scholarly journals Health Reform and the Constitutionality of the Individual Mandate

2011 ◽  
Vol 12 (4) ◽  
pp. 236-244 ◽  
Author(s):  
Jeffrey J. Lee ◽  
Deena Kelly ◽  
Matthew D. McHugh
Keyword(s):  
Health Insurance ◽  
Health Reform ◽  
Access To Health Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Critical Issue ◽  
Economic Effects ◽  
Patient Protection ◽  
Individual Mandate ◽  
The Individual

The Patient Protection and Affordable Care Act (ACA) of 2010 is landmark legislation designed to expand access to health care for virtually all legal U.S. residents. A vital but controversial provision of the ACA requires individuals to maintain health insurance coverage or face a tax penalty—the individual mandate. We examine the constitutionality of the individual mandate by analyzing relevant court decisions. A critical issue has been defining the “activities” Congress is authorized to regulate. Some judges determined that the mandate was constitutional because the decision to go without health insurance, that is, to self-insure, is an activity with substantial economic effects within the overall scheme of the ACA. Opponents suggest that Congress overstepped its authority by regulating “inactivity,” that is, compelling people to purchase insurance when they otherwise would not. The U.S. Supreme Court is set to review the issues and the final ruling will shape the effectiveness of health reform.

scholarly journals Health Reform and Changes in Health Insurance Coverage in 2014

2014 ◽  
Vol 371 (9) ◽  
pp. 867-874 ◽  
Author(s):  
Benjamin D. Sommers ◽  
Thomas Musco ◽  
Kenneth Finegold ◽  
Munira Z. Gunja ◽  
Amy Burke ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Reform ◽  
Insurance Coverage ◽  
Health Insurance Coverage

Income, Social Stratification, Class, and Private Health Insurance: A Study of the Baltimore Metropolitan Area

1996 ◽  
Vol 26 (4) ◽  
pp. 655-671 ◽  
Author(s):  
Caries Muntaner ◽  
Ellen Parsons
Keyword(s):  
Health Insurance ◽  
Firm Size ◽  
Social Stratification ◽  
Household Income ◽  
Access To Health Care ◽  
Private Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Metropolitan Statistical Area ◽  
Full Time

Most studies of inequalities and access to health care have used income as the sole indicator of social stratification. Despite the significance of social theory in health insurance research, there are no empirical studies comparing the ability of different models of social stratification to predict health insurance coverage. The aim of this study is to provide a comparative analysis using a variety of theory-driven indicators of social stratification and assess the relative strength of the association between these indicators and private health insurance. Data were collected in a 1993 telephone interview of a random digit dialing sample of the white population in the Baltimore Metropolitan Statistical Area. Indicators of social stratification included employment status, full-time work, education, occupation, industry, household income, firm size, and three types of assets: ownership, organizational, and skill/credential. The association between social stratification and private health insurance was strongest for those having higher household incomes, having attained at least a bachelor's degree, and working in a firm with more than 50 employees, followed by being an owner or manager, and by being employed. The addition of education and firm size improved the prediction of the household income model. The authors conclude that studies of inequalities in health insurance coverage can benefit from the inclusion of theory-driven indicators of social stratification such as human capital, labor market segmentation, and control over productive assets.

The Individual Mandate: Implications for Public Health Law

2011 ◽  
Vol 39 (3) ◽  
pp. 401-413 ◽  
Author(s):  
Wendy E. Parmet
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Universal Coverage ◽  
Health Law ◽  
Healthy Individuals ◽  
Sick People ◽  
Patient Protection ◽  
Death Spiral ◽  
Individual Mandate ◽  
The Individual

No provision of the Patient Protection and Affordable Care Act (PPACA) has proven to be more contentious than the so-called “individual mandate.” Starting in 2014, the mandate will impose a penalty on non-exempt individuals who lack health insurance. According to Congress, the mandate is essential to ensuring near universal coverage. Without it, PPACA’s insurance reforms will lead healthy individuals to delay purchasing health insurance until they require medical care, resulting in risk pools with a disproportionate share of high-risk people. The price of insurance will then climb, causing more and more not-so-sick people to forego health insurance. The resulting “death spiral” will make insurance unaffordable to many more Americans.

National Health Care Reform and the Public's Health

2011 ◽  
Vol 39 (S1) ◽  
pp. 65-68 ◽  
Author(s):  
Corey S. Davis ◽  
Sarah Somers
Keyword(s):  
Health Insurance ◽  
Access To Care ◽  
Insurance Coverage ◽  
Population Level ◽  
Health Insurance Coverage ◽  
President Obama ◽  
National Health Care ◽  
Patient Protection ◽  
Access To Health ◽  
Title Iv

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA or the Act) into law. ACA aims to improve access to care and health outcomes through a number of mechanisms, including requiring most individuals to carry health insurance, prohibiting insurers from denying health insurance coverage based on pre-existing conditions, and creating exchanges through which individuals and families not eligible for employer- or government-sponsored health insurance may purchase coverage. While the Act is aimed primarily at improving individual health by increasing access to health insurance, it also contains a number of provisions targeted directly at improving health at the population level. Most of these provisions, which encompass a variety of disease prevention and access-to-care initiatives, are found in ACA Title IV.

Religious Exemptions to the PPACA's Health Insurance Mandate

2011 ◽  
Vol 37 (4) ◽  
pp. 624-651 ◽  
Author(s):  
Samuel T. Grover
Keyword(s):  
Health Insurance ◽  
Focal Point ◽  
Circuit Court ◽  
Patient Protection ◽  
Commerce Clause ◽  
Legal Challenges ◽  
Individual Mandate ◽  
Insurance Mandate ◽  
The Individual ◽  
Circuit Courts

Arguably the most controversial change to the U.S. healthcare system written into the Patient Protection and Affordable Care Act (“PPACA” or the “Act”) is what has been colorfully termed the Act’s “individual mandate,” the provision that establishes tax penalties for those who do not maintain health insurance in 2014 and beyond. Though the health insurance mandate does not go into effect until 2014, it has already faced numerous constitutional challenges in district and circuit courts, with entirely inconsistent results. Conflicting decisions regarding the Act’s constitutionality at the circuit court level cry out for Supreme Court review. But while the individual mandate’s validity under either the Commerce Clause or Congress’s taxing power has been the focal point of litigation thus far, another aspect of the individual mandate may undermine the goal of establishing universal, affordable healthcare coverage for all Americans. As currently written, the religious conscience exemption from the PPACA’s individual mandate threatens the efficacy of the Act and potentially exposes it to legal challenges under the Constitution’s Religion Clauses.

scholarly journals Health Reform: What's Insurance Got to Do with It? Recognizing Health Insurance as a Separate Species of Insurance

2010 ◽  
Vol 36 (2-3) ◽  
pp. 436-451 ◽  
Author(s):  
Wendy K. Mariner
Keyword(s):  
Health Insurance ◽  
Health Reform ◽  
Access To Health Care ◽  
The United States ◽  
Separate Species ◽  
Insurance Law ◽  
Insurance Reform ◽  
Patient Protection ◽  
Health Insurance Reform ◽  
Actuarial Fairness

Health reform debates in the United States are typically conducted using the language of insurance. President Barack Obama described his hopes for expanding access to care as “health insurance reform.” Both proponents and opponents of reform debated the merits of reform proposals leading to the Patient Protection and Affordable Care Act of 2010 in insurance terms. Yet, disagreements over the structure of reform reveal deep differences in what proponents and opponents of reform mean by insurance and the role it should play in mediating access to health care. Scholars of insurance law are likely to describe insurance somewhat narrowly as a risk spreading device. Industry representatives, among others, often view conventional indemnity insurance as the norm. From this perspective, reforms that move too far beyond underwriting risks can be seen as undermining actuarial fairness, threatening the very idea of insurance and possibly the industry itself.

Sign in / Sign up

Export Citation Format

Share Document