Law Commons^™

Health Insurance Rate Review, John Aloysius Cogan Jr.

John Aloysius Cogan Jr.

Predicting The Fallout From King V. Burwell - Exchanges And The Aca, Nicholas Bagley, David K. Jones, Timothy Stoltzfus Jost

Timothy S. Jost

The U.S. Supreme Court's surprise announcement on November 7 that it would hear King v. Burwell struck fear in the hearts of supporters of the Affordable Cara Act (ACA). At stake is the legality of an Internal Revenue Service (IRS) rule extending tax credits to the 4.5 million people who bought their health plans in the 34 states that declined to establish their own health insurance exchanges under the ACA. The case hinges on enigmatic statutory language that seems to link the amount of tax credits to a health plan purchased "through an Exchange established by the State." According to …

How Obamacare’S Future Rests On A Single Clause, Alan E. Garfield

Alan E Garfield

No abstract provided.

Mandatory Process, Matthew Lawrence

Matthew B. Lawrence

The Insurance Aspects Of Damages, Robert H. Jerry Ii, Douglas R. Richmond

Robert H. Jerry II

"[I]t is difficult ... to imagine an event or transaction that does not involve insurance in some way." So it is with the most salient event in the lives of Tony and Donna Sabia, whose son Tony John Sabia, or "Little Tony," was born with profound disabilities. In the final analysis, the ability of Tony and Donna to pay for the future medical care and living expenses needed by their son depends on whether they can reach the liability insurance coverage possessed by the health care providers who attended Donna and Little Tony at the time of his birth. It …

The American Right-Wing Policy Agenda, Timothy Stoltzfus Jost

Timothy S. Jost

Right-wing health policy is alive and well in the United States. Pro-business and libertarian health policy advocacy groups, generously funded by right-wing foundations (and, in some instances, by the health care industry), produce a continuous stream of press releases, policy-statements, books, articles, and symposia, as well as testimony before legislative and administrative bodies. Their positions are taken very seriously by the American media, who make certain that right-wing policy experts are represented in any discussion of current health policy issues.

Private Or Public Approaches To Insuring The Uninsured: Lessons From International Experience With Private Insurance, Timothy Stoltzfus Jost

Timothy S. Jost

In the recent past a broad consensus has emerged in the United States that the best way to expand coverage of the uninsured is to use tax subsidies to encourage the purchase of private health insurance policies. Many advocates of this approach also call for replacing employment-related group policies with individual policies, and for minimizing regulation of private insurance. Those who advocate these policies, however, have rarely considered the experience that other nations have had with private health insurance. In fact most other countries have private insurance markets, and in many countries private insurance plays a significant role in financing …

The Massachusetts Health Plan: Public Insurance For The Poor, Private Insurance For The Wealthy, Self-Insurance For The Rest?, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.

Shifting Risk Of Ruin To Consumers: The Role Of Tax Law In American Health Policy, Timothy Stoltzfus Jost

Timothy S. Jost

No abstract provided.

The Role Of State Regulation In Consumer-Driven Health Care, Timothy Stoltzfus Jost, Mark A. Hall

Timothy S. Jost

The Consumer-directed health care movement has recently been given a major boost by section 223 of the Medicare Modernization Act, which provides federal income tax subsidies for health savings accounts coupled with high deductible health plans. The federal tax subsidy, however, will only be available in states whose program of insurance regulation permits high deductible health plans to exist. The MMA represents, therefore, a new approach to federalism in health insurance - offering tax incentives for states to change their approach to insurance regulation rather than preempting state regulation or imposing federal regulation. To date the states have generally responded …

Health Insurance Exchanges: Legal Issues, Timothy S. Jost

Timothy S. Jost

Health insurance exchanges (HIE) are entities that organize the market for health insurance by connecting small businesses and individuals into larger pools that spread the risk for insurance companies, while facilitating the availability, choice and purchase of private health insurance for the uninsured. While there are legal issues that warrant consideration under a federal, state, or private exchange framework, those issues are not insurmountable barriers to implementation.

Reform Of The United States Health Care System: An Overview, Robert B. Leflar

Robert B Leflar

This essay, written for readers unfamiliar with the details of American health law and policy, portrays the essential features of the battle for health reform in the United States and of the law that survived the battle: the Patient Protection and Affordable Care Act (PPACA). The essay summarizes key aspects of the U.S. health care system and how it compares in terms of costs and results with other advanced nations’ systems. The political and legal conflicts leading up to and following PPACA’s enactment are described. The major features of the law, attempting to address problems of access to health care, …

Equality Standards For Health Insurance Coverage: Will The Mental Health Parity And Addiction Equity Act End The Discrimination?, Ellen M. Weber

Ellen M. Weber

Congress enacted the Mental Health Parity and Addiction Equity Act in 2008 to end discriminatory health insurance coverage for persons with mental health and substance use disorders in large employer health plans. Adopting a comprehensive regulatory approach akin to other civil rights laws, the Parity Act requires “equity” in all plan features, including cost-sharing, durational limits and, most critically, the plan management practices that are used to deny many families medically necessary behavioral health care. Beginning in 2014, all health plans regulated by the Affordable Care Act must also comply with parity standards, effectively ending the second-class insurance status of …

Restoring Legal Immigrants' State Health Insurance- The Finch Case, Wendy E. Parmet, Lorianne Sainsbury-Wong

Wendy E. Parmet

In Finch v. Commonwealth Insurance Connector Authority, 461 Mass. 232 (2012), the Massachusetts Supreme Judicial Court held that a 2009 law barring a class of legal immigrants from a state funded health insurance program for low income adults violated the state Constitution. This article presents our perspective as plaintiff’s counsel. We focus on the pragmatic issues that we confronted as we considered whether or not to pursue litigation, and the forum and claims to pursue.

Brief Of Amici Curiae: The Leadership Conference On Civil And Human Rights, Asian American Legal Defense And Education Fund, National Aids Housing Coalition, National Economic And Social Rights Initiative, National Health Care For The Homeless Council, National Law Center On Homelessness & Poverty, Poverty & Race Research Action Council, Urban Justice Center And Wild For Human Rights In Support Of Respondents Regarding Medicaid Expansion, In The Supreme Court Of The United States, State Of Florida, Et Al., V. United States Department Of Health And Human Services, Et Al., On Writ Of Certiorari To The United States Court Of Appeals For The Eleventh Circuit, No. 11-400, Martha F. Davis, Margaret Woo, Risa E. Kaufman

Margaret Y. K. Woo

This amicus brief was filed before the Supreme Court in the Medicaid Expansion portion of the Affordable Care Act (ACA) litigation on behalf of the Leadership Conference on Civil and Human Rights and other national organizations concerned with the international human rights implications of the ACA litigation, particularly with regard to race discrimination. The brief first argues that the international context of the ACA is relevant to the Court’s consideration of the law’s constitutionality, noting the many times when Court has taken international law into account in rendering decisions. The brief then chronicles the occasions on which international bodies and …

Genetic Information And Health Insurance: State Legislative Approaches, Karen H. Rothenberg

Karen H. Rothenberg

No abstract provided.

The Potential For Discrimination In Health Insurance Based On Predictive Genetic Tests, Karen H. Rothenberg

Karen H. Rothenberg

No abstract provided.

Advances In Genetic Research And Technologies: Challenges For Public Policy, Karen H. Rothenberg

Karen H. Rothenberg

No abstract provided.

Overcoming Fears Of Erisa Preemption To Cover The Working Uninsured: Lessons Learned From Hawaii, California, And Massachusetts, Angela Tokuda

Angela Tokuda

As the debate for national health care reform continues to evolve, the question remains to what extent will national reform leave room to preserve state-level experimentation, especially in light of ERISA (Employee Retirement Income Security Act) preemption. ERISA preemption has remained a formidable obstacle to state efforts. However, three states, Hawaii, California and Massachusetts, have been successful in expanding health insurance coverage at the local level. Although each state utilizes different objectives to cover their uninsured population, each faces the same threat of ERISA preemption. Nonetheless, these states have come up with unique ways to avoid ERISA preemption. This paper …

In Search Of An Enforceable Medical Malpractice Exculpatory Agreement: Introducing Confidential Contracts As A Solution To The Doctor-Patient Relationship Problem, Matthew Lawrence

Matthew B. Lawrence