About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

54 U. Kan. L. Rev. 73 (2005-2006)
Discrimination against the Unhealthy in Health Insurance

handle is hein.journals/ukalr54 and id is 83 raw text is: Discrimination Against the Unhealthy in Health Insurance Mary Crossley* I. INTRODUCTION What ends do we expect health insurance to serve in our society? This unresolved question, which one scholar aptly terms the struggle for the soul of health insurance' arises today in many settings. This struggle pits a social solidarity vision of health coverage (by which insurance permits the risk of medical costs to be spread broadly across society, so that healthy persons subsidize the care received by unhealthy persons) against an individualistic vision of health coverage (by which insurance enables each person to pay an amount that reflects as closely as possible his own anticipated cost of care).2 The tension between these two views may emerge, for example, in debates over proposals to require community rating of insurance premiums or to mandate that insurers cover particular services.3 Laws that prohibit discrimination in health insurance also highlight this tension. These laws-whether they apply directly to insurance issuers or to employers providing health insurance coverage as an employment benefit-seem to embody the social solidarity view that persons with particular traits should neither be denied a place in the insurance pool nor be subjected to inferior coverage. The application of these antidiscrimination laws to health insurance occupies center stage in controversies over whether employers are required to provide prescription contraceptive coverage for their employees4 and whether . Dean and Professor of Law, University of Pittsburgh School of Law. 1. Deborah A. Stone, The Struggle for the Soul of Health Insurance, 18 J. HEALTH POL., POL'Y & L. 287, 287 (1993). 2. See id. (discussing the pitfalls of an individualistic vision). 3. Cf Metro. Life Ins. Co. v. Massachusetts, 471 U.S. 724, 731 (1985) (noting that mandated coverage of mental health benefits responded to adverse selection in voluntary mental health insurance market). 4. See, e.g., Dan Margolies, Area Women Sue AT&T over Contraceptive Coverage, KAN. CITY STAR, Jan. 21, 2003, at D 17 (reporting on a case against the plaintiffs' employer for discrimination, alleging the company insurance plan covered sex-related drugs for men, but not contraceptives for women).

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

Purchase Access

Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most