Document Type


Publication Date



Affordable Care Act, ACA, health care costs, health insurance, uninsured


U.S. hospitals and physicians regularly charge uninsured patients and patients receiving care outside their health-plan networks far more what most health insurers pay and far more than their actual costs. Such practices have triggered over 100 lawsuits and prompted calls for pricing transparency in Congress and price regulation in several states. This Perspective argues that the theory of implied contracts, a foundation in most first-year courses in contract law, offers a useful legal and ethical mechanism for handling these troubling problems in health care billing.

Library of Congress Subject Headings

Patient Protection and Affordable Care Act, Cost of medical care, Medically uninsured persons, Health insurance