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Discrimination Against the Unhealthy in Health Insurance


Mary Crossley


University of Pittsburgh - School of Law

July 21, 2008

Kansas Law Review, Vol. 54, p. 73, 2005
U. of Pittsburgh Legal Studies Research Paper

Abstract:     
As employers seek to contain their health care costs and politicians create coverage mechanisms to promote individual empowerment, people with health problems increasingly are forced to shoulder the load of their own medical costs. The trend towards consumerism in health coverage shifts not simply costs, but also insurance risk, to individual insureds, and the results may be particularly dire for people in poor health. This Article describes a growing body of research showing that unhealthy people can be expected disproportionately to pay the price for consumerism, not only in dollars, but in preventable disease and disability as well. In short, consumerist coverage vehicles (including health savings accounts) discriminate against the unhealthy by impact. This Article examines existing laws protecting against health status discrimination in health insurance, but these laws do not address impact discrimination. Recognizing that some might attempt to justify this disproportionate impact on unhealthy people by invoking a principle of actuarial fairness, the Article also reviews various laws prohibiting other forms of discrimination in health insurance in order to reveal our society's willingness to elevate other social values above actuarial fairness. This Article calls for more careful scrutiny of consumerism's effects and a sustained dialogue regarding the limits a just society should place on the burdens borne by unhealthy persons.

Number of Pages in PDF File: 81

Keywords: civil rights, equality, discrimination, unhealthy, health insurance, social justice, medical expenses, economics

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Date posted: July 27, 2008 ; Last revised: May 13, 2009

Suggested Citation

Crossley, Mary, Discrimination Against the Unhealthy in Health Insurance (July 21, 2008). Kansas Law Review, Vol. 54, p. 73, 2005; U. of Pittsburgh Legal Studies Research Paper. Available at SSRN: http://ssrn.com/abstract=1167043

Contact Information

Mary Crossley (Contact Author)
University of Pittsburgh - School of Law ( email )
3900 Forbes Ave.
Pittsburgh, PA 15260
United States
412-648-5300 (Phone)
412-648-2649 (Fax)
HOME PAGE: http://www.law.pitt.edu/faculty/profiles/crossleyma

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