Kentucky Assoc. of Health Plans, Inc. v. Miller
January 14, 2003 (00-1471)
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Case Summary
In 1994, the Kentucky Health Care Reform Act was passed. One part of this legislation, the "any willing provider" provision, states that a health insurer "shall not discriminate against any provider who is located within the geographic coverage area of the health benefit plan and is willing to meet the terms and conditions for participation established by the health benefit plan." In April 1997, several HMOs filed suit claiming that the "any willing provider" provision should be invalidated because it is preempted by ERISA. The district court ruled that the Kentucky statute was not preempted by ERISA because the statute regulated insurance rather than employment benefit plans. The U.S. Court of Appeals for the Sixth Circuit affirmed, holding that the state regulatory scheme was aimed specifically at the insurance industry and, as a result, fell under ERISA’s saving clause. The opinion of the Sixth Circuit is found at 227 F. 3d 352.

To see the opinion of the lower court, click here.


PREDICTED OUTCOME ACTUAL
OUTCOME
Forecasting
Model
Expert
One
Expert
Two
Expert
Three
5-4 to Affirm 6-3 to Affirm 6-3 to Reverse 6-3 to Affirm 9-0 to Affirm
VOTING TO REVERSE
O'Connor
Souter
Ginsburg
Breyer
Rehnquist
Scalia
Thomas
Rehnquist
O'Connor
Scalia
Kennedy
Thomas
Breyer
Rehnquist
Scalia
Thomas
VOTING TO AFFIRM
Rehnquist
Stevens
Scalia
Kennedy
Thomas
Stevens
O'Connor
Kennedy
Souter
Ginsburg
Breyer
Stevens
Souter
Ginsburg
Stevens
O'Connor
Kennedy
Souter
Ginsburg
Breyer
Rehnquist
Stevens
O'Connor
Scalia
Kennedy
Souter
Thomas
Ginsburg
Breyer

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