Tag Archives: insurance

11.23.09

The Confusing Insurance Categories in the Senate Bill

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Another feature of the Senate bill that compares unfavorably with the House bill is its confusing definitions of insurance coverage. The House bill recognizes one category of private insurance, a “qualified health benefits plan,” which employers are obligated to provide and individuals to buy. This term is used throughout the bill. Only grandfathered plans are […]

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11.23.09

The Senate Bill and the States

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In my post of November 16, Returning to the Articles of Confederation, I compared the position that I expected the Senate bill to take on the role of the states in implementing health reform unfavorably to the approach taken by the House bill. The language of the Senate bill is now available, and, unfortunately, it […]

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11.18.09

Does HR 3962 Make Being Uninsured a Crime?

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According to the Wall Street Journal of November 18, the latest front of the health care debate is a charge that people who refuse to buy health insurance could, under the House bill, spend five years in prison. The article quotes Rep. Peter Roskam (R. Ill.) as stating “if you don’t comply with the individual […]

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11.17.09

ERISA Tort Preemption and HR 3962, Take Four

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In recent days, Mark Hall, Richard Johnson, and Peter Jacobson have all offered opinions as to how HR 3962, if enacted, would affect ERISA preemption of state tort claims against insurers. Let me offer a fourth opinion. First, remember that ERISA tort liability preemption is based primarily on section 502 of ERISA (29 USC 1132). […]

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11.17.09

Reform’s Hidden Hazards? An Interview with Karen Pollitz

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Karen Pollitz is a research professor at the Georgetown University Health Policy Institute. The O’Neill Institute’s Lester Feder spoke with her on November 16 about potential loopholes in reform legislation. Lester Feder: I want to start by asking what you think of the reform proposals that have emerged. Karen Pollitz: I think we’ve got a […]

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11.16.09

Returning to the Articles of Confederation?

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A week ago the House of Representatives adopted HR 3962, the “Affordable Health Care for America Act.” In the very near future, the Senate will begin consideration of some version of the “America’s Healthy Future Act” or the “Affordable Health Choices Act.” Although we do not know the exact language of the Senate bill, its […]

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11.15.09

ERISA Preemption Redux

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In a recent post, Mark Hall raises an interesting issue regarding ERISA preemption and the proposal in HR 3962, the recently enacted House of Representatives’ health reform bill. Mark suggests that: “1) for insurance sold outside of the exchange, ERISA law and its preemption remains the same; 2) for insurance sold inside the exchange, ERISA […]

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11.10.09

What About ERISA’s Tort Liability Pre-Emption?

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In addition to largely ignoring tort reform, the health reform process is ignoring the hash that Congress and courts previously have made of ERISA’s pre-emption of state tort suits against health insurers.  Readers will recall that, according to AETNA v. Davila, 542 U.S. 200 (2004), personal injuries caused by insurance claims denials cannot be adequately […]

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11.02.09

HR 3962, ERISA, HIPAA, McCarran-Ferguson, and State Law. How Does the Puzzle Fit Together?

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Congress is not writing on a clean slate in enacting health care financing reform legislation. We already have, of course, massive federal health care programs: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Hundreds of pages of the bills Congress is considering are consumed by amendments to the statutes governing these programs. The legislation […]

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10.24.09

More Legal Issues Raised by Health Insurance Exchange Legislation

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The following is part of a memorandum on legal and policy issues raised by health insurance exchanges, which will be presented at the O’Neill Center’s Legal Issues in Health Care Reform conference on Monday, October 26. The full paper from which it is taken is available here. In my last post, I discussed the constitutional […]

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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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