The Patient Protection and Affordable Care Act includes provisions intended to promote “comparative effectiveness research” (CER) — i.e., the direct comparison of existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms. To fund CER, the Act establishes a new nonprofit organization called the Patient-Centered Outcomes Research Institute (PCORI). Funding for PCORI is provided through fees paid by health insurance issuers and group health plans into a newly created Patient-Centered Outcomes Research Trust Fund (the Trust). The requirements imposed on health insurance issuers and group health plans to pay CER fees are found in the following provisions of the Internal Revenue Code as added by the Act...

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