Author: Jane Kim
Published: 02 September 2017
Journal of Public Health, Volume 39, Issue 3, September 2017, Pages 433–439,
This article does not explore possible constitutional challenges to guaranteed issue laws. Some of those challenges have been made and decided by the courts. In order to understand the current challenges to such a mandate, however, it is important to understand the background context. Thus, this article takes a largely historical overview of the growth of the public health system and healthcare regulations in the USA, including their constitutional foundations. This approach reveals how a slow but steady progression of federal healthcare regulations culminated in the promulgation of the ACA mandates, including guaranteed issue health plans, by expanding existing laws under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)8 and the Employee Retirement Income Security Act of 1974 (ERISA).9 Although these laws appear to provide for universal healthcare, in fact, universal healthcare in the USA is still illusory.