On December 2, 2015, the U.S. Supreme Court heard arguments for Gobeille v. Liberty Mutual Insurance Company. In 2012, Liberty Mutual Insurance Company filed a claim against Vermont’s all-payer claims database, Vermont Healthcare Claims Uniform Reporting and Evaluation System or VHCURES, stating that the VHCURES statute is preempted by the Employee Retirement Income Security Act of 1974 (ERISA). Although the federal district court ruled in Vermont’s favor, that decision was reversed by the Second Circuit Court of Appeals, which held that the VHCURES statute is preempted as applied to certain self-funded health care plans governed by ERISA. On March 1, 2016, the Supreme Court of the United States ruled 6-2 that ERISA preempts Vermont law in Gobeille v. Liberty Mutual Insurance Company.
APCD Council Activities
Since March 1, 2016, the APCD Council has been talking to many members of the APCD stakeholder community to better understand the implications of the SCOTUS Gobeille v. Liberty Mutual Insurance Company decision, which has caused widespread concern throughout the health research and policy communities, underscoring the importance of the role of APCDs in improving the health and health care of individuals, and validating longstanding efforts by states to establish these important databases.
The APCD Council is disappointed that the decision went against the Green Mountain Care Board in Vermont, but the significant attention to the issues since the ruling highlights the pressing need for APCDs in the current landscape and broad support for exploring options going forward. State entities remain committed to supporting data-driven decision making, and to collecting data through the APCD to support transparency and transformation in health care.
While the Gobeille decision raises difficult questions, states across the country are working closely with the carriers, employers, and policy makers to identify the best ways to support the ongoing needs of the data submitters and state entities. To date, key activities resulting from the decision include:
- Reviewing the data submission requirements in states, and how they are affected by the ruling. While there are many plans covered by ERISA (and, therefore, this ruling), data from many plans are not impacted by this ruling.
- Developing tools to communicate directly with employers to ensure that employer stakeholders understand the value of APCDs for improving the health of a state. Employers have an important role ensuring that an APCD can be used to drive changes in the local health care environment that support the health of their employees. In instances that an employer would like to opt out of submitting data to an APCD, states are identifying the mechanisms for employers to communicate interest in opting out of the data submissions to the states.
- Analyzing the options for alternatives to data collection authority offered in the Supreme Court’s opinions and what pathways may exist to leverage those alternatives. The Supreme Court specifically noted the Department of Labor as having a potential role in data acquisition efforts, and that is currently being explored.
The SCOTUS decision has created new barriers to transparency and health reform efforts, but has also highlighted the value of state APCDs, and states are actively addressing the issues resulting from the decision. The APCD Council is actively working to coordinate state efforts around these issues. If states are interested in participating in these conversations, please reach out with input to firstname.lastname@example.org.
- How employer participation in the MA APCD can curb health care costs, Massachusetts' Center for Health Information and Analysis, June 2016
- The Value of All-Payer Claims Databases for Employers, APCD Council, April 2016
- Key Regulatory Issues Facing APCD States Post Gobeille v. Liberty Mutual, APCD Council, April 2016
- Vermont’s Petition for Certiorari
- Brief of New York et al. in Support
- Liberty Mutual’s Brief in Opposition
- Brief of the United States Solicitor General
- Vermont’s Reply Brief
- Vermont’s Supplemental Brief
- Liberty Mutual’s Supplemental Brief
- Vermont’s Opening Brief
- Liberty Mutual's Response Brief
- Vermont's Reply Brief
- Joint Appendix
- Merits Brief of the United States Solicitor General
- Amicus Brief of New York et al. (joined by Colorado, Connecticut, Hawai‘I, Illinois, Kansas, Maine, Maryland, Massachusetts, Minnesota, Nebraska, Oregon, Rhode Island, Tennessee, Texas, Utah, And Washington, and the District Of Columbia)
- Amicus Brief of New Hampshire
- Amicus Brief of National Governors Association, National Conference Of State Legislatures, Council Of State Governments, National Association Of Insurance Commissioners, And Association Of State And Territorial Health Officials
- Amicus Brief of Center for Health Law & Policy Innovation and public health researchers
- Amicus Brief of NAHDO et al.
- Amicus Brief of CT Health Insurance Exchange
- Amicus Brief of American Medical Association and Vermont Medical Society
- Amicus Brief of AARP, Families USA and US PIRG
- Amicus Brief of American Hospital Association and Association of American Medical Colleges
- Amicus Brief of Zelinsky
- Amicus Brief of Association Of American Physicians And Surgeons and Vermonters For Health Care Freedom
- Amicus Brief of Blue Cross and Blue Shield
- Amicus Brief of New England Legal Foundation
- Amicus Brief of American Benefits Council et al
- Amicus Brief of National Coordinating Committee of Multiemployer Plans