Skip to Main Content

Tag Archives: insurance

11.23.09

The Confusing Insurance Categories in the Senate Bill

By Tim Jost

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 […]

Categories:
Thematic Areas:

11.17.09

ERISA Tort Preemption and HR 3962, Take Four

By Tim Jost

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). […]

Categories:
Thematic Areas:

11.17.09

Reform’s Hidden Hazards? An Interview with Karen Pollitz

By Lester Feder

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 […]

Categories:
Thematic Areas:

11.16.09

Returning to the Articles of Confederation?

By Tim Jost

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 […]

Categories:
Thematic Areas:

11.15.09

ERISA Preemption Redux

By Peter Jacobson

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 […]

Categories:
Thematic Areas:

11.10.09

What About ERISA’s Tort Liability Pre-Emption?

By Mark Hall

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 […]

Categories:
Thematic Areas:

11.02.09

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

By Tim Jost

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 […]

Categories:
Thematic Areas:

10.24.09

More Legal Issues Raised by Health Insurance Exchange Legislation

By Tim Jost

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 […]

Categories:
Thematic Areas:

The views reflected in this expert column 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.

See the full disclaimer and terms of use.