[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 1136 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                S. 1136

To amend the Employee Retirement Income Security Act of 1974 to provide 
  that the State preemption rules shall not apply to certain actions 
       under State law to protect health insurance policyholders.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 31, 1997

  Mr. Durbin introduced the following bill; which was read twice and 
         referred to the Committee on Labor and Human Resources

_______________________________________________________________________

                                 A BILL


 
To amend the Employee Retirement Income Security Act of 1974 to provide 
  that the State preemption rules shall not apply to certain actions 
       under State law to protect health insurance policyholders.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Employee Health Insurance 
Accountability Act of 1997''.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress finds that--
            (1) employer-sponsored health insurers' treatment rules and 
        coverage determinations affect patients' receipt of health care 
        by restricting the health services that are available to 
        patients;
            (2) physicians' behavior is affected by employer-sponsored 
        health insurers' treatment and coverage determinations;
            (3) medical malpractice is almost exclusively within the 
        jurisdiction of the States;
            (4) section 514(a) of the Employer Retirement Income 
        Security Act of 1974 (29 U.S.C. 1144(a) (``ERISA'')) generally 
        preempts State lawsuits against the entities that provide 
        employee benefits and retirement plans while allowing lawsuits 
        against physicians;
            (5) there is a split among the United States Courts of 
        Appeals on whether ERISA preempts medical malpractice suits 
        against employer-sponsored health insurers;
            (6) in the jurisdictions in which the Courts of Appeals 
        have held that ERISA preempts medical malpractice suits against 
        employer-sponsored health insurers, patients who may have been 
        injured due to their employer-sponsored health insurers' 
        treatment and coverage determinations have been left without a 
        right of action under which to bring a lawsuit to seek just 
        redress for their injuries; and
            (7) it is, therefore, necessary to amend ERISA to clarify 
        that State medical malpractice suits against an employer-
        sponsored health insurer are not preempted.
    (b) Purposes.--The purposes of this Act are as follows:
            (1) To restore accountability to employer-sponsored health 
        insurers for the impact of their treatment rules and coverage 
        determinations on patients' health.
            (2) To increase patient protection from adverse effects on 
        their health due to their employer-sponsored health insurers' 
        treatment rules and coverage determinations.
            (3) To provide patients with legal redress when their 
        employer-sponsored health insurers' treatment rules and 
        coverage determinations cause them harm.
            (4) To provide more equitable assignment of liability among 
        health care decision-makers so that plaintiffs are not forced 
        to attempt to hold physicians liable for the treatment rules 
        and coverage determinations of employer-sponsored health 
        insurers.

SEC. 3. ERISA PREEMPTION NOT TO APPLY TO CERTAIN ACTIONS INVOLVING 
              HEALTH INSURANCE POLICYHOLDERS.

    (a) In General.--Section 514(b) of the Employee Retirement Income 
Savings Act of 1974 (29 U.S.C. 1144(b)) is amended by redesignating 
paragraph (9) as paragraph (10) and by inserting after paragraph (8) 
the following paragraph:
            ``(9) Subsection (a) shall not be construed to preempt any 
        cause of action under State law to recover damages for medical 
        malpractice, personal injury, or wrongful death against any 
        entity that arises out of the provision by such entity of 
        insurance or administrative services to or for an employee 
        welfare benefit plan maintained to provide health care 
        benefits.''
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply to causes of action arising on or after the date of enactment of 
this Act.
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