States should be given waivers from a key federal labor law only for comprehensive reform measures-and then only in cases where the state's reform plan fits federal guidelines-according to a U.S. Labor Department task force on healthcare reform.
The task force made the recommendation in a report to Congress last week.
At issue is how much the federal government should relax the requirements of the Employee Retirement Income Security Act, which is designed in part to protect multistate employers by limiting changes states can make to benefit plans. Congress must vote to give states ERISA waivers.
States have called for increased freedom from ERISA to allow them to pursue their own reforms (See related story, p. 44), while businesses have argued that allowing states too much leeway will make it difficult to do business across state borders. With the collapse of healthcare reform this year, many groups say that the issue of ERISA waivers and state flexibility will be at the forefront in 1995 as states continue to look for relief from their Medicaid burdens.
In its report, the Labor Department's Working Group on Health Care Reform said ERISA waivers should be granted only as a final alternative to healthcare reform. Should Congress decide to pass a limited reform package, it ought to include a voluntary minimum benefits package that would pre-empt state benefit mandates.
However, if healthcare reform is abandoned, Congress should consider granting conditional ERISA waivers only to states that pass comprehensive reforms that follow specific federal guidelines designed to ensure that "state laws would look the same to multistate health plans," according to the report.