Thematic Areas

The Role of ERISA Preemption in Health Reform

Peter Jacobson, JD, MPH

Paper Summary

The Employee Retirement Income Security Act (ERISA) is a federal law regulating the administration of private employer-sponsored benefits including health benefits (i.e., health insurance offered by an employer). In general, since the federal government has exercised its authority to preempt state regulation of the administration of private employer-sponsored health plans, states are blocked from enforcing laws interfering with ERISA.

As many states pursue health care reform experiments, ERISA preemption becomes relevant as a potential limit on the scope and type of reforms states are able to enact. The dominant trend in ERISA litigation has been to preempt state legislation and litigation interfering with the administration of private employer sponsored health plans, making large-scale state health care reform initiatives difficult. The purpose of this paper is to examine the trajectory of judicial interpretation of ERISA and to discuss what opportunities exist to facilitate health care initiatives given the constraints of ERISA preemption.

About the Author

Peter D. Jacobson, J.D., M.P.H., is Professor of Health Law and Policy, and Director, Center for Law, Ethics, and Health, at the University of Michigan School of Public Health. He teaches courses on health law, public health law, and health care regulations. Before coming to the University of Michigan, Professor Jacobson was a senior behavioral scientist at the RAND Corporation in Santa Monica, California.

In 1995, he received an Investigator Award in Health Policy Research from the Robert Wood Johnson Foundation to examine the role of the courts in shaping health care policy. The project culminated in the publication of the book Strangers in the Night: Law and Medicine in the Managed Care Era (Oxford University Press, 2002). Jacobson co-authored a law school casebook with Lawrence O. Gostin titled Law and the Health System (Foundation Press, 2005), and is also a co-author of False Hope vs. Evidence-Based Medicine: The Story of a Failed Treatment for Breast Cancer (Oxford University Press, 2007).

Professor Jacobson's current research interests focus on the relationship between law and health care delivery, law and public health systems, public health ethics, and health care safety net services. Currently, he is the Principal Investigator (PI) on studies examining how public health practitioners define and resolve day-to-day ethical challenges, the impact of state and federal law on public health preparedness, and enhancing organizational and operational efficiencies in Michigan's health care safety net providers.