8 Laws Related To Health Insurance

8 Laws Related To Health Insurance

It's always important to be up to date with your health insurance, and the multiple choices and laws can be confusing.

One of the major considerations with health insurance is whether you will choose term or universal insurance. However, when you look further into health insurance law, and the legal aspects of health insurance, it can all seem more complicated. 

We often worry about where we stand with the law when it comes to things such as health insurance. In truth, though, most of the time, it benefits us a great deal. 

With congressional oversight, the US health agencies craft laws that protect the well-being of the public. Let’s take a look at some of the laws related to health insurance that you should know more about! 

#1 – Patient Protection & Affordable Care Act Federal Law

This law impacts everyone, individuals, and groups of employees and employers, no matter if they are covered, are looking for coverage, or have not previously shown interest in coverage. 

This law came in, in 2014, and it requires every person to have health insurance or pay a penalty. Businesses with less than 50 full-time employees do not need to provide insurance under this law, but those with 50-plus employees are subjected to different regulations.

#2 – COBRA Federal Law

The COBRA law affected employers who offer grouped medical coverage. 

At the time of termination, or under any other circumstances of specification, employees might be eligible for their health benefits to continue as have been recognized under COBRA law. Under this, employers need to have 20 employers which are subjected to COBRA requirements.

Employees also have 60 days after the notification of their rights by COBRA to sign up. The longest period during COBRA continued coverage needs to be provided as the maximum coverage period. There are three of these options.

This could be 36, 18, or 18-29 month periods. 18-month coverage must be offered when an employee is terminated or if they suffer a loss of coverage under the group health plan of the employer due to an hours of work reduction. 

Under 36 months the employee is covered in the case of a covered dependent child ceasing dependency, the employee becoming Medicare eligible, divorce or separation, or death.

At 18-29 months of coverage, this is an extension from the 18-month plan for beneficiaries who are disabled or who have become disabled within 60 days of the COBRA coverage starting.

#3 – Employee Retirement Income Security Act of 1974 Federal Law

This law affects all employees in the private sector and sponsors of such which provide health benefits as a group through insurance or otherwise. 

ERISA governs a majority of benefit plan aspects, this even includes how an employer should provide the plan information to employees, and also governs claims and appeals for qualified plans.

#4 – Health Insurance Portability & Accountability Act Federal Law

This law affects all employers who have two or more employees. It allows employees to get health insurance should they change their job or lose their group health insurance. Should an employee qualify for his, they cannot be denied insurance due to any medical history.

#5 – Patient Safety & Quality Improvement Act of 2005.

The PSQIA is an act that protects healthcare workers who may report unsafe conditions. This law was made to encourage people to report medical errors while also maintaining patients’ right to confidentiality. 

To ensure patient privacy, HHS levies fines for breaches of confidentiality. This law also authorizes AHRQ to publish a full list of safety organizations for patients, which will record and analyze safety data for patients. This law is enforced by the OCR.

#6 – Affordable Care Act of 2010

In early 2010, Obama sanctioned the CA, which is a version of all-inclusive coverage. This requires most citizens in the US to apply for health insurance coverage, this levies a penalty for those who fail to secure any insurance, however making exceptions for some groups who are protected. 

Under this law, those who employ over 200 workers need to provide coverage. This is also established in the American Health Benefits Exchange. 

It offers healthcare professionals the ability to take part in shaping the delivery of patient services as well.  

#7 – Hospital Readmissions Reduction Program

The HRRP is an initiative of the Affordable Care Act, it requires the Centers for Medicare and Medicaid Services to reduce the payouts available to care facilities that experience excessive patient readmissions. 

This is a program launched in the late part of 2012, it defines readmissions as repeated patient admissions among participating CMS hospitals within 30 days. There are exceptions for some specific conditions, including pneumonia, and heart failure, as well as multiple illnesses and poor health. 

#8 – Children’s Health Insurance Program

As well as Medicaid, CHIP has created a very powerful foundation for delivering health coverage to children who are living in low-income households. The program originated the CHIPRA and has provided services to a load of clients who were previously disqualified. 

This program has a very thorough history of always providing insurance to underprivileged children, and it even receives funding from the respective states and federal government. 

In these times, the Affordable Care Act makes these services accessible to the vastest number of children who live in low-income homes and families in the history of the country! 


The health care law offers rights and protections that make coverage much more easy and fair for everyone to understand. 

Some protections and rights will apply to plans in the Health Insurance Marketplace, or other individual insurance. Some healthcare laws will apply to all coverages. 

Healthcare laws protect people in many ways, from providing free preventive care, protecting you from employer retaliation, ensuring that health insurance companies cannot cancel your insurance because you got sick and so much more. 

Understanding the laws that surround health care and health insurance is critical, as you know your rights and what you are entitled to, so your health and rights to good healthcare are always maintained and kept safe. 

If you are not sure what your rights are in a specific situation, check out some of these laws we mentioned above, and ensure you are covered.

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