Vanderbilt Law Review

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Congress enacted the Employee Retirement Income Security Act of 1974 ("ERISA) to protect employee interests and ensure a uniform body of law for pension and benefit plans. The statute's expansive preemption clause and preclusion of extra-contractual damages have since been used to immunize Managed Care Organizations ("MCOs") from liability for patients injuries resulting from medical malpractice. Because plaintiffs with preempted claims may receive only the remedies provided for under ERISA-the right or benefit due under the plan-many injured patients have been left with no meaningful remedy.

"[N]ot a model of legislative drafting,"" the statute's broad preemption clause provides that state law claims that "relate to" an ERISA plan are preempted. The ambiguous phrase "relate to" has been the primary focus of the Supreme Court's attempts to determine the reach of the preemption clause.' Relying primarily on a textual interpretation of the statute, the Court has held that, while ERISA does not preempt "run-of-the-mill state-law claims," those plans that have a "connection with or reference to"' an ERISA plan, without being a "tenuous, remote, or peripheral connection,"s are preempted. The Supreme Court's tortured attempts to give effect to the statutory language have led to doctrinal confusion and "chaos" in the lower courts.' Little judicial guidance, therefore, currently exists for interpreting ERISA's poorly constructed preemption clause.

ERISA is implicated in medical malpractice claims through its regulation of employee welfare plans. An "employee welfare benefit plan" under ERISA is a "plan, fund, or program" that an employer establishes or maintains to provide medical, surgical, or hospital care or benefits to participants through the purchase of insurance.' Employer-provided health insurance, therefore, has been interpreted as an employee benefit within the scope of ERISA. If a state cause of action involving health care provided through an ERISA plan, such as a medical malpractice claim, is deemed to "relate to" the employee benefit plan, the cause of action is preempted by ERISA under section 514(a).