ACA的2017年国家创新豁免:ERISA是有意义的医疗改革的障碍吗?

M. Tumber
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引用次数: 2

摘要

2017年,《平价医疗法案》(ACA)的州创新豁免(§1332)将使各州能够放弃ACA的许多条款,并制定自己的创造性解决方案来控制医疗支出。1974年颁布的《雇员退休收入保障法》(ERISA)是为了鼓励雇主赞助福利计划,并尽量减少与现有州法律的潜在冲突。由于ERISA,雇员福利计划(包括健康计划)的监管主要属于联邦管辖范围,涉及约1.31亿人。本文探讨了ERISA在§1332下为有意义的州一级医疗改革提出重大障碍的方式。州法律不能直接提及ERISA,也不能影响ERISA计划的利益、管理或结构。此外,如果一项州法律对雇主的选择限制太多,它可能会违反ERISA。本说明建议,ERISA需要被放弃、修改或废除,以便各州能够根据§1332实施有意义的医疗改革。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The ACA's 2017 State Innovation Waiver: Is ERISA a Roadblock to Meaningful Healthcare Reform?
In 2017, the Affordable Care Act’s (ACA) State Innovation Waiver (§ 1332) will enable states to waive many of the ACA’s provisions and to develop their own creative solutions to reign in healthcare spending. The Employee Retirement Income Security Act of 1974 (ERISA) was enacted to encourage employers to sponsor benefit plans and minimize potential conflicts with existing state laws. Because of ERISA, the regulation of employee benefit plans, including health plans, falls primarily under federal jurisdiction for about 131 million people. This Note explores the ways in which ERISA presents significant roadblocks to meaningful state level healthcare reform under § 1332. State laws cannot directly refer to ERISA, nor influence the benefits, administration, or structure of an ERISA plan. Also, if a state law limits employer choices too much, it will likely violate ERISA. This Note proposes that ERISA needs to be waived, amended or repealed so that states can implement meaningful healthcare reforms under § 1332.
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