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Section 514(a) of ERISA, 29 U.S.C.S. § 1144(a), provides that ERISA shall supersede any and all State laws insofar as they relate to any employee benefit plan covered by ERISA, although, under ERISA § 514(b)(2)(A), 29 U.S.C.S. § 1144(b)(2)(A), pre-emption stops short of any law of any State which regulates insurance. Finally, ERISA § 514(b)(4), 29 U.S.C.S. § 1144(b)(4), saves from pre-emption any generally applicable criminal law of a State.
A New York statute requires hospitals to collect surcharges from patients covered by a commercial insurer but not from patients insured by a Blue Cross/Blue Shield plan, and also subjects certain health maintenance organizations (HMO's) to surcharges. Several commercial insurers and their trade associations filed actions against state officials, claiming that § 514(a) of the Employee Retirement Income Security Act of 1974 (ERISA) -- under which state laws that "relate to" any covered employee benefit plan are superseded -- pre-empts the imposition of surcharges on bills of patients whose commercial insurance coverage is purchased by an ERISA plan, and on HMO's insofar as their membership fees are paid by an ERISA plan. Blue Cross/Blue Shield plans (collectively the Blues) and a hospital association intervened as defendants, and several HMO's and an HMO conference intervened as plaintiffs. The District Court consolidated the actions and granted the plaintiffs summary judgment. The Court of Appeals affirmed, relying on this Court's decisions in Shaw v. Delta Air Lines, Inc., 463 U.S. 85, 77 L. Ed. 2d 490, 103 S. Ct. 2890, and District of Columbia v. Greater Washington Bd. of Trade, 506 U.S. 125, 121 L. Ed. 2d 513, 113 S. Ct. 580, holding that ERISA's pre-emption clause must be read broadly to reach any state law having a connection with, or reference to, covered benefit plans. The court decided that the surcharges were meant to increase the costs of certain insurance and HMO health care and held that this purposeful interference with the choices that ERISA plans make for health care coverage constitutes a "connection with" ERISA plans triggering pre-emption.
Is a New York statute regulating hospital rates for in-patient care, which statute imposed surcharges on commercially insured patients and health maintenance organizations, pre-empted by 514(a) of ERISA?
The court of appeals held that ERISA's pre-emption clause must be read broadly to reach any state law having a connection with, or reference to, covered employee benefit plans. On further review, the Court reversed and remanded because the provisions for surcharges did not relate to employee benefit plans within the meaning of the pre-emption provision of ERISA § 514(a), 29 U.S.C.S. § 1144(a), and accordingly suffered no pre-emption.