Law Commons^™

Hb 1013: Georgia Mental Health Parity Act, Justin Crozier, Betsy Hicks, Jordan Kalteux

Georgia State University Law Review

The Act overhauls Georgia’s mental health system by enforcing compliance with federal mental health parity law. Most notably, the Act requires health insurers to provide coverage for mental health and substance use disorders equitably with physical health and defines generally accepted standards of care. The Act requires insurers to submit annual parity compliance reports and requires the Commissioner to make annual data calls and submit annual reports. The Act requires compliance with a minimum 85% medical loss ratio. The Act provides for cancelable loans to Georgia residents enrolled in related educational programs and creates grant programs for accountability courts. The …

Executive Action To Expand Health Services In The Biden Administration, Timothy M. Westmoreland, Maxwell Gregg Bloche, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

President Biden’s health platform is ambitious, encompassing a public insurance option, a reduced age of eligibility for Medicare, and expanded tax credits to subsidize premiums. Yet, with divided government, he may be unable to achieve bold health reforms. However, his administration can substantially improve health care access through executive action. In this Viewpoint, we propose a series of measures that could increase access to insurance coverage and health care that are achievable under the Affordable Care Act (ACA) and Medicaid.

Health Insurance Coverage And Factors That Affect Access To Healthcare, Bryce A. Jerin

Senior Theses

The modern landscape of the U.S. healthcare economy is a culmination of many decades of debate and growth. The system of health insurance coverage in the United States allows millions of Americans to participate in the delivery and access to care, while keeping millions out. Health insurance coverage, the availability of pharmaceuticals, and hospital billing practices are factors that affect the level of access to care. Healthcare has developed into a complex system with various stakeholders who act on their own incentives. Encouraging rational pricing for health care services is an important step toward ensuring access to care for everyone …

Contracting For Healthcare: Price Terms In Hospital Admission Agreements, George A. Nation Iii

Dickinson Law Review (2017-Present)

This article discusses the application of contract law principles to the relationship between hospitals and patients to determine how much patients owe for the health care they receive. For patients who are covered by in-network health insurance the exact nature of the contract created with the hospital usually is not relevant to the patient’s financial obligation because the patient’s contract with the hospital is superseded by the contract between the patient’s health insurer and the hospital. Nevertheless, even in-network patients are financially impacted, via increased insurance premiums, by the contract analysis discussed here, and for the increasing number of patients …

Brief Of Law Professors Bruce P. Frohnen, Robert P. George, Alan J. Meese, Michael P. Moreland, Nathan B. Oman, Michael Stokes Paulsen, Rodney K. Smith, Steven D. Smith, And O. Carter Snead As Amici Curiae In Support Of The Petitioners, Nathan B. Oman, John D. Adams, Matthew A. Fitzgerald

Nathan B. Oman

No abstract provided.

Why Congress Did Not Think About The Constitution When Enacting The Affordable Care Act, Neal Devins

Neal E. Devins

No abstract provided.

The Failed Promise Of Mental Health Parity In Virginia: A Missing Key In Mental Healthcare Access, Zachary Woerner

William & Mary Business Law Review

For those who suffer from the most serious mental illnesses, access to mental healthcare is critically important, but often frustrated by a Byzantine insurance system. The goal of this Note is to sift through the various mental health insurance parity laws, both nationally and statewide, and determine where this system breaks down. The Note will argue that lack of enforcement of parity laws plays a critical role in much of the dysfunction in the marketplace.

Legislation in Virginia and elsewhere is not always deficient on its face. Instead, laws critically lack regulators willing or able to implement them. This creates …

Chapter 8: Is The Preemption Clause Of Erisa Unconstitutional?, Andrew Morrison, Elizabeth Mccuskey

Faculty Scholarship

The authors suggest plaintiffs and/or state attorneys general should consider taking Justice Clarence Thomas up on his effective suggestion, in the 2016 Supreme Court case of Gobeille v. Liberty Mutual Insurance, to put before the federal courts the question whether the preemption clause of the Employee Retirement Income Security Act of 1974 (“ERISA”) represented a valid exercise of federal power under the Commerce Clause of the Constitution. ERISA’s exceptionally broad statement of preemption does in fact seem to have unconstitutional reach: It purports to preempt “any and all” state laws that simply “relate to” employee benefits, a formulation without logical …

Medicaid For All?: State-Level Single-Payer Health Care, Lindsay Wiley

Articles in Law Reviews & Other Academic Journals

If single-payer health care is ever to become a reality in the United States, it will very likely be pioneered by a state government, much like Canada’s single-payer system was first adopted in the provinces. Canada’s system operates more like U.S. Medicaid — financed nationally but administered largely by the provinces — than U.S. Medicare. This article describes three basic strategies progressive U.S. state governments are exploring for achieving universal access to high-quality health care and better health outcomes for their residents. First, maximizing eligibility for the existing Medicaid program using matching federal funds. Second, taking up the mantle of …

Privacy Of Information And Dna Testing Kits, Shanna Raye Mason

Catholic University Journal of Law and Technology

In modern times, consumers desire for more control over their own health and healthcare. With this growing interest of control, direct to consumer DNA testing kits have never been more popular. However, many consumers are unaware of the potential privacy concerns associated with such use. This comment examines the popularity and privacy risks that are likely unknown to the individual consumer. This comment also addresses the shortcomings of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as well as the Genetic Information Nondiscrimination Act of 2008 (GINA) in regard to protecting individual’s genetic information from misuse. This comment …

The Body Politic: Federalism As Feminism In Health Reform, Elizabeth Mccuskey

Faculty Scholarship

This essay illuminates how modern health law has been mainstreaming feminism under the auspices of health equity and social determinants research. Feminism shares with public health and health policy both the empirical impulse to identify inequality and the normative value of pursing equity in treatment. Using the Affordable Care Act's federal health insurance reforms as a case study of health equity in action, the essay exposes the feminist undercurrents of health insurance reform and the impulse toward mutuality in a body politic. The essay concludes by revisiting-from a feminist perspective-scholars' arguments that equity in health insurance is essential for human …

Healthcare And Its Impact On Nurses: The United States Vs. The United Kingdom, Alexandria Colovos

Mahurin Honors College Capstone Experience/Thesis Projects

Currently, in the United States, the topic of healthcare reform is in the back of everyone’s mind. What will come of our healthcare system? Will the cost of healthcare decrease? Will patients have better access to care? With this Capstone Experience/Thesis, I wanted to explore the differences between the current healthcare system that we have in the United States, to the nearly seventy-year-old National Health Service (NHS) in the United Kingdom, which provides healthcare to all. The NHS is free at the point of care and is funded by taxation. To understand if such a system would work in the …

Obamacare: Under The Knife, Kylan Rutherford

Marriott Student Review

President Trump and Congress have tried and failed to pass through a replacement plan for Obamacare. This article details why this effort failed, and several issues extant in Obamacare that may move the law toward insolvency. These issues are the mandate, guaranteed issue, and the 'risk corridor' funding set up to back struggling insurance companies.

Healthism, Intersectionality, And Health Insurance: The Compounded Problems Of Healthist Discrimination

Marquette Benefits and Social Welfare Law Review

Healthism can identify situations where a person is subject to a particular form of bigotry based on their individual health status. In health insurance, some forms of healthism are unavoidable due to the very nature of health insurance structures. However, when analyzing health insurance programs, particularly those that are funded through government, it is possible to utilize a healthism framework to, first, recognize and minimize and potentially ameliorate the worst effects of healthism combined with intersectionality. This Essay analyzes these issues as they relate to health insurance, Medicare, and the potential role of the Independent Payment Advisory Board.

From The Technical To The Personal: Teaching And Learning Health Insurance Regulation And Reform, Allison K. Hoffman, Whitney A. Brown, Lindsay Cutler

Saint Louis University Law Journal

No abstract provided.

Teaching Health Law From A Social-Ecological Perspective, Lindsay Wiley

Articles in Law Reviews & Other Academic Journals

I started teaching health law relatively recently-in the fall of 2010, just after the Affordable Care Act ("ACA") was enacted, but before much of it had been implemented. This timing has been a blessing because I started with a fresh slate rather than adding the ACA on top of a previously developed course. It has also been a curse, but ultimately I appreciate that I started teaching the course at a time when the ACA was under constant threat. The ever-evolving nature of health law means that health law teachers must always bear in mind a goal that applies to …

From The Technical To The Personal: Teaching And Learning Health Insurance Regulation And Reform, Allison K. Hoffman, Whitney A. Brown, Lindsay Cutler

All Faculty Scholarship

In the Fall of 2016, I taught Health Law and Policy for the fourth consecutive semester. Over time, one thing has become increasingly clear: the aspect of this course that I work with most closely as a scholar—the regulation of health care financing and insurance, including the Patient Protection and Affordable Care Act (ACA)—is also the material that I find the most challenging to teach. Every time I reflect on teaching this material, and hear from students about how they learn this material, the thing that stands out is how critical it is that my students understand the profound impact …

Remedying Stigma-Driven Health Disparities In Sexual Minorities, Valarie K. Blake

Law Faculty Scholarship

No abstract provided.

Everything Old Is New Again: Will Narrow Networks Succeed Where Hmos Failed?, Deborah R. Farringer

Law Faculty Scholarship

As health insurers try to navigate the new limitations set forth under the ACA, including prohibitions on denying individuals with pre-existing conditions and limitations on the rating of patients, insurers are looking towards models that will enable them to control costs without access to their usual tools. What they have developed is not so much a new insurance model, but actually a concept that first arose during the rise of managed care; that is, limited provider networks utilized within health maintenance organizations (“HMOs”). These “new” insurance products, often referred to as narrow networks or high-performance networks, offer beneficiaries a more …

Brief Of Law Professors Bruce P. Frohnen, Robert P. George, Alan J. Meese, Michael P. Moreland, Nathan B. Oman, Michael Stokes Paulsen, Rodney K. Smith, Steven D. Smith, And O. Carter Snead As Amici Curiae In Support Of The Petitioners, Nathan B. Oman, John D. Adams, Matthew A. Fitzgerald

Briefs

No abstract provided.

Do Not Pass Go And Do Not Collect $200: Denying Medical Insurance To Parents Who Register Themselves Before Registering Their Children, Amanda Hamm

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Sex Reassignment Surgery: Required For Transgendered Prisoners But Forbidden For Medicaid, Medicare, And Champus Beneficiaries, Jennifer L. Casazza

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Health Law As Social Justice, Lindsay Wiley

Articles in Law Reviews & Other Academic Journals

Health law is in the midst of a dramatic transformation. From a relatively narrow discipline focused on regulating relationships among individual patients, health care providers, and third-party payers, it is expanding into a far broader field with a burgeoning commitment to access to health care and assurance of healthy living conditions as matters of social justice. Through a series of incremental reform efforts stretching back decades before the Affordable Care Act and encompassing public health law as well as the law of health care financing and delivery, reducing health disparities has become a central focus of American health law and …

Two Years Later And Counting: The Implications Of The Supreme Court's Taxing Power Decision On The Goals Of The Affordable Care Act, Alberto R. Gonzales, Donald B. Stuart

Law Faculty Scholarship

In 2012, in a highly anticipated decision, the United States Supreme Court upheld the constitutionality of a requirement that most Americans obtain health insurance or pay a monetary penalty.' The statute in question that contained this requirement, the Patient Protection and Affordable Care Act (Act or ACA), often labeled as "Obamacare," or the Affordable Care Act, was a monumental piece of legislation (over 900 pages) that was passed by Congress and signed into law by President Barack Obama in 2010. The Act represented a significant overhaul of the country's health care system and structure. The primary objectives of this legislation …

Mind The Gap: Basic Health Along The Aca’S Coverage Continuum, Sallie Thieme Sanford Sanfords@Uw.Edu

Articles

As ACA implementation proceeds, expansion states should mind the gap — the gap between Medicaid and Marketplace. In this transition between insurance platforms, people can stumble. As a bridge between expanded Medicaid and the insurance Marketplaces, the ACA allows states to enact a Basic Health Program (BHP) supported by federal funds. The BHP option, which has been delayed until 2015, aims to reduce insurance costs and increase care continuity for low-income individuals and families. Interested states face a complicated calculus, one with significant unknowns and moving parts. In this article, I first place this new insurance affordability program in the …

A Vision Of An Emerging Right To Health Care In The United States: Expanding Health Care Equity Through Legislative Reform, Allison K. Hoffman

All Faculty Scholarship

When asked to write a chapter on how litigation has advanced a right to health in the U.S., I responded skeptically, both because evidence of the existence of any such right is weak and the role of litigation in promoting its development is small at best. A snapshot of the U.S. health care system evinces the absence of even a more narrow right to health care – a guarantee of equitable access to basic medical care. Instead, it reveals a fragmented picture of public and private financing that leaves many people lacking meaningful access to care. More so, the places …

Group Life And Health Ins. V. Royal Drug Co.: The Narrowing Exemption Of The Business Of Insurance From Federal Antitrust Scrutiny , Stanley K. Yamada Jr.

Pepperdine Law Review

No abstract provided.

Employers’ Use Of Health Insurance Exchanges: Lessons From Massachusetts, Mark A. Hall

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Should Public Buildings Be Used For Worship, Stephen Wermiel

Articles in Law Reviews & Other Academic Journals

No abstract provided.

The Competitive Consequences Of Most-Favored-Nation Provisions, Jonathan Baker, Judith A. Chevalier

Articles in Law Reviews & Other Academic Journals

"Most Favored Nation" contractual provisions have come under scrutiny in recent years by antitrust authorities in both the US and EU. MFNs are a type of vertical agreement between suppliers and buyers. The literature has recognized that there may be efficiency rationales for these arrangements but the literature has also recognized that these arrangements have anticompetitive potential. In this paper, we distill the economics literature on MFNs to explore both possibilities.