A unanimous Supreme Court held 3/2/03 that ERISA does not preempt two Kentucky statutes prohibiting health insurers from excluding willing and qualified health-care providers from "exclusive provider networks." Although ERISA generally preempts all state laws that relate to any employee benefit plan, laws regulating insurance, banking or securities are saved from preemption. The Court established a two-pronged test for determining whether a state statute regulates insurance, and thus is not preempted by ERISA: First, is the statute "specifically directed toward entities engaged in insurance"? Second, does the law "substantially affect the risk pooling arrangement between the insurer and the insured"? The Court held that the Kentucky statutes’ consequential effects on health-care providers did not alter the fact that they are specifically directed toward entities engaged in insurance. It further held that by forcing health insurers to expand the class of health-care providers from whom an insured may receive health services, and thereby undermining the insurer’s ability to obtain discounted rates from providers in return for exclusive access to its members, the laws substantially affect the risk-pooling arrangement between insurer and insured. The decision in this case is important to all businesses involved in the health-care industry.The NAM filed a joint amicus brief 9/11/02 arguing that "any willing provider" laws do not benefit employees because they do not compel doctors to join an MCO, and they do not restrain cost increases because doctors who might otherwise reduce costs to gain volume will be unwilling to do so in a fully open network. If anything, costs will increase from the volume of credentialing, education, billing, and quality and claims management. The NAM joined with the American Association of Health Plans, Inc., the Health Insurance Association of America, and the Blue Cross Blue Shield Association in the brief.