Two House members have introduced a bipartisan bill that could let states their own rules for employers' self-insured dental plans.
Federal law lets states regulate the business of insurance, but a provision in the Employee Retirement Income Security Act of 1974 preempts state efforts to regulate employers' health benefit plans.
In practice, employers and benefits advisors have assumed that ERISA preempts any state laws concerning employers' self-insured benefit plans.
The new Improving Dental Administration Act bill would poke a hole in ERISA premption for self-funded dental plans, according to a summary provided by the American Dental Association, which has joined with many dental professional groups, such as the Academy of General Dentistry, to support the bill.
The bill was introduced by Rep. Jeff Van Drew, R-N.J., who is a dentist, and Rep. Herb Conaway, D-N.J., who has both a medical degree and a law degree.
What it means: ERISA preemption is facing fierce resistance in Washington.
The backdrop: Employers, insurers and benefits groups argue that ERISA preemption encourages employers to offer benefits, by protecting self-insured plans against state benefits mandates and other coverage rules that might make offering multistate coverage more complicated and more expensive.
But health care providers have tried to find ways to get around ERISA preemption, to let states provide protections for the pharmacies in pharmacy benefit managers' networks, the optometrists in vision plans' networks and other types of providers.
In the federal courts, employers and pharmacy benefit managers have been fighting fierce battles over whether states can set their own rules for PBMs that serve self-insured employer health plans.
The introduction of the new Van Drew-Conaway bill could be the start of a new fight over ERISA preemption.
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