Law Commons^™

Pro-Choice Plans, Brendan S. Maher

Faculty Scholarship

After Dobbs v. Jackson Women’s Health Organization, the United States Constitution may no longer protect abortion, but a surprising federal statute does. That statute is called the Employee Retirement Income Security Act of 1974 (“ERISA”), and it has long been one of the most powerful preemptive statutes in the entire United States Code. ERISA regulates “employee benefit plans,” which are the vehicle by which approximately 155 million people receive their health insurance. Plans are thus a major private payer for health benefits—and therefore abortions. While many post-Dobbs anti-abortion laws directly bar abortion by making either the receipt or provision of …

Worker Participation In A Time Of Covid: A Case Study Of Occupational Health And Safety Regulation In Ontario, Alan Hall, Eric Tucker

Articles & Book Chapters

This study examines worker voice in the development and implementation of safety plans or protocols for covid-19 prevention among hospital workers, long-term care workers, and education workers in the Canadian province of Ontario. Although Ontario occupational health and safety law and official public health policy appear to recognize the need for active consultation with workers and labour unions, there were limited – and in some cases no – efforts by employers to meaningfully involve workers, worker representatives (reps), or union officials in assessing covid-19 risks and planning protection and prevention measures. The political and legal efforts of workers and unions …

Threats To Medicaid And Health Equity Intersections, Mary Crossley

Articles

2017 was a tumultuous year politically in the United States on many fronts, but perhaps none more so than health care. For enrollees in the Medicaid program, it was a “year of living precariously.” Long-promised Republican efforts to repeal the Affordable Care Act also took aim at Medicaid, with proposals to fundamentally restructure the program and drastically cut its federal funding. These proposals provoked pushback from multiple fronts, including formal opposition from groups representing people with disabilities and people of color and individual protesters. Opposition by these groups should not have surprised the proponents of “reforming” Medicaid. Both people of …

The Dubious Empirical And Legal Foundations Of Wellness Programs, Adrianna Mcintyre, Nicholas Bagley, Austin Frakt, Aaron Carroll

Articles

The article offers information on the dubious empirical and legal foundations of workplace wellness programs in the U.S. Topics discussed include enactment of Affordable Care Act for expanding the scope of incentives availas; analysis of financial incentives offered to the employees for encouraging their participation in wellness programs; and targeting incentives specifically toward individuals diagnosed with chronic diseases.

Controlling Health Care Spending: More Patient "Skin In The Game?", David Orentlicher

Scholarly Works

In this article, Professor Orentlicher explores the high cost of healthcare and the trend in health insurance to shift the cost of health care to patients in an attempt to influence their behavior and health decisions. He examines such strategies as reference pricing, scaled cost-sharing, and employee wellness programs.

The Pay Or Play Penalty Under The Affordable Care Act: Emerging Issues, Kathryn L. Moore

Law Faculty Scholarly Articles

The Affordable Care Act does not require that employers provide employees with health care coverage. It does, however, impose an excise tax on large employers that fail to offer their employees affordable employer-sponsored health care coverage. The excise tax, commonly referred to as a “pay-or-play penalty,” was scheduled to go into effect beginning in 2014. The United States Treasury Department (“Treasury”), however, has delayed enforcement of the penalty until 2015 for employers with 100 or more full-time employees, and until 2016 for employers with 50 to 99 employees.

Implementation of the pay-or-play penalty has given rise to a host of …

A Comparison Of The Role Of The Employer In The French And U.S. Health Care Systems, Kathryn L. Moore

Law Faculty Scholarly Articles

The United States is unique among developed nations in its heavy reliance on employment-based health insurance. The United States, however, is not the only nation in which employers play an important role in the financing of health care. Indeed, long before employment-based health insurance became common in the United States, countries with social insurance systems, such as France, Germany, Hungary, and the Czech Republic, provided for the delivery of mandatory social insurance benefits, including health insurance, through the workplace.

This article explores the role of the employer in the health care system in one such country: France. The French health …

Working Conditions And Patient Safety: Safe Staffing In Maine's Hospitals, Bureau Of Labor Education. University Of Maine

Bureau of Labor Education

A growing body of research is now documenting how serious problems in the work environments of nursing care in American hospitals are posing a threat to patient safety, as well as contributing to shortages of nurses working in hospital settings and in greater job stress and burnout among nurses. A major factor in this picture, according to a major report by the National Institute of Medicine, is the issue of chronic understaffing among direct care nurses.

Working Sick: Lessons Of Chronic Illness For Health Care Reform, Elizabeth Pendo

All Faculty Scholarship

Although chronic illness is generally associated with the elderly or disabled, chronic conditions are widespread among working-age adults and pose significant challenges for employer-based health care plans. Indeed, a recent study found that the number of working-age adults with a major chronic condition has grown by 25 percent over the past 10 years, to a total of nearly 58 million in 2006. Chronic illness imposes significant costs on workers, employers, and the overall economy. This population accounts for three-quarters of all personal medical spending in the United States, and a Milken Institute study recently estimated that lost workdays and lower …

Research To Practice: The National Survey Of Community Rehabilitation Providers, Fy2004-2005 Report 1: Employment Outcomes Of People With Developmental Disabilities In Integrated Employment, Heike Boeltzig, Dana Scott Gilmore, John Butterworth

Research to Practice Series, Institute for Community Inclusion

Where do people with mental retardation and developmental disabilities work? What are their hours, wages, and benefits? This brief covers partial results from a survey that gives a snapshot of the outcomes for recently employed people with developmental disabilities.

The U.S. Health Care System: Best In The World, Or Just The Most Expensive?, Bureau Of Labor Education. University Of Maine

Bureau of Labor Education

For many years, politicians and insurance companies could blithely proclaim that the U.S. had the best health care system in the world, but as its major shortcomings become more visible, Americans are finding it harder to accept this assertion. The 42.6 million people in the U.S. currently without health insurance are acutely aware that our health care system is not working for everyone, and there is growing recognition that the major problems of rising costs and lack of access constitute a real crisis. However, the search for solutions has not been easy or clear cut. Policymakers often attempt to address …

Policy Brief: Improvements To The Ssdi And Ssi Work Incentives And Expanded Availability Of Health Care Services To Workers With Disabilities Under The Ticket To Work And Work Incentives Improvement Act Of 1999, Robert Silverstein

Policy Briefs Series, Institute for Community Inclusion

This brief gives background information on federal income maintenance and health care programs, and describes the major provisions of the Ticket to Work and Work Incentives Improvement Act.

Policy Brief: The Ticket To Work And Self-Sufficiency Program And Established Under The Ticket To Work And Work Incentives Improvement Act Of 1999, Robert Silverstein

Policy Briefs Series, Institute for Community Inclusion

A description of the major provisions in Title I of the Act, which created the Ticket to Work and Self-Sufficiency Program.

Shaping Regional Economies To Sustain Quality Work: The Cooperative Health Care Network, Peter R. Pitegoff

Faculty Publications

This chapter chronicles a creative response to social retrenchment, a saga of strategic deployment of accessible resources and a reshaping of regional economic forces for the benefit of targeted labor markets. While charting its own course, CHCB is part of a mutually supportive network of health care employers and trainers, including successful home care companies in Philadelphia and the South Bronx. Together, these three corporations form the core of the Cooperative Health Care Network and employ over 500 home health aides. About 80 percent of the employees were formerly dependent on public assistance. The network [network] experience and their applicability …

Working And Poor: The Increasingly Popular Practice Of Excluding Disabled Employees From Health Care Coverage, Maria O'Brien

Faculty Scholarship

One might think, since passage of the Americans With Disabilities Act of 1990 (ADA),' that the employment story for disabled employees or would-be disabled employees was cheerful, or at least improving. This may be true in so far as obtaining and retaining employment is concerned;' however, the ADA, because it permits employers and third-party insurers to continue to utilize traditional risk management techniques, has resulted in reduced or (in some cases) non-existent employee benefits for the disabled. At the same time, more and more employers are opting to self-insure under the Employee Retirement Income Security Act of 1974 (ERISA),3 in …