Insurance Law Commons^™

Using Payroll Deduction To Shelter Individual Health Insurance From Income Tax, David Orentlicher

Scholarly Works

In this article, Professor Orentlicher and his colleagues assess the impact of state laws requiring or encouraging employers to establish ‘‘section 125’’ cafeteria plans that shelter employees’ premium contributions from tax.

So Much For The Commerce Clause Challenge To Individual Mandate Being "Frivolous", Randy E. Barnett

Georgetown Law Faculty Publications and Other Works

Remember when the Commerce Clause challenge to the individual insurance mandate was dismissed by all serious and knowledgeable constitutional law professors and Nancy Pelosi as "frivolous"? Well, as Jonathan notes, the administration is now apparently telling the New York Times that the individual insurance "requirement" and "penalty" is really an exercise of the Tax Power of Congress.

Turning Citizens Into Subjects: Why The Health Insurance Mandate Is Unconstitutional, Randy E. Barnett

Georgetown Law Faculty Publications and Other Works

In 2010 something happened in this country that has never happened before: Congress required that every person enter into a contractual relationship with a private company. While the author realizes that writers make lots of factual claims that readers are wise to be skeptical about, he proves that an economic mandate like this one is unprecedented. If this mandate had ever happened before, everyone reading this passage would know all the contracts the federal government requires them to make, upon pain of a penalty enforced by the Internal Revenue Service (IRS). No reader, however, can recite any such mandate and …

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 …

Who Pays? Who Benefits? Unfairness In American Health Care, Clark C. Havighurst, Barak D. Richman

Faculty Scholarship

American-style health insurance greatly amplifies price-gouging opportunities for health care providers, who inflate prices both to enrich themselves and to subsidize and expand the nation’s health care enterprise. To the extent that lower- and middle-income Americans with private health coverage pay premiums that go to support and expand the system, they are subject to an unfair (regressive) “head tax” levied by unaccountable entities for ostensibly public but also private purposes. Lower-income premium payers also often pay for costly health coverage designed to suit the economic interests and values of professional and other elites rather than their own. They also appear …

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 …

Most Claims Settle: Implications For Alternative Dispute Resolution From A Profile Of Medical-Malpractice Claims In Florida, Neil Vidmar, Mirya Holman, Paul Lee

Faculty Scholarship

No abstract provided.

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 …

Erisa Subrogation And The Controversy Over Sereboff: Silencing The Critics, The Divided Bench Is A Legitimate Standard, Ashley A. P. Frazier

Georgia Law Review

ERISA protects employees in the administration of
employer-sponsored benefit plans. When a party is injured
by third parties and a health and welfare benefit plan
governed by ERISA pays benefits, conflicts have arisen
between insurers seeking subrogation and individuals
seeking full recovery. Injured parties claim they should
not have to reimburse insurers while insurers deny
responsibility for damage caused by third parties. The
Supreme Court set the standard for plan fiduciary rights
to ERISA subrogation in Sereboff v. Mid Atlantic Medical
Services, Inc. Sereboff held that the plain wording of 29
U.S.C. § 1132(a)(3) means equitable relief available under
the …

Family Security Insurance: A New Foundation For Economic Security, Workplace Flexibility 2010, Georgetown University Law Center, Berkeley Center On Health, Economic & Family Security, Uc Berkeley School Of Law

Published Reports

A report released by Georgetown Law's Workplace Flexibility 2010 and the Berkeley Center on Health, Economic & Family Security (Berkeley CHEFS) outlining a blueprint for establishing and financing a new national insurance program to provide wage replacement for time off for health and caregiving needs. The report describes the need among working Americans for time off from work to address personal illness, to care for a new child, or to care for a loved one with a serious illness. It argues that the need for time off is no longer an issue for individual families or select industries, but a …

American Law: Integrating Ultra-Traditional Muslims Through Accommodations, Mohamed A. Elsanousi

Maurer Theses and Dissertations

Appropriate legal accommodations for religious minorities can support their integration into American society. Historically, the teachings and practices of many religious communities that have otherwise conflicted with state or federal law have been successfully preserved through legal accommodations. A brief comparison with the experiences of such groups as the Hasidic Jewish community will provide a context for religiously based legal accommodations for various religious communities within the United States.

This dissertation examines the particular situation of a Tablighi Jamaat community, a Muslim missionary movement, as a means to explore how legal accommodations facilitate the successful, stable integration of such groups. …

Insurance, Stephen L. Cotter, Stephen M. Schatz, Bradley S. Wolff

Mercer Law Review

This survey year, from June 1, 2009 to May 31, 2010, brought significant developments to a broad array of insurance fields. Both the Georgia Supreme Court and the United States Court of Appeals for the Eleventh Circuit held that a cancellation notice for nonpayment of a premium can also contain an offer to reinstate upon payment in the "grace" period. The supreme court has strictly enforced basic concepts of "offer and acceptance" in the context of time-limit policy demands containing less than complete release and indemnity terms, thereby appearing to put insurers in "catch 22" situations with their insureds. A …

Erisa & Uncertainty, Brendan S. Maher, Peter K. Stris

Faculty Scholarship

In the United States, retirement income and health insurance are largely provided through private promises made incident to employment. These “benefit promises” are governed by a statute called ERISA, which many healthcare and pension scholars argue is the cause of fundamental problems with our nation’s health and retirement policy. Inevitably, however, they advance narrowly tailored proposals to amend the statute. This occurs because of the widely-held view that reform should leave undisturbed the underlying core of the statute. This Article develops a theory of ERISA designed to illustrate the unavoidable need for structural reform.

Reauthorizing Schip: Only A Starting Point, Pamela Newell

North Carolina Central Law Review

No abstract provided.

Misclassifying The Insurance Policy: The Unforced Errors Of Unilateral Contract Characterization, Hazel Beh, Jeffrey W. Stempel

Cardozo Law Review

No abstract provided.

The Deepwater Horizon Oil Spill: Potential Insurance Coverage Implications, Lynn K. Neuner, W. Nicholson Price

Articles

More than 300 lawsuits have already been filed in Louisiana, Florida, Texas, Mississippi, and Alabama against BP and other corporations involved in the Deepwater Horizon oil spill, including Transocean, Halliburton, and Cameron, with thousands more anticipated. This article briefly addresses the contours of the coverage lawsuit already filed against BP and other coverage disputes we may see in the future.

Rethinking Trust Law Reform: How Prudent Is Modern Prudent Investor Doctrine?, Stewart E. Sterk

Articles

During the 1990s, modern portfolio theory provided the theoretical foundation for significant reforms in trust investment doctrine-reforms that freed trustees from a legal regime in which they faced potential liability for making "speculative" investments. The reforms enabled trustees to pursue investment policies that protected beneficiaries against inflation risk. But the reforms worked too well; they encouraged trustees to invest a higher percentage of trust assets in equities just in time for a decade that has seen two precipitous stock market declines. Although no sensible investment strategy would have avoided losses during these periods of market turmoil, the doctrinal reforms endorsed …

Equally Insured? Lasting Insurance Industry Reform Came Only With A Rethinking Of Race, Mary L. Heen

Law Faculty Publications

Earlier this decade, some of America’s best-known life insurance companies quietly settled multimillion-dollar civil rights lawsuits challenging race-based life insurance rates and benefits. As a result, those companies closed a chapter of American economic history that began after the Civil War with the door-to-door marketing of small individual life insurance policies to poor workers, including former slaves, and their families. The closing of this chapter in history also marked the end of a form of Jim Crow race discrimination largely invisible to the American public.

The “Licentiousness” In Religious Organizations And Why It Is Not Protected Under Religious Liberty Constitutional Provisions, Marci A. Hamilton

Articles

No abstract provided.

Crisis On Campus: Student Access To Health Care, Bryan A. Liang

University of Michigan Journal of Law Reform

College-aged adults are an overrepresented group in the uninsured population of the United States, and traditionally underserved minorities are disproportionately affected. Students with private health insurance are often functionally uninsured as well, since most schools refuse to accept this traditionally elite calling card on campus. Consequently, the large uninsured and functionally uninsured populations often rely on school-sponsored health insurance plans for access to care. These plans have uneven coverage, limited benefits, exclusions and high co-pays and deductibles, and provide little health care security for their beneficiaries. Further, schools and insurance companies have profited substantially from these student plans, raising the …