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It is estimated that nearly 170 million individuals have employer-based health coverage. As part of a comprehensive health care reform effort, there has been support (including from the Obama Administration) in enacting comprehensive health insurance reform that retains the employer-based system. This report presents selected legal considerations inherent in amending two of the primary federal laws governing employer-sponsored health care: the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code (IRC). ERISA may be a key part of the health reform discussion in two main ways. The first way is if Congress desires to amend the employer-based system, for example, to require financing or benefits for group health plans as provided by employers. If a national proposal were to require employers to provide or contribute to the payment of health benefits or to provide specific benefits as part of group health plans, ERISA could be a vehicle for this type of proposal. Second, if Congress were to amend the role of states in regulating employment-based health benefits, ERISAs express preemption provision, 514, would likely be implicated. Section 514 of ERISA is commonly seen as a barrier for states in enacting health reform that affects the employer-based system. This ...