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.