31 William Mitchell Law Review 843 (2004-2005)
On June 21, 2004, the United States Supreme Court decided the health law “case of the year” in the two consolidated cases of Aetna Health, Inc. v. Davila and CIGNA HealthCare of Texas, Inc. v. Calad. The Court held that section 502(a) of the Employee Retirement Income Security Act of 1974 (ERISA) “completely preempt[s]” and thus invalidates the tort liability provisions of the Texas Health Care Liability Act (THCLA). The case could potentially affect the rights of millions of Americans in a matter of vital concern—whether they will receive the health insurance coverage promised them if they become unable to pay for medical bills out of their own resources. The Court justified its decision as effecting “clear congressional intent.” In reality, congressional intent was anything but clear. The Court’s decision was inconsistent with long-established and logically valid interpretations of procedural statutes, as well as the wording, structure, and underlying policies of ERISA. The decision was also inconsistent with constitutional principles that should inform all jurisprudence. Instead, it was based on Supreme Court precedent that the Court itself had already partially disavowed as “not [giving] much help [in] drawing the line.” This article does not suggest that the Davila/Calad holding was unexpected or completely incongruent with earlier Supreme Court decisions. To the contrary, if the Court had decided the case differently, it would have had to break with its own precedent. This article argues that the Court should have done just that—that the correct decision would have favored more fundamental considerations than the mere desire to remain superficially consistent with its previous holdings and rationales. The Court missed an opportunity to correct what has been called “an unjust and increasingly tangled ERISA regime.” This case had huge national importance, and the issue deserved better and more careful analysis than it was given by the Court.
Nelson, Leonard A.
"Aetna v. Davila/CIGNA v. Calad: A Missed Opportunity,"
William Mitchell Law Review: Vol. 31
, Article 3.
Available at: https://open.mitchellhamline.edu/wmlr/vol31/iss3/3