Join Miranda Yaver, Assistant Professor of Political Science n for an upcoming Faculty Research Talk, Damages Denied: The Impact of ERISA’s Statutory Design on Patients’ Access to Health Care.

Presenters will begin by discussing their topic, and each session will close with a question and answer segment. All presentations are virtual and free and the Zoom link will be sent the day before this discussion.

Despite being written primarily as a pension law, the Employment Retirement Income Security Act (ERISA) of 1974 has come to apply to the majority of employer-sponsored health plans in the United States. However, despite its health care salience, it has a key statutory design feature that limits patients’ ability to access their prescribed care: it precludes damages recovery for those who have been denied health coverage, an insurance practice that is pervasive and increasing. The absence of litigation incentives creates perverse incentives for insurers because it makes it all the more unlikely that patients will be able to obtain legal representation, such that insurers may deny with impunity. Drawing on extant literature on path dependence and on ERISA’s history and implementation, legislative history, and interviews with key congressional staffers, this paper evaluates this statutory design’s persistence across moments of health care reform including the Patients’ Bill of Rights and the Affordable Care Act, and the ways in which this can not only limit patients’ rights upon a coverage denial but exacerbates inequities in the American health care system and reduces health insurer accountability in a manner that can perpetuate the denials themselves.

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