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Full-Text Articles in Law
Four Constitutional Limits That The Minimum Coverage Provision Respects, Neil S. Siegel
Four Constitutional Limits That The Minimum Coverage Provision Respects, Neil S. Siegel
Faculty Scholarship
Opponents of the minimum coverage provision in the Affordable Care Act charge that if Congress can require most people to obtain health insurance or pay a certain amount of money, then Congress can impose whatever mandates it wishes—or, at least, whatever purchase mandates it wishes. This Essay refutes that claim by identifying four limits on the Commerce Clause that the minimum coverage provision honors. Congress may not use its commerce power: (1) to regulate noneconomic subject matter; (2) to impose a regulation that violates constitutional rights, including the right to bodily integrity; (3) to regulate at all, including by imposing …
A Cautious Path Forward On Accountable Care Organizations, Barak D. Richman, Kevin A. Schulman
A Cautious Path Forward On Accountable Care Organizations, Barak D. Richman, Kevin A. Schulman
Faculty Scholarship
The wave of new Accountable Care Organizations (ACOs), spurred by financial incentives in the Affordable Care Act, could become the latest chapter in the steady accumulation of market power by hospitals, health care systems, and physician groups. The main purpose behind forming many ACOs may not be to achieve cost savings but instead to strengthen negotiating power over purchasers in the private sector. This would be an unfortunate sequel to the waves of mergers in the 1990s when health care entities sought to counter market pressure from managed care organizations. The possibility that ACOs might further concentrate health care markets …
The Provider-Monopoly Problem In Health Care, Clark C. Havighurst, Barak D. Richman
The Provider-Monopoly Problem In Health Care, Clark C. Havighurst, Barak D. Richman
Faculty Scholarship
Although federal judges have resisted giving due effect to standard antitrust principles in scrutinizing mergers of nonprofit hospitals, the presence of health insurance makes it especially important to oppose monopoly in health services markets. U.S.-style health insurance gives monopolist providers extraordinary pricing freedom, thus exacerbating monopoly’s usual redistributive effects. Significant allocative inefficiencies - albeit not the kind generally associated with monopoly - also result when the monopolist is a nonprofit hospital. Because it is probably impossible to undo past hospital mergers creating undue market power, we suggest some alternative remedies. One is to apply antitrust rules against "tying" arrangements so …