Health Law and Policy Commons^™

Independence Is The New Health, Laura D. Hermer

Saint Louis University Journal of Health Law & Policy

Medicaid plays key roles in supporting our nation’s health. Under the Affordable Care Act, Medicaid took an even more central position in public health endeavors by extending coverage in all interested states to millions of adults who typically fell through the health care cracks. Nevertheless, the Trump administration is now undoing these gains by actively encouraging states to curtail access to Medicaid in key respects while using the rhetoric of health.

This article examines Trump administration efforts in two contexts: (1) state § 1115 waiver applications seeking to better align their Medicaid programs with cash welfare and food stamp programs, …

Health Justice In The Age Of Alternative Facts And Tax Cuts: Value-Based Care, Medicaid Reform, And The Social Determinants Of Health, Elizabeth Tobin-Tyler

Saint Louis University Journal of Health Law & Policy

Some provisions of the Patient Protection and Affordable Care Act of 2010 (ACA) as well as regulatory policies under the Obama administration reflected the overwhelming evidence that to reduce health care costs, and to improve quality of care and population health, the social determinants of health (SDOH) must be addressed. These policies included funding for partnerships between public health agencies, community organizations, and health care institutions, promotion of value-based payment models that incentivize integrated health and social care delivery, and support for Medicaid program innovations that directly address social needs as part of health care. The Trump administration, through a …

What Hope For Health In All Policies’ Addition And Multiplication Of Equity In An Age Of Subtraction And Division At The Federal Level?: The Memphis Experience, Amy T. Campbell

Saint Louis University Journal of Health Law & Policy

Increasingly, people recognize that social factors, such as poverty, the living environment, and educational status, substantially affect health outcomes. A “health in all policies approach” (HiAP) seeks structural reform of policymaking to require purposeful consideration, across an interconnected range of public sector actors, of the health equity and justice policy-level considerations of these factors. With the election of Donald J. Trump as 45th President in the United States, however, the U.S. entered a world where the math of the day is division and subtraction, rather than addition or multiplication. And yet, hope in HiAP remains through examples of innovative approaches …

Political Rhetoric And Minority Health: Introducing The Rhetoric-Policy-Health Paradigm, Kimberly Cogdell Grainger

Saint Louis University Journal of Health Law & Policy

Rhetoric is a persuasive device that has been studied for centuries by philosophers, thinkers, and teachers. In the political sphere of the Trump era, the bombastic, social media driven dissemination of rhetoric creates the perfect space to increase its effect. Today, there are clear examples of how rhetoric influences policy. This Article explores the link between divisive political rhetoric and policies that negatively affect minority health in the U.S. The rhetoric-policy-health (RPH) paradigm illustrates the connection between rhetoric and health. Existing public health policy research related to Health in All Policies and the social determinants of health combined with rhetorical …

The Faltering Promise Of Fda Tobacco Regulation, Micah L. Berman

Saint Louis University Journal of Health Law & Policy

Congress passed the Tobacco Control Act (TCA) in 2009, giving the FDA the authority to regulate tobacco products for the first time. Ten years later, the promise that the TCA’s enactment would be a transformative moment for public health has not materialized. To the contrary, the FDA’s most notable regulatory effort—requiring graphic warnings on cigarette packages and advertisements—has been struck down in court, and the FDA is now scrambling to address a youth e-cigarette epidemic that caught it off guard. This Article provides a brief review of TCA implementation during the Obama administration, and it reviews the Trump administration’s “comprehensive …

“I Walk In, Sign. I Don’T Have To Go Through Congress.” President Trump’S Use Of Executive Orders To Unravel The Patient Protection And Affordable Care Act, Elizabeth Van Nostrand, Tina Batra Hershey

Saint Louis University Journal of Health Law & Policy

Executive orders, used by presidents to advance their administrations’ agendas, have changed history. These powerful written instruments were used to confine Japanese Americans during World War II, desegregate public schools, and create NASA. On the day of his inauguration, President Donald J. Trump issued his first Executive Order which directed secretaries of executive branch agencies to begin dismantling President Barack Obama’s flagship initiative—the Patient Protection and Affordable Care Act (ACA). This action, along with subsequent executive orders, precipitated a flurry of regulatory change and judicial challenges. Whether President Trump will ultimately be successful in crippling the ACA is still to …

Three Lost Ebola Facts And Public Health Legal Preparedness, Robert Gatter

Saint Louis University Journal of Health Law & Policy

Three key facts about Ebola Transmission should drive policy designed to control the risk of transmission during a crisis.

• Ebola—like HIV—is not easily transmissible human-to-human.
• Ebola has “dry” and “wet” symptoms, and only the wet symptoms threaten public health.
• A fever is Ebola’s canary in a coal mine; it provides timely warning of a coming threat.

Yet, during the U.S. Ebola scare in 2014, these three facts were lost. Unnecessary quarantine, stigma, and burden on those exposed to Ebola resulted, including especially for those who volunteered to fight the disease at its source abroad. Tragically, the law permitted these injustices …

Stretching Armstrong: How The Eighth Circuit Incorrectly Applied Supreme Court Precedent In Does V. Gillespie, Lauren E. Pair

Saint Louis University Journal of Health Law & Policy

Medicaid serves as an important source of health insurance for millions of Americans. One of the Act’s core tenants is the patient’s freedom to choose from any qualified and willing provider. This “freedom of choice” provision was eventually codified, and subsequent protections were put in place to protect a patient’s choice regarding family planning services. However, as states attempt to limit access to family planning services by severing their Medicaid contracts with Planned Parenthood, patients must rely on § 1983 to pursue relief in federal courts. Section 1983 provides a right of action for the violation of any federal right …

The Burden Of A Good Idea: Examining The Impact Of Unfunded Federal Regulatory Mandates On Medicare Participating Hospitals, Rachel Juhas Suddarth

Law Faculty Publications

Health care costs are on the rise. In 1960, the United States spent $9 billion on hospital care. Since then, hospital related spending has grown exponentially. In 2015, the United States spent over $1 trillion on hospital care, with $359.9 billion of those payments coming from the federal Medicare program for the aged and disabled. Researchers have long tried to understand the exact causes of rising health care costs. While many have closely examined the costs associated with population demographics, medical innovation, prescription drug costs, overutilization of services, and fraud or abuse, there is one driving force that does not …

Modernizing Disability Income For Cancer Survivors, Ann C. Hodges

Law Faculty Publications

The medical progress in cancer treatment is worthy of celebration, as survivors of many cancers are living longer. This good news, however, comes with challenges for those survivors. Empirical evidence from researchers at cancer centers demonstrates the devastating impact that cancer has on employment, resulting in serious financial stress for survivors and their families. My previous research used this empirical data to recommend changes in employment laws to meet the need of survivors to maintain employment. This article builds on the prior research by using the empirical evidence of the employment effects of cancer to recommend changes in the disability …

What To Expect When You’Re Expecting…Tanf-Style Medicaid Waivers, Laura D. Hermer

Faculty Scholarship

Many health policy scholars believe that Medicaid, the federal-state coverage program for lower-income Americans, should remain free from welfare reform trappings such as work requirements that are extraneous to the program. It would seem such requirements would be both inappropriate and counterproductive to the goals of Medicaid. Given the high probability that such requirements will, at least at some level, go into effect during the Trump administration, it bears considering what to expect. What evidence, if any, suggests that imposing welfare reform-style requirements on certain Medicaid beneficiaries will yield harmful results to those beneficiaries, or harmful to Medicaid’s programmatic goal …

The International Right To Health Care: A Legal And Moral Defense, Michael Da Silva

Michigan Journal of International Law

In the following, I outline the case against the international right to health care and explain why recognition of such a right is still necessary. The argument is explicitly limited to international human rights law and is primarily descriptive in nature, but I go on to explain the moral reasons to accept this account. Both the positive law and moral reasoning could be used in other health rights debates, but I do not attempt to make such claims here.

The structure of my work is as follows. I first outline three problems with recognizing an international right to health care. …

Independence Is The New Health, Laura D. Hermer

Faculty Scholarship

Medicaid plays key roles in supporting our nation’s health. Under the Affordable Care Act, Medicaid took an even more central position in public health endeavors by extending coverage in all interested states to millions of adults who typically fell through the health care cracks. Nevertheless, the Trump administration is now undoing these gains by actively encouraging states to curtail access to Medicaid in key respects while using the rhetoric of health.

This article examines Trump administration efforts in two contexts: (1) state § 1115 waiver applications seeking to better align their Medicaid programs with cash welfare and food stamp programs, …

Ethical Considerations Of Ovarian And Testicular Tissue Cryopreservation In Pre-Pubertal Children Who Cannot Assent, Katarina Lee

Minnesota Journal of Law & Inequality

No abstract provided.

Removing Obstacles To A Peaceful Death, Kathy L. Cerminara, Barbara A. Noah

Faculty Scholarship

We all will die, but the American health care system often impedes a peaceful death. Instead of a quiet death at home surrounded by loved ones, many of us suffer through overutilization of sometimes-toxic therapeutic interventions long past the time when those interventions do more good than harm. This article proposes revisions to health professional training and payment policy to eliminate as much as possible physical and existential suffering while progressing through the terminal phase of illness. The solution lies in seamless progression from treatment with integrated palliative care to hospice before death, but provider attitudes and payor practices must …

Does Small Group Health Insurance Deliver Group Benefits: An Argument In Favor Of Allowing The Small Group Market To Die, John Aloysius Cogan, Jr.

Faculty Articles and Papers

The small group health insurance market is failing. Today, fewer than one-third of small firms now offer health insurance and the number of people covered by small group insurance continues to drop. These problems invite the obvious question: What should be done about the small group market? Past scholarship on the small group market has largely focused on documenting the market's problems, evaluating the effectiveness of prior reform efforts, and proposing regulatory changes to stabilize the market. This Article takes a different approach to the small group problem by asking a previously unasked question: Does the small group market deliver …

Personhood Seeking New Life With Republican Control, Jonathan Will, I. Glenn Cohen, Eli Y. Adashi

Journal Articles

Just three days prior to the inauguration of Donald J. Trump as President of the United States, Representative Jody B. Hice (R-GA) introduced the Sanctity of Human Life Act (H R. 586), which, if enacted, would provide that the rights associated with legal personhood begin at fertilization. Then, in October 2017, the Department of Health and Human Services released its draft strategic plan, which identifies a core policy of protecting Americans at every stage of life, beginning at conception. While often touted as a means to outlaw abortion, protecting the "lives" of single-celled zygotes may also have implications for the …

Controlling Health Care Costs Under The Aca – Chaos, Uncertainty, And Transition With The Centers For Medicare And Medicaid Innovation And The Independent Payment Advisory Board, Gwendolyn R. Majette

Law Faculty Articles and Essays

This article addresses two components of the new governing architecture (NGA) that help to reform the delivery of health care and to control costs of the health care system: the Center for Medicare and Medicaid Innovation (CMMI) and the Independent Payment Advisory Board (IPAB). The republican controlled federal government has partially disassembled these two components, threatening the effectiveness of federal delivery system reform and cost control initiatives.

Implementing A Public Health Perspective In Fda Drug Regulation, Patricia J. Zettler, Margaret Foster Riley, Aaron S. Kesselheim

Faculty Publications By Year

There is, without question, a public health crisis in the United States arising from both illicit and prescription opioid misuse, addiction, and overdose. The Food and Drug Administration (FDA) is one regulator with an important role to play in minimizing the harms associated with prescription opioids, while also ensuring that prescription opioids are available for the evidence-based management of pain. One question, however, is to what extent the agency can consider in its decisions to approve opioids and keep existing ones on the market the provider and patient behaviors contributing to the epidemic. This is, in part, because FDA’s approval …

Index: Sports Law In Law Reviews And Journals, Jordan Lysiak

Marquette Sports Law Review

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