Health Insurance and Access to Care

Who receives health care in the United States—and who is denied—is shaped by a complex set of legal, regulatory, and financial decisions. This seminar examines the modern legal battles that determine access to care, coverage obligations, and payment structures. Each week, students engage in structured pro/con debates on major controversies in U.S. health care law, developing advocacy skills and gaining a deeper understanding of the forces that shape the system. The key issues covered in the course will include:

1. •ACA subsidies and the future of marketplace coverage
2. •Medicaid access barriers and state‑level restrictions
3. •Prescription drug pricing and federal regulatory authority
4. •Supreme Court decisions that redefine coverage obligations
5. •Medicare Advantage payment systems: innovation or fraud risk
6. •Prior Authorizations, step therapy, and administrative interventions
7. •The No Surprises Act and out‑of‑network payment disputes
8. •Vertical integration between insurers and health care providers
9. •The evolving role of Pharmacy Benefit Managers and their impact on consumers
10. •Defining “medical necessity” in coverage disputes
11. •Preventive services, vaccines, and the future of evidence‑based care

This course is designed for students interested in trial litigation, health law, regulatory practice, or policy advocacy. It is particularly well‑suited for students who want to sharpen their argumentation skills and engage with real‑world legal controversies. Students will be assessed based on a final paper and presentation, as well as class participation and engagement in the weekly issue debates.