Ryan Hart


Since the passage of the Patient Protection and Affordable Care Act ("ACA") in 2010, the percentage of individuals carrying health insurance in the United States has consistently increased. An unintended consequence of the ACA is that it has undermined the historical justification of the collateral source rule. The collateral source rule, which precludes a defendant from introducing evidence of a plaintiffs insurance coverage, has persisted for nearly 150 years primarily because insurance coverage was not the ubiquitous product that it is today.

In Pennsylvania, the intersection of the ACA and the collateral source rule has especially affected the medical malpractice field. An increasing number of insured plaintiffs in Pennsylvania medical malpractice lawsuits are able to collect twice for their future medical expenses-once when their heath insurance provider pays the plaintiffs' medical bills, and again when defendants pay these same bills.

The collateral source rule is not only incongruous with the ACA, but it also conflicts with state legislation, such as the Medical Care Availability and Reduction of Error Act ("MCARE Act"). The MCARE Act demonstrates a clear public policy reflecting the legislature's desire to reduce physicians' medical malpractice liability premiums and to retain competent physicians in the Commonwealth. The continuance of the collateral source rule, and its perpetuation of double recoveries, is directly at odds with such public policy.

This Comment discusses the evolution of the collateral source rule in Pennsylvania and reviews the seminal cases that have shaped the rule's application in medical malpractice proceedings. Additionally, this Comment explains how state legislation, primarily the MCARE Act, altered the collateral source rule's function. Finally, this Comment presents three practical avenues by which the Commonwealth can amend or abrogate the collateral source rule that are both consistent with existing public policy and protective of injured plaintiffs.



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