Gobeille v. Liberty Mutual Insurance Company
Issues
Does the Employee Retirement Income Security Act of 1974 (ERISA) preempt Vermont data reporting laws, which require companies that process insurance claims to report certain medical claims data to the state?
Vermont enacted legislation that created a “unified health care database” designed to improve the affordability and quality of health care in Vermont by collecting and analyzing statewide data on insurance claims. See Liberty Mut. Ins. Co. v. Donegan, 746 F.3d 497, 500–01 (2d Cir. 2014); see also Vt. Stat. Ann. tit. 18 § 9410(a)(1). Liberty Mutual offers a health insurance benefit plan to Vermont residents; the Employee Retirement Income Security Act of 1974 (“ERISA”) governs benefit plans. See id. ERISA requires benefits plans to make claim data reports to the Department of Labor, and generally preempts any state laws that relate to an employee benefit plan. See id. at 503. In August 2011, the Vermont Department of Banking, Insurance, Securities and Health Care Administration (the “Department”) subpoenaed claims data from Blue Cross and Blue Shield of Massachusetts, the company that administers Liberty Mutual’s Plan. See id. at 502. In district court, Liberty Mutual sought to enjoin the subpoena, arguing ERISA preempted Vermont’s reporting requirements. See id. On appeal, the Court of Appeals for the Second Circuit held that ERISA did preempt the reporting requirements. See id. But Alfred Gobeille, chair of the Vermont Green Mountain Care Board, maintains that ERISA does not preempt Vermont’s law, because (1) Vermont’s law falls under the traditional state power to regulate health care, (2) the law does not infringe any core function of ERISA, and (3) Congress intended for states to retain the ability to collect health care data. See Brief for Petitioner, Alfred Gobeille at 25. Liberty Mutual counters, arguing that Vermont’s reporting requirements conflict with Congress’s intent to create a uniform federal reporting regime, and thus constitute precisely the kind of state law that Congress intended ERISA to preempt. See Brief for Respondent, Liberty Mut. Ins. Co. at 13. The Supreme Court’s resolution of this case will impact the cost to consumers of purchasing health care, the quality of that care, and the resources that the insurance companies must spend on claims data reporting procedures. See Brief of Amici Curiae AARP et al., in Support of Petitioner at 9-10, 11; Brief of Amici Curiae The American Benefits Council et al., in Support of Respondent at 24, 27-28.
Questions as Framed for the Court by the Parties
May Vermont apply its health care database law to the third-party administrator for a self-insured ERISA plan?
Liberty Mutual Insurance Company administers a health plan, the Liberty Mutual Medical Plan (the “Plan”), which covers 84,000 people nationwide and 137 people in Vermont. See Liberty Mut. Ins. Co. v. Donegan, 746 F.3d 497, 501 (2d Cir.
Written by
Edited by
Additional Resources
- Lisa Schenker, Who Controls the Data? U.S. Supreme Court Agrees to Hear Healthcare Case, Modern Healthcare (June 29, 2015).