Law Commons^™

Party Polarization And Judicial Review: Lessons From The Affordable Care Act, Neal Devins

Faculty Publications

Congress paid nearly no attention to the Constitution when enacting the Affordable Care Act (ACA) in 2010. Legislative hearings and committee reports ignored the Constitution altogether; legislative debates largely did the same. This Essay both highlights Congress’s indifference to the Constitution when enacting the ACA and examines the reasons behind this legislative failure. In particular, this Essay advances three explanations. First, Congress is generally uninterested in “public goods” like constitutional interpretation. Second, the polarization of Democrats and Republicans in Congress further depresses Congress’s interest in thinking about the Constitution; instead, the majority party seeks to limit opportunities for the minority …

Open Sesame - Anatomy Of Regulatory Regime For Foreign Investment In China’S Private Health Insurance Market, Tao Liang

Tao LIANG

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

Faculty Publications

No abstract provided.

The Individual Mandate And The Taxing Power, Erik M. Jensen

Faculty Publications

This article, prepared for a symposium at the Salmon P. Chase College of Law, Northern Kentucky University, considers whether the Taxing Clause provides an alternative constitutional basis, as some have recently argued, for the individual mandate in the Patient Protection and Affordable Care Act of 21 - the requirement, going into effect in 214, that most individuals acquire satisfactory health insurance or pay a penalty. The article concludes that the Taxing Clause arguments are misguided. At best, the Clause can provide authority for the penalty, not for the mandate as a whole. Furthermore, the article questions whether the penalty will …

Cobra Subsidies: A Compelling Narrative Of Policy Impact On The Unemployed, Uninsured, Hannah N. Gregg

CMC Senior Theses

This paper analyzes a 2009 U.S. policy which provided short term federal subsidies for COBRA health insurance premiums. COBRA allows the recently unemployed to continue purchasing health insurance through their employment-based insurance plan for a short time period after they become unemployed. Early analysis found low take-up rates for COBRA insurance due to the exceedingly high cost of full health insurance premiums, especially for those who have just lost a steady employment income. A short term 65 percent federal subsidy for COBRA insurance was implemented as a part of the American Recovery and Reinvestment Act in 2009. Subsidy policy proposed …

Creating Multi-State Qualified Health Plans In Health Insurance Exchanges: Lessons For Rural And Urban America From The Federal Employees Health Benefits Program, Sidney D. Watson, Yolonda Campbell, Timothy Mcbride

Saint Louis University Journal of Health Law & Policy

No abstract provided.

Can You Really Keep Your Health Care Plan? The Limits Of Grandfathering Under The Affordable Care Act, Elizabeth Weeks Leonard

Scholarly Works

This article examines the rhetoric and reality of President Obama's repeated hallmark promise during federal health reform that "you can keep your health plan," as one example of the Administration's equivocal stance toward deregulation. Although rhetorically supporting the popular preference for decreased government involvement in health care, the Obama Administration, in several instances, has achieved significant re-regulation through the intricacies of executive branch rule-making. The Affordable Care Act's "grandfather rule" (Section 1251, "Preservation of Right to Maintain Existing Coverage") purports to uphold the "you can keep your health plan" promise. But the regulatory requirements for plans to retain grandfathered status …

The Future Of Employment-Based Health Insurance After The Patient Protection And Affordable Case Act, Kathryn L. Moore

Law Faculty Scholarly Articles

In the United States, unlike in all other advanced industrial states, health care is financed principally through employment-based health insurance. In 2009, more than 156 million individuals under the age of sixty-five, or 59% of that population, were covered by employment- based health insurance.

On March 21, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA). Described as seminal as the enactment of the Employee Retirement Income Security Act (ERISA), PPACA fundamentally reforms the American health care system. PPACA, however, does not eliminate the system’s reliance on employment- based health insurance. Instead, it builds on, and arguably …

Erisa Preemption Doctrine As Health Policy, Joshua P. Booth, Larry I. Palmer

Faculty Publications

No abstract provided.

Will Employers Undermine Health Care Reform By Dumping Sick Employees?, Daniel Benjamin Schwarcz, Amy Monahan

Daniel Benjamin Schwarcz

This Article argues that federal health care reform may induce employers to redesign their health plans to encourage high-risk employees to opt out of employer-provided coverage and instead acquire coverage on the individual market. Although largely overlooked in public policy debates, this prospect of employer dumping of high-risk employees raises serious concerns about the sustainability of health care reform. In particular, it threatens the viability of individual insurance markets and insurance exchanges by raising the prospect of adverse selection caused by the entrance of a disproportionately high-risk segment of the population. This risk, in turn, threatens to indirectly increase the …

Race, Sex And Genes At Work: Uncovering The Lessons Of Norman-Bloodsaw, Elizabeth Pendo

All Faculty Scholarship

The Genetic Information Nondiscrimination Act of 2008 (“GINA”) is the first federal, uniform protection against the use of genetic information in both the workplace and health insurance. Signed into law on May 21, 2008, GINA prohibits an employer or health insurer from acquiring or using an individual’s genetic information, with some exceptions. One of the goals of GINA is to eradicate actual, or perceived, discrimination based on genetic information in the workplace and in health insurance. Although the threat of genetic discrimination is often discussed in universal terms - as something that could happen to any of us - the …

Will Americans Embrace Single-Payer Health Insurance: The Intractable Barriers Of Inertia, Free Market, And Culture, Susan A. Channick

Susan Channick

This article posits that the adoption of single-payer health insurance is effectively impossible in the United States. In spite of evidence that a single-payer system might be substantially more efficient and inexpensive than the complex, administratively-burdened multi-payer system we currently have, the probability that it will be part of health care reform is remote at best. The article identifies a number of reasons that a single-payer health insurance system cannot succeed ranging from inertia, path dependence, the expense of Medicare, the American belief in looking to the private sector for solutions to even large social problems, the fear of big …

Will Americans Embrace Single-Payer Health Insurance: The Intractable Barriers Of Inertia, Free Market, And Culture, Susan Adler Channick

Susan Channick

This article posits that the adoption of single-payer health insurance is effectively impossible in the United States. In spite of evidence that a single-payer system might be substantially more efficient and inexpensive than the complex, administratively-burdened multi-payer system we currently have, the probability that it can be part of health care reform is remote at best. The article identifies a number of reasons that a single-payer health insurance system cannot succeed ranging from inertia, path dependence, the expense of Medicare, the American belief in looking to the private sector for solutions to even large societal problems, the fear of big …

U.S. V. Rxdepot: The Battle Between Canadian Store-Front Companies, The Fda And Brand-Name Companies, Michael Rosenquist

Marquette Intellectual Property Law Review

Prescription drugs are taken by millions of Americans each year for everything from seasonal allergies to beating cancer. However, millions of Americans each year are without health insurance of some form of prescription drug coverage. When the costs of prescriptions are beyond those Americans' reach, where should they turn to for help? RxDepot, Inc. was a company founded by an entrepreneur, Carl Moore, who believed he had the answer to the problem. In 2002, he began opening stores in the United States where customers could bring in the prescription, have it sent to a Canadian pharmacy, and receive their prescriptions …

Can Consumer-Choice Plans Satisfy Patients? Problems With Theory And Practice In Health Insurance Contracts, Wendy K. Mariner

Faculty Scholarship

Much scholarship has considered whether health care - and insurance - should be distributed by voluntary contract or subject to government standards or regulation. Contracts will likely play a key distributive role in any future health care system. Yet we do not fully understand where private contracting does and does not work to further the goals of equitable access to affordable care. This article examines the role of health insurance policies in defining and enforcing access to medical care, focusing on private employment-based group health benefit plans. It describes models of consumer choice health plans and critiques their capacity for …

A Battle Over Birth "Control": Legal And Legislative Employer Prescription Contraception Benefit Mandates, C. Keanin Loomis

William & Mary Bill of Rights Journal

Under the Pregnancy Discrimination Act (PDA), employers are prohibited from discriminating against women by treating pregnancy and childbirth different from other medical conditions. Employers who offer medical benefits to their employees have thus been required to cover pregnancy-related medical costs on the same terms as other medical coverage. The cost of prescription contraception, however, has generally not been covered by employer-sponsored medical plans, even while other prescription drugs were. This Note examines the recent case of Erickson v. Bartell Drug Co., which challenged this practice of excluding prescription contraception coverage as discriminatory under the PDA, and argues that further federal …

Aids Caps, Contraceptive Coverage, And The Law: An Analysis Of The Federal Anti-Discrimination Statutes’ Applicability To Health Insurance, Sharona Hoffman

Faculty Publications

Traditionally, health insurers have enjoyed the freedom to determine their own terms of coverage, to decide to what extent, if any, patients should be reimbursed for different kinds of treatment, and to establish premium prices. Health insurers typically deny coverage for speech therapy, eye glasses, hearing aids, most foot care, and treatment for infertility. Many insurance providers also exclude or severely limit coverage for mental health, dental care, AIDS, diabetes mellitus, morbid obesity, epilepsy, and alcoholism or drug abuse. Therefore, while some Americans enjoy full coverage for all their health needs, others who have insurance and suffer from serious or …

A Proposal For Federal Legislation To Address Health Insurance Coverage For Experimental And Investigational Treatments, Sharona Hoffman

Faculty Publications

Health insurance coverage for experimental treatments has generated significant debate and frequent litigation in recent years. In many cases, denials of coverage for investigational therapies constitute economically and ethically sound policy. This article argues, however, that health insurance providers should be required to cover experimental treatments in limited circumstances, namely, when they are administered in phase III clinical trials to patients with terminal illnesses who are likely to die within two years. This coverage mandate would help the sickest patients, who have no other treatment options, and would benefit medical researchers, who often face a dearth of patients willing to …

The Contingent Employee Benefits Problem, Mark Berger

Faculty Works

In the contemporary American workplace, benefits are a critical a component of overall compensation. American workers look to their employers for such non-salary items as retirement programs, health insurance, sick pay, and paid vacations. However, the costs of such benefits have been rising rapidly and employers have sought ways to avoid paying them. Increasingly, employers have been using various techniques to create a pool of contingent workers who, even if they work side-by-side with the employer's traditional employees, nevertheless receive none of the benefits made available to members of the regular workforce. These contingent employee arrangements include utilizing contract workers, …