Health insurance premiums will increase while health care quality may diminish due to the decision by the U.S. Supreme Court upholding Kentuckys any willing provider statute, health insurers say.
“Ultimately, it is the American worker who will bear the brunt of this decision,” says Donald Young, president of the Health Insurance Association of America, Washington, in response to the unanimous Supreme Court decision in the case of Kentucky Association of Health Plans v. Miller.
AWP laws, Young says, reflect unnecessary government interference in private relationships between doctors and health plans.
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The Supreme Courts decision upholding AWP laws represents “another step for those who believe the government can best determine how health care should be financed and delivered, further limiting choices for health care consumers,” Young says.
Health plans say that AWP laws may undermine health maintenance organizations, because they prevent HMOs from assuring member physicians that the physicians will have a sufficient volume of patients to make the HMO arrangement economically feasible.
The issue in the Kentucky Association case involves Kentuckys AWP law, which says that health insurers may not discriminate against any health care provider who is willing to meet the terms and conditions for participation in a health plan.
The Kentucky Association of Health Plans sued to prevent enforcement of the law, arguing that it is preempted by the Employee Retirement Income Security Act.
ERISA preempts state laws that relate to employee benefit plans, but state laws that regulate the business of insurance are saved from preemption.
The Kentucky Association argued that the AWP law does not regulate the business of insurance and thus is not saved from preemption.
Both a U.S. District Court and the Sixth Circuit Court of Appeals ruled against the Kentucky Association, and upheld the AWP law.
The U.S. Supreme Court, in a unanimous opinion written by Justice Antonin Scalia, agreed.