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In the Fall of 2016, I taught Health Law and Policy for the fourth consecutive semester. Over time, one thing has become increasingly clear: the aspect of this course that I work with most closely as a scholar—the regulation of health care financing and insurance, including the Patient Protection and Affordable Care Act (ACA)—is also the material that I find the most challenging to teach. Every time I reflect on teaching this material, and hear from students about how they learn this material, the thing that stands out is how critical it is that my students understand the profound impact that this technical subject has on individuals’ lives.

Health insurance regulation simultaneously shapes and is an expression of social values. It defines the types of harms we expect individuals to shoulder on their own and what we are willing to mitigate collectively, as a society. Every rule that expands the scope of insurance—whether private or social insurance—is a signal of greater social solidarity with respect to each other’s health. Every contraction of the scope of insurance is the opposite, and leaves individuals more vulnerable to poor health or financial insecurity due to high health care spending. These broader implications are what draw me to the topic—as a teacher and as a scholar. My ultimate goal is for my students to understand this social meaning: why insurance is regulated as it is, how that regulation reflects larger social values, and the impact—both intended and unintended—that insurance regulation has on the shape of our society.

When asked to write this Article on teaching health insurance regulation and reform for the Saint Louis University Law Journal Teaching Issue, I took the opportunity to confirm that what I thought worked in the classroom was actually working. To this end, I asked two of my former students to reflect, as my co-authors, on learning health insurance regulation and reform in my Health Law and Policy class, and I discovered that some of my aims were hitting the mark and others could benefit from refinement. In Part I of this Article, I describe my goals and approaches in teaching these topics as well as why this material can be difficult to teach. My student co-authors reflect on their own experiences in learning this material in Part II, including what they took away from it and what questions remain. In the final Part of the Article, I highlight how my co-authors’ insights have informed my teaching.


Health Insurance, Health Reform, Legal Teaching, Health Law, Health Policy, ERISA

Publication Title

St. Louis University Law Journal

Publication Citation

61 St. Louis U. L. J. 411 (2017)