The Brutal Math of Repealing the Individual Mandate
Is the country really better off if millions of people forgo medical care, and millions more go bankrupt, so that corporations can pay lower taxes? That’s not a rhetorical question. Those are the stakes of the game.
Update | Week of October 30, 2017
A proposed rule on essential health benefits may be illegal. A repeal of the individual mandate may be included in the tax reform bill.
Updates | The Week of October 23, 2017
Senate Majority Leader Mitch McConnell signaled he would bring the bipartisan Murray-Alexander proposal to a vote if President Trump issued his support. The Administration bypassed a key administrative law procedure with its new birth control regulations.
Trump and the Essential Health Benefits
The Trump administration wants to relax the rule requiring health plan to cover the essential health benefits. But its proposal has some legal problems.
Versus Trump Emergency Pod: JD v. DHS
On this week’s episode of Versus Trump, Easha and Charlie have a quick turn-around emergency pod to discuss an ongoing—wait, just now resolved—case filed by a pregnant 17-year-old girl in federal immigration custody who seeks an abortion. Easha and Charlie first talk about the procedural wrangling that this case has wrought and second about the legal claims in the case, which bring them into the exciting worlds of reproductive rights, immigration law, and international relations. Listen now!
Updates | The Week of October 16
President Trump's proposed overhaul of the Affordable Care Act will do clear harm and violates the Take Care clause of the Constitution. The bipartisan bill to preserve health care subsidies for low-income Americans under the Affordable Care Act must win over more Republicans and President Trump to succeed.
Versus Trump: The Contraception Mandate Challenges
On this week’s episode of Versus Trump, Easha and Jason discuss the Administration's drastic expansion of the number of companies that may now offer health insurance that does not cover birth control, as well as several lawsuits that were immediately filed challenging these new regulations. Listen now!
Updates | The Week of September 25, 2017
Commentary continued on the Graham-Cassidy healthcare bill. Senator Susan Collins announced her opposition to the bill, depriving it of a crucial vote needed for passage.
Versus Trump: The FOIA Spectacular!
On this week’s episode of Versus Trump, Easha and Charlie discuss all things FOIA—that is, the Freedom of Information Act. Listen now!
Updates | The Week of July 24, 2017
Republican healthcare reform efforts faced a roller coaster week in the Senate, culminating in a dramatic rejection of the so-called "skinny repeal."
Health Care Reform Part IV: A Reminder that What We Do Matters
The House will vote today on the American Health Care Act. Yet amendments to the bill were published only last night, there has been no updated score from the Congressional Budget Office (CBO), and no public hearings have been held. This is not an appropriate process.
Trump has declared open war on Obamacare
With its abrupt decision to terminate the cost-sharing subsidies, the Trump administration has thrown the exchanges into chaos on the eve of open enrollment; it has imperiled the full faith and credit of the United States; and it will cause a massive increase in federal spending.
Versus Trump: The Healthcare Episode
On a new episode of Versus Trump, Take Care's podcast, Easha and Jason dig into healthcare for the first time, as they take a deep dive into the House v. Price litigation that addresses whether certain payments to insurers under the Affordable Care Act have been properly appropriated. They also debate immigration rhetoric vs. action and discuss drug testing for unemployment benefits. Listen now!
Here's How Trump Could Sabotage Obamacare
Should the Trump Administration do whatever it can to make Obamacare work? Or should it sabotage the law in an effort to force Democrats to the bargaining table?
Health Care Reform Part I: “Nobody Knew That Health Care Could Be So Complicated”
The GOP health care bill would result in millions of Americans with pre-existing conditions losing their insurance. Statements by Trump to the contrary just aren't true. Whether he doesn't understand his own plan or is misrepresenting it, Trump has an obligation to be honest about what he has proposed for the nation's health care system.
Why Process Matters: Health Care Reform Edition
While attention is drawn to Comey’s very public hearing, something else is happening, largely in secret. The Senate is moving forward with a health care bill that will likely take coverage from tens of millions of Americans, and that will likely cut taxes for the wealthy on the backs of the poor.
The Michigan Morsel
To corral some last-minute votes, the House leadership has endorsed the Upton amendment to the American Health Care Act. That’s a shame: the amendment works at cross-purposes with other parts of the AHCA, is arbitrarily structured, and is ambiguous on a key point. It’s another example of the perils of doing health policy on the fly.
Trump’s Latest Affront To Women, and to the Constitution
A draft of the Trump Administration's revised contraception mandate has been leaked. If implemented, this policy would weaken civil rights for women. Moreover, the plan could violate the Establishment Clause by providing a religious accommodation for some private citizens only by shifting costs to others who may not share their beliefs.
Moral Convictions And The Contraception Exemptions
Yet another major flaw in the draft contraception rule, which would not only allow employers to drop contraception coverage for *religious* reasons, but would also (without any lawful basis) allow employers who have *moral* objections to do the same.
Can you smell the freedom?
In an op-ed in the L.A. Times, I explain why the Senate health care bill would hurt, not help, freedom.
HIV is a Health Condition — Not a Crime
Despite consensus that criminalizing HIV has little public health effect, is not supported by scientific knowledge of transmission risks, and may violate the Americans with Disabilities, states are still enforcing laws against people living with HIV.
Obamacare As Superstatute
The Affordable Care Act has wrought a normative transformation in American views on healthcare and public policy
What Happens Next for the ACA?
President Trump has said that “the best thing we can do politically speaking is let Obamacare explode,” and there’s a lot he can do to make that explosion a reality. Here is what you need to know about what might come next.
The EEOC's Rule on Wellness Programs Is Busted
A federal judge has held that EEOC violated the APA in issuing a rule that would have allowed employers to penalize employees who opted out of wellness programs. But the judge has left the rule in place for now.
Graham-Cassidy should be seen for what it is: an effort to prevent any level of government, state or federal, from making good on the promise of universal coverage.
Graham-Cassidy Is Unconstitutional
Graham-Cassidy has a constitutional flaw: the funding formula for the block grants to states that form the bill’s core is unconstitutional.
Ending a Critical Obamacare Subsidy
The Trump administration will terminate the Affordable Care Act’s cost-sharing payments, further destabilizing the already-fragile exchanges on the eve of open enrollment. The legal fallout will be complex, messy, and expensive.
Disability Advocates Challenge Medicaid Cuts
Hundreds of people in wheelchairs, with walkers, and using ventilators protested in Senators’ offices and RNC offices across the country. Many traveled far from their homes, suffered blazing temperatures, and were denied access to bathrooms and elevators, to make their voices heard. And Senators and RNC staff refused to meet them, had them forcibly ejected, and called police to arrest them.
Reliance Defenses in the Trump Era and Beyond
The transition to President Trump has massively shifted federal enforcement priorities. Does the Constitution protect people who relied on Obama's immigration, healthcare, or marijuana policies?
An Update in House v. Price: When Inaction Masks Turmoil
Insurance companies are filing their applications for 2018 plans and rates now, with the last deadline in some states coming on June 21, and with many having passed already. If you’re an insurer and you don't know what the rules of the game will be, how can you play it?
Confusion Over The Essential Health Benefits
Last night, House Republicans released the text of the final manager’s amendment to the American Health Care Act. If it becomes law, the individual insurance market will likely collapse nationwide in 2018.
Waivers Are Dead, Long Live Waivers
The new skinny repeal bill contains an unwelcome surprise: a waiver provision that may provide a backdoor way for states to undo some of the ACA’s most significant protections.
Health Care Reform Part II: Real Trumpcare Versus Unicorn Trumpcare
There are important differences between the *real* GOP healthcare bill and the *imaginary* healthcare bill that President Trump has described in interviews. Those differences may affect insurance coverage for millions of Americans and the price of insurance for many more.
Versus Trump: "What About Congress? + Steven Wu"
On a new episode of Versus Trump, Take Care's podcast, Easha, Jason, and Charlie discuss Congress's role and powers in investigations of the Executive. Then, Jason talks with Steven Wu, a Deputy Solicitor General in the Office of New York Attorney General Eric Schneiderman, about the case against Trump University, the active role of states in recent years, and other issues in which New York is adverse to the President. Listen now!
From Big Waiver to Waiver Unlimited
Perhaps the biggest concern with BCRA is that state waivers could degrade the financial protections available for employer-sponsored coverage
Healthcare Reform Part V: Don’t Forget About HHS
Waivers granted by HHS are critical to the design of the Republican healthcare legislation and may have a huge effect on how it works in practice. Here's a preliminary analysis of how HHS Secretary Tom Price is likely to exercise his discretion with respect to waivers.
The New Contraception Rule Is Procedurally Flawed
The Trump Department of Health and Human Services has proposed a massive expansion of the program that provides employers and exemption from providing their employees with contraceptive coverage. But they have not sought notice-and-comment on the rule, and that could be a major problem.
Taking the Nuclear Option Off the Table
Last Thursday, fifteen states and the District of Columbia moved to intervene in House v. Price, the case about the ACA’s cost-sharing reductions. At the same time, they asked the court to hear the case promptly. This is a bigger deal than it may seem, and could offer some comfort to insurers that are in desperate need of it.
New bipartisan legislation to restore the cost-sharing payments would also make some changes to the rules governing ACA waivers. How substantial are those changes?
Updates | The Week of July 31, 2017
Congressional Republicans are weighing their options, some bipartisan, some not, in the wake of the skinny repeal failure. The White House has the opportunity to help or hurt insurance markets.
Updates | The Week of April 10, 2017
Despite the failure of the proposed American Health Care Act, the Trump administration and congressional Republicans continue to discuss plans to repeal and replace the Affordable Care Act. The Trump administration continues to consider the possibility of withholding insurer subsidies.
Updates | The Week of April 17, 2017
Proposed amendments to an updated Republican health care bill have been circulating, prompting legal scholars and advocates to push back on specific elements.
Updates | The Week of March 20, 2017
As the President and Speaker attempted unsuccessfully to glue together a coalition to pass their Affordable Care Act (ACA) replacement plan, Take Care contributors examined its constitutionality in reference to arguments made against the ACA and looked at the consequences of the administration’s indecision on health policy.
Updates | The Week of April 24, 2017
The House delayed a vote on a revised healthcare bill, denying President Trump a 100-day win. The House Freedom Caucus, which opposed President Trump's earlier plan to repeal the Affordable Care Act, now supports a more conservative version of the bill.
Updates | The Week of March 27, 2017
Last week saw the demise of Republican efforts to repeal and replace the Affordable Care Act. But this week saw concerns that the Trump Administration could nonetheless cause the ACA to implode. On Take Care, Nick Bagley and Rachel Sachs analyzed this possibility.
Updates | The Week of July 10, 2017
Embattled Senate Republicans released a new health care bill. State Attorneys General attempting to intervene in the House v. Price litigation face opposition from both parties.
Updates | The Week of August 14, 2017
The CBO released its conclusions regarding President Trump's proposal to cut cost-sharing reduction payments to insurers. Secretary of the Interior Ryan Zinke may have violated federal law when he attempted to pressure Senator Lisa Murkowski into voting for the ACA repeal.
Updates | The Week of July 17, 2017
The Republican healthcare proposal fell apart in the Senate after several Senators pulled their support. Majority Leader Mitch McConnell unsuccessfully attempted to push a vote on full repeal.
Updates | The Week of June 12, 2017
The Senate is trying to replace the Affordable Care Act in secret. Women's health advocates have shifted their focus to the state level since the election.
Updates | The Week of June 19, 2017
The Senate proposes its bill to replace the Affordable Care Act while the Administration extends cost-sharing payments for June.
Updates | The Week of May 8, 2017
Extensive commentary continued on the American Health Care Act. Senators condemned HHS Secretary Tom Price for closing off agency communication with Congress.
Updates | The Week of July 3, 2017
Commentary continued on the GOP's struggle to repeal or replace the Affordable Care Act. The Trump Administration is moving ahead on repealing a rule that protects residents of long-term care facilities from mandatory arbitration agreements.