Over the past decade, however, 18 states have embraced a new approach to revealing and clarifying the pricing practices of the health care industry. They have created “all-payer claims databases” in which they compile information on the prices that all insurers, public and private, pay for medical care. Although the databases vary in their particulars, they all share a market-oriented goal: greater transparency with regard to the prices that drive health care spending. Depending on local policies, that transparency can serve any number of purposes. It can aid state regulators in fashioning new payment models, help researchers better understand the effects of payment and benefits policies, and enable people with high-deductible health plans to comparison shop.
An impending Supreme Court case, Gobeille v. Liberty Mutual, however, threatens to cripple these databases and other state initiatives that aim to improve the health care system. Gobeille involves the Employee Retirement Income Security Act (ERISA), a complex federal statute that regulates employee benefit plans. Among other things, the statute sets minimum funding requirements for pension plans, obliges plan administrators to act in employees' best interests, and requires employers to provide their employees with information about their benefits.
Read Full Article »