Law Commons^™

An Unfulfilled Promise: Section 1557'S Failure To Effectively Confront Discrimination In Healthcare, Majesta-Doré Legnini

William & Mary Journal of Race, Gender, and Social Justice

When the Patient Protection and Affordable Care Act passed, it offered a broad promise to provide access to quality care on a nondiscriminatory basis. To achieve nondiscrimination, Congress included Section 1557, which integrated the nondiscrimination protections granted under Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments, Section 504, and the Age Discrimination Act. The language of the statute has proved that the section cannot achieve its broad promise. Covering only intentional discrimination and usually interpreted to divide the standard so that intersectional discrimination cannot be redressed, Section 1557 fails to address discrimination in …

Predetermined? The Prospect Of Social Determinant-Based Section 1115 Waivers After Stewart V. Azar, Griffin Schoenbaum

Dickinson Law Review (2017-Present)

Section 1115 of the Social Security Act allows the Secretary of Health and Human Services (the “Secretary”) to waive some of Medicaid’s requirements so states can enact “demonstration projects.” A demonstration project is an experiment a state can conduct by modifying aspects of its Medicaid program. To waive Medicaid’s requirements for this purpose, the Secretary must determine that the proposed demonstration project will likely assist in promoting Medicaid’s objectives.

Using this standard, President Trump’s Secretary has approved waiver requests to enact demonstration projects that contain “community engagement” requirements. The U.S. District Court for the District of Columbia has heard each …

Keeping The Healthcare Industry Accountable, Yoori Chung

Journal of the National Association of Administrative Law Judiciary

No abstract provided.

Sex, Drugs, Trump And Birth Control, Desire’E Martinelli

William & Mary Journal of Race, Gender, and Social Justice

This Article explores both medical and legal reasons as to why OTC access to contraception is needed and justified. It also applies current changes in the government and discusses how the repeal of the Affordable Care Act (ACA) could substantially affect birth control. Alternative and traditional options are presented and analyzed to determine their viability.

Pumping 9 To 5: Why The Flsa’S Provisions Provide Illusory Protections For Breastfeeding Moms In The Workplace, Kierstin Jodway

Belmont Law Review

On March 30, 2010, former President Barack Obama signed into law the Patient Protection and Affordable Care Act, which amended the Fair Labor Standards Act (“FLSA”) of 1938. Due to this amendment, the FLSA now requires employers to provide workplace accommodations for working mothers who wish to continue expressing breast milk after returning to work. Although this legislation was intended to be a step in support of transforming the role of women in the workplace, in practice its protections fail to advance the legal policies and progressive changes to the American workplace that our society has tirelessly pushed for. This …

Justice Scalia, Originalism And Textualism, Thomas A. Schweitzer

Touro Law Review

No abstract provided.

Black Health Matters: Disparities, Community Health, And Interest Convergence, Mary Crossley

Michigan Journal of Race and Law

Health disparities represent a significant strand in the fabric of racial injustice in the United States, one that has proven exceptionally durable. Many millions of dollars have been invested in addressing racial disparities over the past three decades. Researchers have identified disparities, unpacked their causes, and tracked their trajectories, with only limited progress in narrowing the health gap between whites and racial and ethnic minorities. The implementation of the Affordable Care Act (ACA) and the movement toward value-based payment methods for health care may supply a new avenue for addressing disparities. This Article argues that the ACA’s requirement that tax-exempt …

The Affordable Care Act Is Not Tort Reform, Andrew F. Popper

Catholic University Law Review

On March 23, 2010, President Obama signed The Patient Protection and Affordable Care Act (PPACA). Prior to the enactment of the PPACA, Congress held several hearings focused on subrogation and relaxation of collateral source restrictions as well as caps on damages in an effort to promote tort reform. While the ACA included provisions on medical liability reform, the suggested tort reform was thwarted, and the ACA had no actual legal effect on limiting medical malpractice liability. This article argues that the reality is that the PPACA has done nothing to change the admissibility of collateral sources nor has it enhanced …

The Affordable Care Act, Experience Rating, And The Problem Of Non-Vaccination, Eric Esshaki

University of Michigan Journal of Law Reform Caveat

Polio, the whooping cough, and the mumps, among many other communicable diseases, were once prevalent in communities within the developed world and killed millions of people.1 The advent of vaccinations contained or eradicated several of these diseases.2 However, these diseases still exist in the environment3 and are making a comeback in the United States.4 Their persistence is directly attributable to the rising trend among parents refusing to vaccinate their children.5 One proposed solution to this problem is to hold parents liable in tort when others are harmed by their failure to vaccinate. Another proposed solution argues that parents should pay …

Thou Shalt Not Electioneer: Religious Nonprofit Political Activity And The Threat “God Pacs” Pose To Democracy And Religion, Jonathan Backer

Michigan Law Review

The Supreme Court’s 2010 decision in Citizens United v. FEC invalidated a longstanding restriction on corporate and union campaign spending in federal elections, freeing entities with diverse political goals to spend unlimited amounts supporting candidates for federal office. Houses of worship and other religious nonprofits, however, remain strictly prohibited from engaging in partisan political activity as a condition of tax-exempt status under Internal Revenue Code § 501(c)(3). Absent this “electioneering prohibition,” religious nonprofits would be very attractive vehicles for political activity. These 501(c)(3) organizations can attract donors with the incentive of tax deductions for contributions. Moreover, houses of worship need …

Diy Solutions To The Hobby Lobby Problem, Kristin Haule

Loyola of Los Angeles Law Review

No abstract provided.

The (Not So Dire) Future Of The Necessary And Proper Power After National Federation Of Independent Business V. Sebelius, Celestine Richards Mcconville

William & Mary Bill of Rights Journal

No abstract provided.

Spending Medicare’S Dollars Wisely: Taking Aim At Hospitals’ Cultures Of Overtreatment, Jessica Mantel

University of Michigan Journal of Law Reform

With Medicare’s rising costs threatening the country’s fiscal health, policymakers have focused their attention on a primary cause of Medicare’s high price tag—the overtreatment of patients. Guided by professional norms that demand they do “everything possible” for their patients, physicians frequently order additional diagnostic tests, perform more procedures, utilize costly technologies, and provide more inpatient care. Much of this care, however, does not improve Medicare patients’ health, but only increases Medicare spending. Reducing the overtreatment of patients requires aligning physicians’ interests with the government’s goal of spending Medicare’s dollars wisely. Toward that end, recent Medicare payment reforms establish a range …

The Next Stage Of Health Care Reform: Controlling Costs By Paying Health Plans Based On Health Options, Dale B. Thompson

Akron Law Review

There are two problems in “demonizing” health insurance plans and MA. One is that it diverts attention from perhaps the most important long-term problem for health care: the need to control rising costs. Recent estimates say that expenditures on health care have grown from approximately seven percent of gross domestic product (GDP) in 1970, to nine percent in 1980, twelve percent in 1990, fourteen percent in 2000, and sixteen percent in 2008. Expenditures are projected to be over nineteen percent of GDP in 2019. While it is certainly true that health care insurance plans are not perfect and that there …

Realsim Over Formalism And The Presumption Of Constitutionality: Chief Justice Roberts' Opinion Upholding The Individual Mandate, Wilson Huhn

Akron Law Review

In National Federation of Independent Business v. Sebelius, Chief Justice John Roberts cast the deciding vote to uphold the individual mandate of the Affordable Care Act. Speaking for the Court in Part IIIC of his opinion, Roberts found that the individual mandate was properly enacted pursuant to the General Welfare Clause. Two aspects of his opinion in particular drove this result. In deciding whether the individual mandate constitutes a “tax” within the meaning of the Constitution, the Chief Justice engaged in realistic analysis rather than legal formalism. In addition, Roberts reasoned that, if fairly possible, the statute had to be …

Assets, Costs, And Affordability: Why Magi-Based Medicaid Benefits Don't Account For True Need, Sara K. Hunkler

Indiana Journal of Law and Social Equality

In 2014, Mary, an asset-wealthy individual, will qualify for Medicaid ahead of Bob, a needier individual with less net wealth and significantly higher medical costs, solely because Bob’s income is slightly higher. The current income-based eligibility standards for Medicaid mandated by the Patient Protection and Affordable Care Act (PPACA) do not adequately reflect an individual’s need for federal assistance because they neglect to consider an individual’s assets, debts, and the circumstantial cost of their healthcare. Thus, these new federal standards permit significant disparities in the treatment of similarly situated impoverished individuals and allow prioritization of asset-wealthy individuals over their more …

God And Guns: The Free Exercise Of Religion Problems Of Regulating Guns In Churches And Other Houses Of Worship, John M.A. Dipippa

Marquette Law Review

This Article demonstrates that the cases raising religious liberty challenges to state regulation of weapons in houses of worship reveal the persistent problems plaguing religious liberty cases. First, these cases illustrate the difficulties non-mainstream religious claims face. Courts may not understand the religious nature of the claim or they may devalue claims that do not seem “normal” or “reasonable.” This is compounded by how few religious liberty claimants, especially non-mainstream religions, win their cases. Second, the cases are part of the larger debate about how easy it should be to get judicially imposed religious exemptions from general and neutral laws. …

Blue Skies For Black Lung Benefits Act Survivors? Courts' Interpretations Of § 932(L) Following The Enactment Of The Patient Protection And Affordable Care Act, Maureen Hughes

Catholic University Law Review

This Note summarizes the amendments made to the Black Lung Benefits Act (BLBA) following its passage in 1969 through the enactment of the 2010 Patient Protection and Affordable Care Act (PPACA). The Note also addresses the split among the circuits over the meaning of the revised language in 30 U.S.C. § 932(l) (2012), and explains the reasoning of the Third, Fourth, Sixth, and Eleventh Circuits regarding the effect of the PPACA on BLBA benefit eligibility for miners’ dependent survivors. Further, this Note explains the significance of, and necessity in, resolving the confusion over § 932(l), and …

Restoring The Parameters Of Public Health In A Time Of Hobby Lobby And Ebola: The Case For A Wellness Account, John D. Blum

Belmont Law Review

The genesis of this piece lies in two seemingly unrelated events in law and public health, the governmental response to the Ebola crisis, and the U.S. Supreme Court ruling in Burwell v. Hobby Lobby, sparked by religious objections to certain employer mandates under the Affordable Care Act. While this essay focuses on the Burwell v. Hobby Lobby case and not Ebola, its core premise is that health policy is best served when government authorities focus strategies and responses within the parameters of individual and population concern. This piece will propose an alternative approach to women’s health promotion, a wellness account, …

The Great Tactician: The Chief Justice, Obamacare, And Walking The Tightrope Of Partisan Politics, Katherine H. Blankenship

Belmont Law Review

This note argues that true judicial restraint is a fictional impossibility. Any practice of judicial restraint is at the very same moment an exercise of judicial activism because a judge cannot approach the law from a truly objective, mechanical position. Every judicial opinion is influenced not only by the political and moral vantage point of the judge, but also the judge’s policy and societal concerns. This thesis is illustrated by a case study of National Federation of Independent Business v. Sebelius, and, specifically, Chief Justice Roberts’s opinion regarding the individual mandate and the Medicaid provision of the Affordable Care Act. …

To Yoder Or Not To Yoder? How The Spending Clause Holding In National Federation Of Independent Business V. Sebelius Can Be Used To Challenge The No Child Left Behind Act, Christopher Roma

Pace Law Review

States such as California, Texas, Montana, Nebraska and Pennsylvania all have either declined to apply for waivers out of the testing, accountability, and penalty schemes of No Child Left Behind; or, have had their applications rejected by the Department of Education. This Article argues that these states would have a legitimate challenge to NCLB as unconstitutionally coercive based on the precedent of Sebelius. As discussed more in the sections that follow, not only is NCLB and Title I the largest federal funding program behind Medicaid, it also shares many of the characteristics that the opinions in Sebelius found to be …

Breastfeeding On A Nickel And A Dime: Why The Affordable Care Act's Nursing Mothers Amendment Won't Help Low-Wage Workers, Nancy Ehrenreich, Jamie Siebrese

Michigan Journal of Race and Law

As part of the Patient Protection and Affordable Care Act of 2010 (also known as “Obamacare”), Congress passed a new law requiring employers to provide accommodation to working mothers who want to express breast milk while at work. This accommodation requirement is a step forward from the preceding legal regime, under which federal courts consistently found that “lactation discrimination” did not constitute sex discrimination. But this Article predicts that the new law will nevertheless fall short of guaranteeing all women the ability to work while breastfeeding. The generality of the Act’s brief provisions, along with the broad discretion it assigns …

Health Care For Low-Income Classes In An Individual Mandate System: Lessons The United States Can Learn From Switzerland, Mason F. Reid

Georgia Journal of International & Comparative Law

No abstract provided.

Health Care Reform: Treatment Effectiveness Information Nationwide, Robert B. Leflar

University of Arkansas at Little Rock Law Review

No abstract provided.

Brown V. Board Of Education And National Federation Of Independent Business V. Sebelius: A Comparative Analysis Of Social Change, Brian G. Gilmore

University of Arkansas at Little Rock Law Review

No abstract provided.

Building A Better Laboratory: The Federal Role In Promoting Health System Experimentation, Kristin Madison

Pepperdine Law Review

While expanding federal involvement in the health care system, the Patient Protection and Affordable Care Act (ACA) preserves states' roles as policy laboratories and private providers' roles as health care delivery laboratories. State-based and provider-based laboratories suffer from many shortcomings, however, as mechanisms to develop, evaluate, and facilitate diffusion of reforms within the health system. This Article argues that the federal government can take steps to address these shortcomings. It first briefly reviews ACA provisions that promote policy and delivery experimentation. It then suggests that by tying funding to policy outcomes, making use of regulatory variation and regulatory menus, and …

A Corporation Has No Soul — The Business Entity Law Response To Challenges To The Ppaca Contraceptive Mandate, Thomas E. Rutledge

William & Mary Business Law Review

The most contentious matter in the implementation of the Patient Protection and Affordable Care Act is not one of health care, but rather one of the law of business organizations. Numerous for-profit business organizations have challenged the portion of the PPACA and its related regulations requiring that group health insurance plans provide, on a no-cost sharing basis, coverage for a variety of procedures and prescription medicines involving contraception and what some describe as “abortificants.” In these suits, the various business ventures and their owners assert that they should be exempt from the requirement of the mandate on the basis that, …

Medicaid Expansion By Any Other Name: Exploring The Feasibility Of Expanded Access To Care In The Wake Of Nfib V. Sebelius, Michele Johnson, Kristin Ware

Belmont Law Review

This Article will examine aspects of the Tennessee Plan for Medicaid coverage in order to make the argument that Tennessee must either accept the Medicaid expansion as codified in the Affordable Care Act, or make modifications to the Tennessee Plan that better comport with the federal waiver program, the central goals of Medicaid, the United States Constitution, and the spirit of cooperative federalism.

Protecting From Endless Harm: A Roadmap For Coercion Challenges After N.F.I.B. V. Sebelius, Eric Turner

Chicago-Kent Law Review

In N.F.I.B. v. Sebelius, a plurality of the Supreme Court struck down the Patient Protection and Affordable Care Act’s Medicaid (PPACA) expansion. The Court did so by holding that the doctrine “coerced” States into implementing federal policy by threatening to withhold Medicaid funding to states that did not reform their Medicaid programs. This marks the first time a program properly enacted under Congress’ Spending Power has been found to coerce the states. The Court’s coercion analysis, however, has raised more questions than it answered. The plurality’s language is vague, and commentators have struggled to analyze the holding. But what …

Who Can Afford It?: The Patient Protection And Affordable Care Act's Failure To Regulate Excessive Cost-Sharing Of Prescription Biologic Drugs , Michael Callam

Journal of Law and Health

This Note will discuss how the PPACA’s abbreviated approval pathway for biological products creates an expedited procedure to bring less expensive biologic drugs to the market, but ultimately fails to make those biologic drugs affordable because of its lack of provisions limiting insurers’ use of excessive cost-sharing requirements. Part II provides an overview of prescription drugs, compares biologics with traditional prescription drugs, and provides a brief legislative history of prescription drug laws. Part III analyzes the impact of the abbreviated approval pathway on biologic drugs’ costs to prescribed patients. It also examines the PPACA’s effects on biologics inclusion into health …