The Annals of Health Law Editorial Board is pleased to present our Summer 2015 Issue.
The Editorial Board prides itself on endeavoring to seek out articles that uniquely
contribute to the field of health law and policy. Through selection and publication of
works that address important issues within the health care community, the Annals strives
for continued recognition as one of the country’s preeminent health law and policy
publications. As such, we are pleased to present Volume 24 Issue 2, featuring articles
authored in conjunction with the eighth annual Beazley Institute for Health Law and
Policy Access to Health Care Symposium.
Within the past few years, the face of health insurance in the United States has
transformed significantly, and with an eye to the future, the Annals is proud to introduce
an issue focused on how health insurance in the United States is evolving to meet the
needs of Americans. The articles in this issue explore the implications of both the United
States’ shift away from the traditional health insurance model, and the industry’s
movement toward full implementation of the Affordable Care Act (ACA). Each author
featured in this Issue presents a novel, contemporary, and intellectual discussion that will
enhance our readers’ abilities to navigate the current health insurance tableau.
The Issue begins with a discussion of innovation. In our first article, author Robert B
Leflar elucidates two of Arkansas’s ground-breaking health reform initiatives: the
“private option” for Medicaid expansion, which extends private health insurance to the
state’s lower income residents, and the Arkansas Payment Improvement Initiative, a
program that shifts provider incentives away from fee-for-service payment structures,
directing them instead toward a value-based structure. Professor Leflar discusses the
initiatives, their early outcomes—and seeming success—against a backdrop of a
historically “red” state’s political environment.
Our second article discusses the impact of the ACA’s Essential Health Benefit (EHB)
coverage requirements on the application of conventional rules of insurance policy
interpretation. Author Wendy K. Mariner proposes that, given the shift toward private
health insurance as a means of financing health care, the insurance law applied to plans
with EHB coverage under the ACA should utilize elements of both statutory
interpretation and reasonable expectations doctrines and adopt a hybrid approach as the
new method for interpreting ACA plans. Professor Mariner asserts that such an approach
would allow the legislative purpose of the ACA to become the focus of interpretation so
that the plans may be fairly interpreted across the board.
Our concluding article highlights the long history of voluntary employment-based health
insurance (EBHI) in the United States and its relationship to the ACA. Authors Arnold J.
Rosoff and Anthony W. Orlando explore the history of EBHI in the U.S., weighing the
costs and benefits of the ACA’s attempt to alter a system traditionally rooted in the minds
of the American people as being tied to employment. The authors provide insight into
employer actions and decisions surrounding the evolving health insurance landscape and