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Full-Text Articles in Insurance Law
Essential Health Benefits And The Affordable Care Act: Law And Process, Nicholas Bagley, Helen Levy
Essential Health Benefits And The Affordable Care Act: Law And Process, Nicholas Bagley, Helen Levy
Law & Economics Working Papers
Beginning in 2014, the Affordable Care Act (ACA) will require private insurance plans sold in the individual and small-group markets to cover a roster of “essential health benefits.” Precisely which benefits should count as essential, however, was left to the discretion of the Department of Health and Human Services (HHS). The matter was both important and controversial. HHS nonetheless announced its policy on essential health benefits by posting on its website a 13-page bulletin stating that it would allow each state to define essential benefits for itself by choosing a “benchmark” plan modeled on existing plans in the state. On …
An Insurance Structure To Encourage Investment In Preventative Health Care, Nicholas Georgakopoulos
An Insurance Structure To Encourage Investment In Preventative Health Care, Nicholas Georgakopoulos
University of Michigan Journal of Law Reform
The incentives for investments in Americans' health are poorly aligned. Health insurers are not sufficiently motivated to invest for the long term. The structure of health insurance does not compensate insurers for investments in lasting health, such as measures preventing chronic disease. If an American changes insurers, the new insurer reaps the benefits of the good health the prior insurer's investment produced. This Essay explores insurers' incentives to invest in health, illustrates how those incentives fail, explores possible improvements, and shows that subsequent insurers should have an obligation to compensate the prior insurer for the averted expenses of expected diseases …