A cure for the Blues: resolving nonprofit Blue Cross conversions

This Article analyzes the issues involved in converting nonprofit Blue Cross organizations to for-profit status. These issues have arisen in the context of litigation regarding the "reorganization" of Blue Cross and Blue Shield of Missouri ("BCBSMo"). BCBSMo had reorganized by creating and transferring a majority of its business to a new for-profit subsidiary. Missouri consumer groups and state regulators characterized the "reorganization" as a conversion requiring BCBSMo to transfer its assets to a foundation dedicated to charitable health purposes. BCBSMo, however, denied that it had any obligation to leave behind its assets in the nonprofit sector. The BCBSMo litigation raises issues common to most conversions of nonprofit healthcare organizations, particularly conversions of nonprofit Blue Cross plans. This Article provides a road map for state regulators and the public to follow in ensuring that the public interest is fully protected in such conversions.     

Americanising Brexit Britain's Welfare State?

Will the British welfare state revert to an Americanisation trajectory or retain features of the European model after April 2019? After a period of historically prolonged austerity and substantial working age welfare reform, with the UK facing yet another renegotiation of the social contract in a post‐Brexit world, the question of whether there remains space for an alternative to the ‘American’ model is of crucial importance. We argue that there has been a blurring of differences across the American and European welfare states in terms of working age benefits, as most countries have adopted aspects of work‐based conditionality reforms, which attach the receipt of benefits to the active pursuit of work and, to varying extents, the underlying politics of US welfare reform, where there are large coalitions supportive of more punitive policies towards low‐income adults and minorities. These trends are taking place against the backdrop of a second major shift: increasing restrictions on benefits for immigrants. This double narrowing of the welfare state, making benefits conditional for citizens and excluding those who are not citizens, seemingly sets the agenda for a more restrictive post‐Brexit welfare state. The experience of the last two decades suggests, however, that the adoption of the American model has not been wholesale; steering a middle path between punitive conditional American benefits and more traditionally generous universal benefits is on the agenda across advanced welfare states.