"There's been a tremendous amount of federal pre-emption of state law in last couple of decades," Dr. Kincaid said.

Although there are exceptions, the managed care industry has generally supported a broad view of federal pre-emption under Erisa for the purpose of nationwide uniformity.

Our cases recognize federal pre-emption of state law in three variants: express pre-emption, field pre-emption, and conflict pre-emption.

The order, which did not involve Congress, injected complex questions of federal pre-emption and separation of powers into the mix.

The question before the Court in Beck, then, was whether such governmental action extended to the acts of unions in the private sector where there was no such federal pre-emption.

While federal pre-emption of state and local rule doesn't give railroads a complete pass, the railroads and local and state authorities generally disagree as to what the limits are.

Rejecting a claim of federal pre-emption, the court ruled 5 to 4 that states have authority to protect the rights of patients in disputes with managed-care companies.

However the industry does not support proposals for total federal pre-emption in all areas related to deregulation and restructuring.

To maximize innovation, Congress should allow for federal pre-emption of state and other federal regulatory authorities for information-market contracts that pass an economic purpose test.

The decision confirms federal pre-emption of all state law claims for benefit administration and coverage disputes.