-
[show abstract]
[hide abstract]
ABSTRACT: Perhaps the biggest of the many surprises found in the Supreme Court's June 28 decision on the Affordable Care Act (ACA) was the Court's conclusion that the law's Medicaid expansion scheduled for 2014 was unconstitutional.(1) Attention before June 28 was focused on whether the Court would uphold the individual mandate to obtain health insurance coverage, but in the wake of the Court's decision, focus has shifted to the question of whether states will refuse to participate in expanding the Medicaid program, given the Court's holding that the Secretary of Health and Human Services cannot enforce the expansion as a mandate. . . .
New England Journal of Medicine 07/2012; 367(11):983-5. · 53.30 Impact Factor
-
New England Journal of Medicine 02/2012; 366(6):487-9. · 53.30 Impact Factor
-
New England Journal of Medicine 10/2011; 365(16):e34. · 53.30 Impact Factor
-
Timothy Stoltzfus Jost
Journal of Health Politics Policy and Law 06/2011; 36(3):501-6. · 0.87 Impact Factor
-
Timothy Stoltzfus Jost
New England Journal of Medicine 05/2011; 364(19):e40. · 53.30 Impact Factor
-
Timothy Stoltzfus Jost
[show abstract]
[hide abstract]
ABSTRACT: On January 31, 2011, federal judge Roger Vinson declared the entire Patient Protection and Affordable Care Act (ACA) unconstitutional.(1) Judge Vinson concluded that Congress had no authority to enact one provision of the law that requires uninsured individuals who can afford health insurance to purchase it. Since that provision is the cornerstone of the entire edifice, Vinson opined, the rest of the law also must fall. The states have broad authority to adopt laws that protect the public health and safety. But the powers of Congress are limited to those delegated by the Constitution. The federal government argued that the . . .
New England Journal of Medicine 02/2011; 364(9):e17. · 53.30 Impact Factor
-
Timothy Stoltzfus Jost
[show abstract]
[hide abstract]
ABSTRACT: Few undertakings in the short history of the implementation of health care reform have been as difficult or contentious as the drafting of regulations to define the statute's “medical loss ratio” requirement. Beginning in 2011, health insurers must report annually the percentage of their premium revenue (excluding expenditures for taxes and regulatory fees) that they spend on “reimbursement for clinical services” and on “activities that improve health care quality.” This is their medical loss ratio. If the medical loss ratio of an insurer in the individual or small-group market falls below 80% (or, for large-group insurers, 85%), the insurer must . . .
New England Journal of Medicine 10/2010; 363(20):1883-5. · 53.30 Impact Factor
-
Timothy Stoltzfus Jost
New England Journal of Medicine 07/2010; 363(2):103-5. · 53.30 Impact Factor
-
Kenneth Arrow,
Alan Auerbach,
John Bertko,
Shannon Brownlee,
Lawrence P Casalino,
Jim Cooper,
Francis J Crosson,
Alain Enthoven,
Elizabeth Falcone,
Robert C Feldman, [......],
Jonathan Skinner,
Stephen M Shortell,
Samuel O Thier,
Sean Tunis,
Lucien Wulsin,
Paul Yock,
Gabi Bin Nun,
Stirling Bryan,
Osnat Luxenburg,
Wynand P M M van de Ven
[show abstract]
[hide abstract]
ABSTRACT: The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges. Employers should also be allowed to participate in these exchanges for their employees' coverage. 8. Create a health coverage board with broad stakeholder representation to determine and periodically update the affordable standard benefit package available through state or regional insurance exchanges.
Annals of internal medicine 05/2009; 150(7):493-5. · 16.73 Impact Factor
-
Timothy Stoltzfus Jost
The Journal of Law Medicine & Ethics 01/2009; 37 Suppl 2:51-70. · 1.22 Impact Factor
-
Timothy Stoltzfus Jost
[show abstract]
[hide abstract]
ABSTRACT: Health policy in the United States is not presently based on the solidarity principle. Public insurance reaches only the elderly, disabled, and poor. Most non-elderly Americans are privately insured, and about 17.5 percent of the population is uninsured. Many Americans who are privately insured lack adequate insurance and suffer financial distress when they need medical care. A recent move toward "consumer-driven" health care, i.e., insurance with higher cost-sharing, is likely to aggravate this problem. The fundamental problem is that Americans are caught between two sharply conflicting visions of justice. For many Americans, "just" health insurance means actuarially fair insurance-everyone pays a premium based on his or her own risk profile. Those who believe in this vision of justice have been in the political ascendancy for the past decade. For other Americans, however, justice looks very much like solidarity--the healthy help those in poor health, the wealthy help those who lack wealth. Everyone should receive at least a basic minimum of health care, which should be publicly funded if necessary. This vision may be moving toward the political ascendancy.
Medicine and law 10/2008; 27(3):605-16.
-
Timothy Stoltzfus Jost
Health Economics Policy and Law 04/2007; 2(Pt 2):233-9. · 1.33 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Federal Trade Commission and Department of Justice 2004 report Improving Health Care: A Dose of Competition expresses a clear allegiance to competition as the organizing principle for health care. In Europe, by contrast, the key organizing principle of health care systems is solidarity. Solidarity means that all have access to health care based on medical needs, regardless of ability to pay. This is not to say that competition is not important in Europe, but competition must take place within the context of solidarity. This article critiques the report from a European perspective, describes the role of competition in Europe (focusing in particular on European Union law), and suggests that the United States could learn from the European perspective.
Journal of Health Politics Policy and Law 07/2006; 31(3):687-703. · 0.87 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Consumer-directed health care movement has recently been given a major boost by section 223 of the Medicare Modernization Act, which provides federal income tax subsidies for health savings accounts coupled with high deductible health plans. The federal tax subsidy, however, will only be available in states whose program of insurance regulation permits high deductible health plans to exist. The MMA represents, therefore, a new approach to federalism in health insurance - offering tax incentives for states to change their approach to insurance regulation rather than preempting state regulation or imposing federal regulation. To date the states have generally responded positively to the federal inducement by adapting their regulations to the federal model. We question, however, whether the states are fully considering the new challenges to insurance regulation raised by consumer-driven health care. This article, based on interviews with state regulators, insurance company representatives, and other experts, attempts to ask the questions that states must answer in deciding how to regulate this new form of health care finance.
Washington & Lee Legal Studies Research Paper Series. 12/2005;
-
Timothy Stoltzfus Jost
Yale journal of health policy, law, and ethics 02/2005; 5(1):437-49.
-
Timothy Stoltzfus Jost
The Journal of Law Medicine & Ethics 02/2004; 32(3):433-41. · 1.22 Impact Factor
-
Timothy Stoltzfus Jost
Health matrix 02/2004; 14(1):141-7.
-
Timothy Stoltzfus Jost
Yale journal of health policy, law, and ethics 02/2004; 4(1):69-84.
-
Timothy Stoltzfus Jost
The American Journal of Comparative Law 02/2002; 50(3):633-46. · 0.65 Impact Factor
-
Timothy Stoltzfus Jost
The Journal of contemporary health law and policy 02/2002; 18(3):613-7.
