – data that shows how much was paid for health care services – to the state’s APCD.
Is Vermont the only state with APCD?
Currently 18 states have enacted laws to create APCD and 20 more are considering doing so.
What does this mean for states?
This case could have a chilling effect on APCD and the critical analysis regarding the costs and quality that they enable- if the court rules that self-insured employers need not provide data to those programs.
A decision against Vermont’s APCD will likely weaken an important and still evolving tool states have to guide their reforms – independent, complete claims data that includes all payers, whether regulated by the state or the federal government.
NASHP Resources
- Update: Sixth Circuit Declines to Expand ERISA; State Assessments on Self Funded Insurers Upheld
- Gobeille v. Liberty Mutual Update: Developments We are Watching
- Blog: Are States Losing Key Tools for Health Reform?
- Chart: Overview of State Programs that Utilize an Assessment of Self-Funded ERISA Plans
- Blog: All Eyes on Michigan: Will Assessments on All Health Plans Survive
- Blog: Gobeille v. Liberty Mutual: Decision
- Chart: All Amicus Briefs Filed in Gobeille v. Liberty Mutual
- What’s at Stake for States? The Lines are Drawn in Gobeille v. Liberty Mutual
- Vermont Gets its Day in Court on ERISA: Supreme Court Agrees to Hear Gobeille v. Liberty Mutual Next Term
- Are We There Yet? An Update on Gobeille v. Liberty Mutual
- Don’t Take Your Eyes Off Vermont: Gobeille v. Liberty Mutual Insurance Company