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One Important SC Case Could Influence California Health Care

There have been a lot of California health care reform initiatives over the last few years, and this doesn’t look to change any time soon now that another case looks to influence health care reform as it is brought before the Supreme Court.


Health care reform

Source: iStock.com/iodrakon


There are actually several pending cases that could result in national healthcare repercussions. The one you may have heard about is King v. Burwell, which challenges federal subsidies for health insurance. However, a new case has popped up in Vermont that involves claims data reporting that could have a huge impact on the way the government collects and analyzes healthcare data.

Over the last ten years, 16 states have established mandatory APCD (All-Payer Claims Database Systems) that collect and analyze information from health insurers in order to guide payment reform efforts. Around 30 other states are either considering or pursuing some type of data gathering similar to APCD. The issue is that Liberty Mutual Insurance, an insurer in Vermont, which is one of the 16 states with mandatory APCD systems, is refusing to provide its information to the state. The insurer’s argument is that Vermont law is superseded by the Employee Retirement Income Security Act of 1974. They are contending that self-insured plans require claims data reporting already and that the state’s laws are interfering. 

Experts believe that this case could have a huge effect not only on Vermont but the entire country as well. While the results of the case may not have a direct impact on California health care reform initiatives, all states will take the decision into account before they consider making a long-term investment in APCDs.

The Liberty Mutual Insurance case in Vermont could affect healthcare reform throughout the country. For more healthcare information, contact us at the Benefits Store today.

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