ERISA Preemption of State “Play or Pay” Mandates: How PPACA Clouds an Already Confusing Picture

Abstract

From the introduction:

Although ERISA preemption was ranked among the top "eight pertinent issues" that needed to be addressed in order to achieve comprehensive health care reform, Congress opted to avoid it when it passed the Patient Protection and Affordable Health Care Act on March 23, 2010, and the Health Care and Education Reconciliation Act just one week later ("PPACA" or the "Act", collectively). Currently 180 million Americans receive employer-sponsored health benefits, and millions more will do so once PPACA takes full effect over the next few years. This expansion of employer based coverage, coupled with what the Act does and does not do regarding the role of employers, makes ERISA preemption potentially more problematic than ever. Thus, to accomplish meaningful improvements in how employer-sponsored health benefits are financed and delivered, Congress must tackle ERISA preemption of state "play or pay" laws if it expects to improve instead of simply expand and exacerbate existing problems with employer coverage.