Abstract

For most of the first two decades after the enactment of the Employee Retirement Income Security Act of 1974, health policymakers did not seem to recognize the full impact that ERISA would have on regulation of health insurance and health care coverage. Perhaps the early court decisions in which the courts clarified that states could regulate insurance companies and the products they sold to ERISA plan sponsors gave them false comfort that because Congress appeared to recognize the role of the states in regulating insurance, ERISA might have only a tangential impact on health care reform efforts.