Forensic Economics by Frank D. Tinari

Author:Frank D. Tinari
Language: eng
Format: epub
Publisher: Palgrave Macmillan US, New York

9.7 Court Treatment of the Affordable Care Act

Given the recent passage and implementation of the ACA, state and federal courts’ treatment of the ACA with respect to medical losses is still rapidly evolving, but several court rulings have addressed the issue arriving at conflicting conclusions. In Deeds v. University of Pennsylvania Medical Center (2015), the Superior Court of Pennsylvania ordered a new trial after a defense verdict in a medical malpractice case because defense counsel’s comments suggesting that the minor-plaintiff’s medical costs were being covered by Medicaid and the ACA were a “patent violation of the collateral source rule.” Similarly, in Vasquez-Sierra v. Hennepin Faculty Associates (2012), Minnesota state courts rejected the defense’s argument that annual medical damages for Ms. Vasquez-Sierra be capped at approximately $7000 per year, the sum of out-of-pocket medical and insurance premium costs, stating, “[The court]... is not inclined to speculate that the recent and controversial federal health care legislation upends Minnesota’s collateral source doctrine. Until the Minnesota legislature passes new legislation regarding collateral sources in light of the Affordable Care Act, this court will not re-write long-standing law regarding collateral sources.” Persuaded by the reasoning of Vasquez-Sierra, the US District Court, Minnesota District in Halsne v. Avera Health (2014) found that any benefits received through the Affordable Care Act do not provide a basis for reducing the potential award to plaintiff. Similarly, in Caronia v. Philip Morris USA (2013), a New York state case, the plaintiffs sought compensation to cover the cost of monitoring for future smoking-related diseases. The defendant unsuccessfully argued that the ACA would allow the plaintiffs to obtain free access to the monitoring services that they were seeking.

Other courts have appealed to the uncertain future of the ACA as a reason to omit consideration of the current law from damage awards. A California state court in Aidan Ming-Ho Leung v. Verdugo Hills Hospital (2013) determined that despite defense arguments that the ACA provided guaranteed access to insurance, future health insurance would not be taken into account when calculating the expected future medical costs stating, “the mere possibility that private insurance coverage will continue, and the availability of government programs for the purchase of insurance, do not, in themselves, constitute relevant, admissible evidence of the future insurance benefits that a plaintiff is reasonably certain to receive.” In CSC v US (2013), a US District Court judge ruled that, “the viability of the Affordable Care Act is far too speculative to give [an ACA] plan any credence.” Finally, in Brewster v. Southern Home Rentals (2012), an Alabama court found that references to “the possibility of future insurance coverage would be too speculative to be relevant, or if relevant at all, any probative value of this evidence is substantially outweighed by the danger of confusion of the issues and misleading the jury.”

In contrast, other courts have taken a much more favorable view of considering the ACA, especially in more recent rulings. In Michigan, the court in Donaldson v. Advantage Health Physicians (2015) ruled in a

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