United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1995-07-25 monographic deposited born digital 70 p. GA 1.13:HEHS-95-167 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-95-167 P0b002ee180379f2d f:he95167 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-95-167 machine generated eng fdlp REPORT GAOREPORTS-HEHS-95-167 HEHS-95-167 Employee medical benefits Health insurance cost control Judicial opinions Health insurance Insurance premiums State law Insurance regulation State taxes Hawaii Massachusetts New York Oregon North Carolina Letter Report HEHS

Pursuant to congressional requests, GAO provided information on the: (1) Employee Retirement Income Security Act's (ERISA) relationship to the current system of employer-based health coverage; (2) implications of the trend toward employer self-funding on the oversight of employees' health care coverage; (3) kinds of state actions preempted by ERISA; and (4) advantages of ERISA preemption to employers that offer health care coverage to their workers.<p/>GAO found that: (1) although historically courts have interpreted ERISA to broadly restrict state regulation of employer health plans, recent Supreme Court decisions may allow states greater flexibility under general health care regulation provisions; (2) self-funded employer health plans appear to be increasing, but many employers are moderating their risks by using stop-loss coverage or managed care arrangements; (3) about 40 percent of ERISA plans, which cover about 44 million people, are employer self-funded plans which states are preempted from regulating and taxing because they are not considered to be insurance; (4) other ERISA plans cover an additional 27 percent of the U.S. population; (5) states believe that ERISA impedes their ability to ensure adequate consumer protections and enact health cost reduction reforms; (6) states also believe that they should be able to tax and collect data on all health plan participants uniformly; (6) employers believe that ERISA has made it possible for them to offer their employees health care coverage tailored to their needs and thus reduce their costs; and (7) employers fear that changes to ERISA that would give states greater regulatory flexibility would increase their costs and jeopardize their ability to provide employee health coverage. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-95-167/html/GAOREPORTS-HEHS-95-167.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-95-167/pdf/GAOREPORTS-HEHS-95-167.pdf GAO/HEHS-95-167 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-95-167 Letter Report GAO/HEHS-95-167; Employer-Based Health Plans: Issues, Trends, and Challenges Posed by ERISA; Employee medical benefits Health insurance cost control Judicial opinions Health insurance Insurance premiums State law Insurance regulation State taxes Hawaii Massachusetts New York Oregon North Carolina Title 15 Section 1012 Title 15 Section 1012(b) 15 U.S.C. 1012 15 U.S.C. 1012(b) Title 29 Section 1144(b)(6) Title 29 Section 1161et seq. Title 29 Section 301et seq. 29 U.S.C. 1144(b)(6) 29 U.S.C. 1161et seq. 29 U.S.C. 301et seq. Volume 59 Page 33 59 Stat. 33 Volume 72 Page 997 72 Stat. 997 Volume 88 Page 829 88 Stat. 829 Public Law 79-15 Public Law 85-836 Public Law 93-406