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Rationing has become a dirty word, though many argue that rationing is necessary if we wish to improve the American health care system [2]. Supporters of the new health care act, the Patient Protection and Affordable Care Act (ACA), are resolute in their stance that the act does not promote rationing [3]. Yet the Supreme Court already recognizes that rationing plays a crucial part in the health care system [4]. In the famous United States Supreme Court case Pegram v. Herdrich, Justice David Souter wrote about the pivotal role of rationing in managed care organizations, contending that “no HMO organization could survive without some incentive connecting physician reward with treatment rationing” [5].

ERISA's Effect on Claims of Injury due to Denial of Coverage