This seminar addresses the health insurance marketplace from a legal perspective, with a focus on how access to health care services is impacted by the manner in which this marketplace is financed and managed. Topics to be explored include:

1. (1) the Affordable Care Act’s insurance reform provisions and where the expanded role of federal subsidies in this marketplace facilitates consumer access to coverage;
2. (2) Federal regulations that anticipate increased health care price transparency to consumers from both hospitals and health plans will improve the health insurance marketplace;
3. (3) How the Employee Retirement Income Security Act (“ERISA”) affects health care coverage offered by employer group health plans, while at the same time acting as a barrier to meaningful State health insurance reforms;
4. (4) Changing provider health care payment systems and their relationship to costs, quality and consumer satisfaction with health care services;
5. (5) The role of private health insurers in providing coverage to Medicare beneficiaries and Medicaid recipients on a full risk basis, and whether adequate controls exist to ensure access and quality of care for these populations;
6. (6) Prescription drug pricing, including the prescription drug price negotiation provisions of the Inflation Reduction Act where constitutional challenges brought by the pharmaceutical industry to delay or defeat their implementation are now pending in federal courts;
7. (7) The role of the Supreme Court in determining consumer access to certain health care services, such as preventive health services and gender affirming care, and the ongoing challenges of coverage related to women’s reproductive decisions.

Course requirements include a seminar paper on a topic of interest to a prospective employer in the healthcare sector.