SUPREME COURT OF THE UNITED STATES
_________________
No. 14–181
_________________
ALFRED GOBEILLE, in his official capacity as
chair of the vermont green mountaincare board, PETITIONER
v.
LIBERTYMUTUAL INSURANCE COMPANY
on writ of certiorari to the united states
court of appeals for the second circuit
[March 1, 2016]
Justice Ginsburg, with whom Justice Sotomayor
joins, dissenting.
To better control health care outcomes and
costs, Vermont requires all public and private entities that pay
for health care services provided to Vermont residents to supply
data to the State’s all-payer claims database. Many States have
similar databases in place or in development. The question
presented in this case is whether Vermont’s health care
data-collection law is preempted by the Employer Retirement Income
Security Act of 1974 (ERISA), 88Stat. 832, 29 U. S. C.
§1001
et seq., the federal law regulating employee
benefit plans. I would hold that Vermont’s effort to track health
care services provided to its residents and the cost of those
services does not impermissibly intrude on ERISA’s dominion over
employee benefit plans.
I
In 2005, the Vermont Legislature established
the Vermont Health Care Uniform Reporting and Evaluation System, a
database populated by information on health care claims paid by
insurers and other coverage providers. See Vt. Stat. Ann., Tit. 18,
§9410 (2015 Cum. Supp.); Reg. H–2008–01, Code Vt. Rules 21–040–021,
§4(D) (2016) (directing insurers and other coverage providers to
“submit medical claims data, pharmacy claims data, member
eligibility data, provider data, and other information related to
health care provided to Vermont residents and health care provided
by Vermont health care providers and facilities”). Health insurers
and other coverage providers must report the required data if they
cover at least 200 Vermont residents. §3(Ab).
Seventeen other States have enacted similar
database systems, called “all-payer claims databases.”[
1] These States, like Vermont, collect
health-claims data to serve compelling interests, including
identification of reforms effective to drive down health care
costs, evaluation of relative utility of different treatment
options, and detection of instances of discrimination in the
provision of care. See Brief for National Governors Association et
al. as
Amici Curiae 11–14; Brief for Harvard Law School
Center for Health Law and Policy Innovation et al. as
Amici
Curiae 11–18; Brief for State of New York et al. as
Amici
Curiae 12–20. See also Vt. Stat. Ann., Tit. 18, §9410(a)(1)
(Vermont’s data-collection law is designed to help “identif[y]
health care needs and infor[m] health care policy,” “evaluat[e] the
effectiveness of intervention programs on improving patient
outcomes,” “compar[e] costs between various treatment settings and
approaches,” “determin[e] the capacity and distribution of existing
resources,” and “provid[e] information to . . .
purchasers of health care”).[
2]
Respondent Liberty Mutual Insurance Company
(Lib-erty), in common with legions of employers, provides health
care to its employees through a self-insured plan, administered by
Blue Cross/Blue Shield (Blue Cross).[
3] Because Blue Cross administers thousands of health care
policies in Vermont, the State requires it to report data for all
of the plans it administers, and Blue Cross has complied with this
mandate. In 2010, for example, Blue Cross reported data on over
7,000 Vermont health care-plan beneficiaries. Roughly half of the
beneficiaries received coverage through self-insured employer
policies. App. 205. In 2011, at Liberty’s request, Blue Cross did
not submit data on Vermont residents who received coverage through
Liberty’s plan.
Id., at 21–23. Vermont ordered Blue Cross to
provide the claims data.
Id., at 23, 31–33. Lib-erty
instructed Blue Cross not to comply and, shortly thereafter, filed
the instant suit, seeking to block Vermont from obtaining the
data.
In defense of its resistance to Vermont’s
data-collection law, Liberty relies on its plan’s status as an
ERISA-covered “employee welfare benefit plan,” defined as “any
plan, fund, or program . . . established or maintained by
an employer . . . for the purpose of providing for its
participants or their beneficiaries, through the purchase of
insurance or otherwise, . . . medical, surgical, or
hospital care or benefits, or benefits in the event of sickness.”
29 U. S. C. §1002(1). Because ERISA directs plan
fiduciaries to conserve plan assets for the purpose of “providing
benefits to participants,” §1104(a)(1)(A)(ii), Liberty maintains
that ERISA preempts diverse state health-claims reporting laws. If
there is to be mandatory health-claims reporting by ERISA plans,
Liberty urges, the source of the mandate should be a uniform
national reporting regime. See Brief for Respondent 26–29; Tr. of
Oral Arg. 32–33.
Opposing ERISA-grounded preemption of its
data-collection law, Vermont points out that the efficacy of the
State’s law depends on comprehensive reporting,
i.e.,
collecting data on numerous beneficiaries from each of several
major segments of the health care market. See Brief for Petitioner
12; Brief for Harvard Law School Center for Health Law and Policy
Innovation et al. as
Amici Curiae 18–19.[
4] About half of Americans with health insurance
receive coverage from their employers, Dept. of Commerce, Bureau of
Census, J. Smith & C. Medalia, Health Insurance Coverage in the
United States: 2013, p. 2 (2014), and 61% of such persons are
covered by an employer’s self-insured plan. Brief for Harvard Law
School Center for Health Law and Policy Innovation et al. as
Amici Curiae 20. In Vermont, about 20% of the database’s
total content originates from employer self-insured plans. Brief
for Petitioner 12, and n. 10. Stopping States from collecting
claims data from self-insured employer health care plans would thus
hugely undermine the reporting regimes on which Vermont and other
States depend to maintain and improve the quality, and hold down
the cost, of health care services.
The United States District Court for the
District of Vermont rejected Liberty’s plea for preemption.
Vermont’s data-collection law, that court determined, served the
State’s undoubted interest in regulating health care markets, and
did not substantially interfere with the operation of Liberty’s
ERISA plans. See App. to Pet. for Cert. 64–66, 78–79. The Court of
Appeals for the Second Circuit reversed, two to one.
Liberty
Mut. Ins. Co. v.
Donegan, 746 F. 3d 497
(2014). The majority acknowledged that the Supreme Court’s
ERISA-preemption decisions of the 1990’s “marked something of a
pivot” in starting with a presumption “ ‘that Congress does
not intend to supplant state law,’ especially if the ‘state action
[occurs] in fields of traditional state regulation,’ like health
care.”
Id., at 506 (quoting
New York State Conference of
Blue Cross & Blue Shield Plans v.
Travelers Ins.
Co., 514 U. S. 645 –655 (1995)). Nonetheless, the majority
con-cluded that ERISA preempted the application of Vermont’s
data-collection law to Liberty’s plan. 746 F. 3d
, at
506, 508. The reporting of information about plan benefits, the
majority reasoned, qualifies as a “core ERISA functio[n]” and,
therefore, must be “subject to a uniform federal standard.”
Id., at 505, 508. Judge Straub dissented, offering a concise
critique of the majority’s opinion:
“The majority finds that the burden
imposed by the Vermont reporting requirement warrants preemption of
the [data-collection] statute. This conclusion falters for two
primary reasons. First, the reporting requirement imposed by the
Vermont statute differs in kind from the ‘reporting’ that is
required by ERISA and therefore was not the kind of state law
Congress intended to preempt. Second, Liberty Mutual has failed to
show any actual burden, much less a burden that triggers ERISA
preemption. Rather, the Vermont statute . . . does not
interfere with an ERISA plan’s administration of benefits.”
Id., at 511.
II
Essentially for the reasons Judge Straub
identified, I would hold that ERISA does not preempt Vermont’s
data-collection statute. That law and ERISA serve different
purposes. ERISA’s domain is the design and administration of
employee benefit plans: notably, prescriptions on the vesting of
benefits, claims processing, and the designation of beneficiaries.
See
Travelers, 514 U. S., at 656 (“Congress intended to
ensure that plans and plan sponsors would be subject to a uniform
body of benefits law. . . .” (internal quotation
marks omitted)). Its reporting requirements, geared to those
functions, ensure that the plans in fact provide covered benefits.
Vermont’s data-collection statute, in contrast, aims to improve the
quality and utilization, and reduce the cost, of health care in
Vermont by providing consumers, government officials, and
researchers with comprehensive data about the health care delivery
system. Nor does Vermont’s law impose burdens on ERISA plans of the
kind this Court has found sufficient to warrant preemption.
ERISA’s preemption clause provides that the Act
“shall supersede any and all State laws insofar as they may now or
hereafter relate to any employee benefit plan.” 29
U. S. C. §1144(a). Lacking clear direction from the
clause’s “opaque” text,
De Buono v.
NYSA–ILA Medical and
Clinical Services Fund, 520 U. S. 806, 809 (1997) , the
Court has sought to honor Congress’ evident call for an expansive
preemption principle without invalidating state regulations falling
outside ERISA’s domain. See
Travelers, 514 U. S., at
655–656 (“The governing text of [the] ERISA [preemption clause] is
clearly expansive. . . . [But] [i]f ‘relate to’ were
taken to extend to the furthest stretch of its indeterminacy, then
for all practical purposes pre-emption would never run its course,
for really, universally, relations stop nowhere.” (some internal
quotation marks omitted)).[
5]
Seeking to bring some measure of determinacy to
ERISA preemption, the Court has stated: “[A] law ‘relates to’ an
employee benefit plan . . . if it has a connection with
or reference to such a plan.”
Id., at 656 (some internal
quotation marks omitted). In this case, the Court of Appeals found,
and the parties do not here contest, that Vermont’s data-collection
law lacks “reference to” ERISA plans because the law applies to all
health care payers and does not home in on ERISA plans. See 746
F. 3d, at 508, n. 9. The question, therefore, is whether
the law has an impermissible “connection with” ERISA plans. Because
the term “ ‘connection with’ is scarcely more restrictive than
‘relate to,’ ” the Court has “cautioned against
. . . uncritical literalism,”
Egelhoff v.
Egelhoff, 532 U. S. 141, 147 (2001) (internal quotation
marks omitted), and has set out this further formulation: “[T]o
determine whether a state law has the forbidden connection, we look
both to the objectives of the ERISA statute as a guide to the scope
of the state law that Congress understood would survive, as well as
to the nature of the effect of the state law on ERISA plans.”
Ibid. (internal quotation marks omitted).
In framing preemption doctrine, the Court does
not “assum[e] lightly that Congress has derogated state regulation,
but instead . . . addresse[s] claims of pre-emption with
the starting presumption that Congress does not intend to supplant
state law,”
Travelers, 514 U. S., at 654, especially
where the State’s regulation deals with “matters of health and
safety,”
De Buono, 520 U. S., at 814 (internal
quotation marks omitted). In
Travelers and subsequent
decisions upholding state laws against preemption challenges, this
Court made clear that this presumption plays an important role in
ERISA cases.
Travelers, 514 U. S., at 654, 661;
California Div. of Labor Standards Enforcement v.
Dillingham Constr., N. A., Inc., 519 U. S. 316 –331
(1997);
De Buono, 520 U. S., at 814. Vermont’s
data-collection law is a vital part of the State’s control of its
own health care market. See
supra, at 1–2, 4; 746
F. 3d, at 513 (Straub, J., dissenting). The presumption
against preemption should thus apply full strength, and Liberty has
not rebutted it,
i.e., it has not shown that ERISA demands
the preemption of Vermont’s data-collection law. To the contrary,
the Court’s ERISA preemption precedent points
against
preemption in this case.
A
To determine whether Vermont’s data-collection
law, as applied to Liberty’s plan, has an impermissible “connection
with” ERISA plans, I look first to the “objectives of the ERISA
statute as a guide.”
Egelhoff, 532 U. S., at 147;
Oneok, Inc. v.
Learjet, Inc., 575 U. S. ___, ___
(2015) (slip op., at 11) (emphasizing “the importance of
considering the
target at which the state law
aims”
in applying ordinary field-preemption principles). Because ERISA’s
reporting requirements and the Vermont law elicit different
information and serve distinct purposes, there is no sensible
reason to find the Vermont data-collection law preempted.
ERISA-covered benefit plans must, absent
exemption, file annual reports containing financial and actuarial
data to enable the Secretary of Labor to evaluate plans’ management
and solvency. See 29 U. S. C. §§1023, 1024(a)(2)(B);
Dillingham, 519 U. S., at 326–327 (Congress
“established extensive reporting . . . requirements” to
protect against “the mismanagement of funds accumulated to finance
employee benefits and the failure to pay employees’ benefits from
accumulated funds.” (internal quotation marks omitted)).[
6]
Beyond debate, Vermont’s data-collection law
does not seek to regulate the management and solvency of
ERISA-covered welfare plans. See
supra, at 2 (reciting
objectives of the Vermont data-collection law). Vermont requests no
information on plan finances. See Reg. H–2008–01, Code of Vt. Rules
21–040–021, §4(D);
supra, at 2 (detailing the types of data
collected by Vermont). The State collects data on paid health care
claims, not denied claims. See §5(A)(8). Vermont seeks a better
understanding of how its residents obtain health care and how
effective that care is. Unlike ERISA superintendence, Vermont’s
interest does not lie in reviewing whether a self-insured provider
is keeping its bargain to covered employees. Nor does Vermont’s
statute even arguably regulate relationships among the prime ERISA
entities: beneficiaries, participants, administrators, employees,
trustees and other fiduciaries, and the plan itself.
Despite these significant differences between
ERISA’s reporting requirements and Vermont’s data-collection
regime, Liberty contends that Congress intended to spare ERISA
plans from benefit-related reporting requirements unless those
requirements are nationally uniform. In support of this contention,
Liberty points to dicta from this Court’s opinions and selections
from ERISA’s legislative history. See,
e.g., Travelers, 514
U. S., at 661 (“ ‘[S]ubject matters covered by ERISA
[include] reporting, disclosure, fiduciary responsibility, and the
like.’ ” (quoting
Shaw v.
Delta Air Lines, Inc.,
463 U. S. 85, 98 (1983) ));
Ingersoll-Rand Co. v.
McClendon, 498 U. S. 133, 137 (1990) (ERISA “sets
various uniform standards, including rules concerning reporting,
disclosure, and fiduciary responsibility, for both pension and
welfare plans.”); 120 Cong. Rec. 29942 (1974) (remarks of Sen.
Javits) (“State laws compelling disclosure from . . .
plans . . . will be superseded.”). Far from unambiguously
endorsing Liberty’s sweeping view of ERISA’s preemptive scope,
these statements can be read at least as reasonably for the
unremarkable principle that ERISA preempts state reporting rules
designed to serve the same purposes as ERISA’s reporting
requirements. This more limited understanding is consistent with
the Court’s admonition to pay close attention to the “objectives of
the ERISA statute as a guide.”
Egelhoff, 532 U. S., at
147.
B
Satisfied that ERISA’s objectives do not
require preemption of Vermont’s data-collection law, I turn to the
“nature of the effect of the state law on ERISA plans.”
Ibid. The imposition of some burdens on the administration
of ERISA plans, the Court has held, does not suffice to require
preemption. See
De Buono, 520 U. S., at 815. While a
law imposing costs so acute as to effectively dictate how a plan is
designed or administered could trigger preemption, see
id.,
at 816, n. 16, no such extreme effects are present here.
Moreover, no “central matter of plan administration,”
Egelhoff, 532 U. S., at 148, is touched by Vermont’s
data-collection law. That law prescribes no vesting requirements,
benefit levels, beneficiary designations, or rules on how claims
should be processed or paid. Indeed, Vermont’s law does not require
Liberty to do anything. The burden of compliance falls on Blue
Cross, which apparently provides the data without protest on behalf
of other self-funded plans. See
supra, at 3.
Reporting and disclosure are no doubt required
of ERISA plans, but those requirements are ancillary to the areas
ERISA governs. Reporting and recordkeeping incident to state laws
of general applicability have been upheld as they bear on ERISA
plans. In
De Buono, 520 U. S., at 809–810, 816, for
example, the Court held that a gross-receipts tax on patient
services provided by a hospital operated by an ERISA plan was not
preempted, even though administration of the tax required filing
quarterly reports. And in
Dillingham, 519 U. S., at
319, the Court held that California’s prevailing-wage law was not
preempted as applied to apprenticeship programs established by
ERISA plans. Prevailing-wage laws typically require employees to
keep records of the wages paid to employees and make them available
for review by state authorities. See,
e.g., Cal. Lab. Code
Ann. §1776 (West 1989) (prevailing-wage law in
Dillingham).
The Second Circuit erred, then, in holding that ERISA preempts any
state-law reporting obligation that is more than “slight.” See 746
F. 3d, at 508–509.
The Vermont data-collection statute keeps
company with the laws considered in
De Buono and
Dillingham: It is generally applicable and does not involve
“a central matter of plan administration.”
Egelhoff, 532
U. S., at 148. And, as Judge Straub emphasized in his dissent,
Liberty “failed to provide any details or showing of the alleged
burden,” instead “arguing only that ‘all regulations have their
costs.’ ” 746 F. 3d, at 515 (quoting Liberty’s appellate
brief).
As the United States explains, the supposition
indulged by the Second Circuit that Vermont’s law imposed a
substantial burden “is not obvious, or even particularly plausible,
without any factual support.” Brief for United States as
Amicus
Curiae 28. The data-collection law “essentially requires Blue
Cross [Liberty’s third-party administrator] to take information
generated in the ordinary course of its claims-payment operations
and report that information in a prescribed format to the [State].”
Ibid. The Court of Appeals majority accentuated the sheer
number of data entries that must be reported to Vermont. See 746
F. 3d, at 509–510, and n. 13. Accord
ante, at 1
(opinion of Breyer, J.) Entirely overlooked in that enumeration is
the technological capacity for efficient computer-based data
storage, formatting, and submission. See Brief for National
Association of Health Data Organizations et al. as
Amici
Curiae 7–9, 13 (describing three-step electronic path data take
from health provider, to insurer or health care plan, and
ultimately to the State’s database).[
7] Where regulatory compliance depends upon the use of
evolving technologies, it should be incumbent on the objector to
show concretely what the alleged regulatory burden in fact
entails.[
8]
Because data-collection laws like Vermont’s are
not uniform from State to State, compliance is inevitably
burdensome, Liberty successfully argued in the Court of Appeals.
The Court replays this reasoning in today’s opinion. See
ante, at 7, 10. But state-law diversity is a hallmark of our
political system and has been lauded in this Court’s opinions. See,
e.g., Arizona State Legislature v.
Arizona Independent
Redistricting Comm’n, 576 U. S. ___, ___ (2015) (slip op.,
at 28) (“This Court has long recognized the role of States as
laboratories for devising solutions to difficult legal problems.”
(citing
New State Ice Co. v.
Liebmann, 285 U. S.
262, 311 (1932) (Brandeis, J., dissenting); internal quotation
marks omitted)). Something more than an inherent characteristic of
our federal system, therefore, must underpin the ERISA-grounded
preemption Liberty urges.[
9]
Liberty points to
Egelhoff as exemplary.
In
Egelhoff, 532 U. S., at 143–144, a deceased
ERISA-plan participant’s ex-spouse challenged a state law that
revoked her beneficiary status automatically upon her divorce, even
though the ERISA plan’s terms did not. The Court held that ERISA
preempted the law because it “binds ERISA plan administrators to a
particular choice of rules for determining beneficiary status.”
Id., at 147. In that context, the Court said: “Requiring
ERISA administrators to master the relevant laws of 50 States
. . . would undermine the congressional goal of
minimizing the administrative and financial burdens on plan
administrators—burdens ultimately borne by the beneficiaries.”
Id., at 149–150 (internal quotation marks and brackets
omitted).
The Court took care, however, to confine
Egelhoff to issues implicating “a central matter of plan
administration,” in other words, “a core ERISA concern.”
Id., at 147–148. What does that category comprise? As
earlier described, see
supra, at 6, 11, prescriptions on
benefit levels, beneficiary designations, vesting requirements, and
rules on processing and payment of claims would rank under the
central or core ERISA subject-matter rubric.[
10] So, too, would reporting and disclosure
obligations, but of what kind? Those that further regulation of the
design and administration of employee benefit plans,
i.e.,
reporting and disclosures tied to the areas ERISA governs. ERISA’s
reporting and disclosure requirements are thus concerned with
mismanagement of funds, failure to pay employee benefits, plan
assets or allocations, all information bearing on the financial
integrity of the plan. See
supra, at 8–9. Vermont’s
data-collection law, eliciting information on medical claims,
services provided to beneficiaries, charges and payment for those
services, and demographic makeup of those receiving benefits, does
not fit the bill any more than reporting relating to a plan’s taxes
or wage payments does.
Numerous States have informed the Court of their
urgent need for information yielded by their health care
data-collection laws. See Brief for National Governors Association
et al. as
Amici Curiae; Brief for State of New York et
al. as
Amici Curiae; Brief for Connecticut Health Insurance
Exchange as
Amicus Curiae; Brief for State of New Hampshire
as
Amicus Curiae. Wait until the Federal Government acts is
the Court’s response. The Department of Labor’s capacious grant of
statutory authority, the Court observes, might allow it to collect
the same data Vermont and other States seek about ERISA plan
health-benefit payments. See
ante, at 10;
ante, at
2–3 (opinion of Breyer, J.). Once the information is collected, the
Court conjectures, the Department could pass the data on to the
States. Cf.
ante, at 2–3 (opinion of Breyer, J.) (suggesting
that States could seek the Department’s permission to enforce
reporting requirements like Vermont’s). It is unsettling, however,
to leave the States dependent on a federal agency’s grace,
i.e., the Department of Labor’s willingness to take on a
chore divorced from ERISA’s objectives.[
11]
* * *
Declaring “reporting,” unmodified, a central
or core ERISA function, as the Second Circuit did, 746 F. 3d,
at 508, passes the line this Court drew in
Travelers,
De
Buono, and
Dillingham when it reined in §1144(a) so that
it would no longer operate as a “super-preemption” provision.
Bogan, Protecting Patient Rights Despite ERISA, 74 Tulane L. Rev.
951, 959 (2000); see
supra, at 8. I dissent from the Court’s
retrieval of preemption doctrine that belongs in the discard
bin.