The Supreme Court held 6-2 in Gobeille v. Liberty Mutual Insurance Company that the Employee Retirement Income Security Act (ERISA) preempts Vermont’s all-payers claims database (APCD) law. Seventeen other states collect health care claims data. The State and Local Legal Center (SLLC) filed an amicus brief arguing against ERISA preemption, which Justice Ginsburg cited three times in her dissenting opinion.

ERISA applies to the majority of health insurance plans. Rather than guaranteeing substantive benefits, it mandates oversight over plans. ERISA preempts all state laws that “relate” to any employee benefits plan. Vermont’s APCD law requires health insurers to report to the state information related to health care costs, prices, quality, and utilization, among other things.

Policymakers in the states and territories (“the states”) are facing two major health care dilemmas in 2012—Medicaid spending and implementation of the Affordable Care Act. Medicaid  enrollment continues to grow, federal stimulus funds have disappeared and in many states providers are pressing for increased reimbursement. States also must grapple with complying with mandates in the federal health care reform law. The U.S. Supreme Court is expected to rule on the constitutionality of the law sometime in 2012. In the meantime, states must decide how far to go in their own implementation.

Top-of-the-mind health care topics in states are Medicaid and implementation of the federal Affordable Care Act. Medicaid enrollment continues to grow, federal stimulus funds have disappeared, and in many states providers are pressuring for increased reimbursement. States also must grapple with complying with mandates in the federal Affordable Care Act. The U.S. Supreme Court is expected to rule on the constitutionality of the law sometime in 2012. In the meantime, states must decide how far to go in their own implementation.

 

Ask state legislators what the top health issues will be in the upcoming 2011 session and the answer is likely to be “Medicaid, Medicaid and Medicaid.” States will struggle to maintain service levels for current enrollees. At the same time, states need to begin planning for the coverage expansions mandated by federal health reform even as many fear the budget math is simply unworkable. 

A survey of states' adoption of health information technology, included methodology and percent of prescriptions transmitted electronically.