Jones & Bartlett Learning Health Blog

    Like a Phoenix from the Ashes…The Senate’s Health Reform Efforts Live On

    Posted by Sophie Teague on Sep 20, 2017 12:11:00 PM

    by Sara Wilensky, JD, PhD
    Co-author of Essentials of Health Policy and Law, 3rd Edition

    With the passage of the American Health Care Act (AHCA) in the House on May 4, 2017, the health reform debate moved to the Senate.  The Senate completely scrapped the House bill and released its own version of health reform, the Better Care Reconciliation Act of 2017 (BCRA).  Despite important differences, AHCA and BCRA followed roughly the same contours. Both bills reduced taxes, eliminated government mandates, lowered federal government spending, lowered premiums for some people while increasing them for others, phased out Medicaid expansion under the Affordable Care Act (ACA), and ended Medicaid as an entitlement program. According to the nonpartisan Congressional Budget Office (CBO), the effect of the bills would be to increase the number of uninsured, reduce the deficit, lower costs for young and healthy consumers, and increase costs for older and poorer consumers.[1],[2] Unlike the House, however, the Senate could not muster enough Republican support to pass BCRA (or the Senate’s other two bills), stalling the health reform debate in Congress.  After a month of relative quiet, the Senate is trying again with its consideration of the Graham-Cassidy bill to repeal and replace the ACA.

     

    Read More

    Topics: Affordable Care Act (ACA), Public Health, sara wilensky, Essentials of Health Policy and Law

    "Delivering Health Care in America" Authors Celebrate 20 Years with New 7th Edition Coming in October

    Posted by Sophie Teague on May 23, 2017 3:29:20 PM

    By Leiyu Shi, DrPH, MBA, MPA, Johns Hopkins Bloomberg School of Public Health
    & Douglas A. Singh, PhD, MBA, Indiana University at South Bend, School of Business and Economics
    Authors, Delivering Health Care in America, 7th Edition (Available Oct. 13, 2017)

     

    With this Seventh Edition, we celebrate 20 years of serving instructors, students, policymakers, and others, both at home and overseas, with up-to-date information on a dynamic United States health care delivery system. Much has changed and much will continue to change in the future as the nation will grapple with critical issues of access, cost, and quality. Indeed, much of the developing and developed world will also be contending with similar issues.

    People in the United States, in particular, had just gotten a taste of a far-reaching health care reform with President Barack Obama’s signature Affordable Care Act (ACA), nicknamed Obamacare. The law produced mixed results that are documented in this new edition.

    Read More

    Topics: New Edition, Affordable Care Act (ACA), Author, health administration, National Health, Public health management, Delivering Health Care in America, Public Administration, shi & singh

    What’s Ahead for the Affordable Care Act?

    Posted by Sophie Teague on May 4, 2017 2:36:36 PM

    By Donna K. Hammaker, MGA, JD
    Author of Health Care Management and the Law, 2nd Edition & Health Care Ethics and the Law, 1st Edition

    The current political situation makes it probable that changes will be made to the Affordable Care Act (ACA), if it is not repealed. Although some ask why the government cannot simply get out of health care and allow market forces to regulate the industry, the history of U.S. health care is the best explanation of why this strategy does not work. The government did stay out of the individual market until it passed the ACA in 2010 at a time when millions could not obtain health insurance and costs were skyrocketing at an unsustainable pace.

    Read More

    Topics: Affordable Care Act (ACA), Author, Donna Hammaker

    Teaching the ACA Under the Threat of ‘Repeal and Replace’: Our Authors Weigh In

    Posted by Sophie Teague on Feb 22, 2017 8:56:11 AM

    ‘Repeal and Replace’ seems to be the mantra of the new White House administration. What does the future of the Affordable Care Act (ACA) look like? How should educators approach the topic in classroom discussion? We asked our authors for their opinion and here’s what they said:

    Read More

    Topics: Affordable Care Act (ACA), health administration, Public Administration

    Obamacare Could Be in for a Bumpy Ride

    Posted by Sophie Teague on Feb 22, 2017 8:45:01 AM

    By Nancy Niles, MPH, MS, MBA, PhD
    Author of Basics of the U.S. Health Care System, 3rd Edition

    The Affordable Care Act is a very complex healthcare law that resulted in an extensive set of regulations with several deadlines established over the years to implement the act.  The Republicans have tried to repeal it for years. I was shocked and dismayed that they had no replacement at hand to repeal and replace. This process is often called 'repeal and delay' because the process can be so lengthy.  Obamacare has to be defunded and then replaced with another program. There are already competing bills regarding the replacement. There are many in the majority party worried about the proposed options to replace this system.

    Read More

    Topics: Affordable Care Act (ACA), Nancy Niles

    The Future of the ACA: A Health Policy Expert’s Opinion

    Posted by Sophie Teague on Feb 22, 2017 8:39:23 AM

    by Sara Wilensky, JD, PhD
    Co-author of Essentials of Health Policy and Law, 3rd Edition

    With the Republicans in control of the Executive and Legislative branches of government, the outlook for the ACA is grim.  Republicans in Congress consistently tried to repeal and hinder the success of the ACA since its passage in 2010 with only Democratic support.  House Republicans passed multiple bills repealing the ACA despite Obama’s veto threat.  Therefore, isn’t it a forgone conclusion that the ACA is history?  Not necessarily.  As the Republicans are discovering, it is much easier to protest than to govern. 

    Read More

    Topics: Affordable Care Act (ACA), Public Health, sara wilensky, Essentials of Health Policy and Law

    Health Reform and the Supreme Court Decision – Part 4

    Posted by Cassie Peterson on Jul 9, 2012 2:29:45 PM

    Jones & Bartlett Learning Author and Health Policy Expert Joel Teitelbaum Weighs in on the Health Reform Case Before the Supreme Court.

    Read More

    Topics: Commerce Clause, Constitution, Affordable Care Act (ACA), Author, Congress, health administration, Medicaid, Patient Protection and Affordable Care Act, Supreme Court, Tenth Amendment, Supreme Court Health Reform Decision

    Health Reform and the Supreme Court Decision – Part 3

    Posted by Cassie Peterson on Jun 11, 2012 8:11:46 AM

    Jones & Bartlett Learning Author and Health Policy Expert Joel Teitelbaum weighs in on the Health Reform Case Before the Supreme Court.

    Read More

    Topics: Commerce Clause, Constitution, Affordable Care Act (ACA), Author, Congress, health administration, Medicaid, Patient Protection and Affordable Care Act, Supreme Court, Tenth Amendment, Supreme Court Health Reform Decision

    Health Reform and the Supreme Court Decision – Part 2

    Posted by Cassie Peterson on May 8, 2012 5:02:50 PM

    Jones & Bartlett Learning Author and Health Policy Expert Joel Teitelbaum Weighs in on the Health Reform Case Before the Supreme Court.

    During the final week of March, the United States Supreme Court engaged in an historic debate about the meaning and constitutionality of the Patient Protection and Affordable Care Act (known as Affordable Care Act, or ACA).  The culmination of some 30 legal challenges to the ACA, the Supreme Court heard oral arguments on a series of legal issues:

    1. Whether the ACA’s individual coverage requirement is a tax for purposes of the Anti-Injunction Act.
    2. Whether Congress has the power under Article I of the Constitution to enact the minimum coverage requirement.
    3. Whether, if the coverage requirement is found unconstitutional, it is “severable” from the remainder of the ACA.
    4. Whether the ACA’s requirement that states expand Medicaid eligibility or risk losing federal funds is unduly coercive in violation of the Tenth Amendment.

    In this blog post, the second of a four-part series, I focus on questions two and three.  The first post discussed Question One, , the third post will discuss the question concerning the Medicaid expansion, and the fourth post will describe the Court’s eventual ruling in the case, which is expected by the end of June.

    Whether Congress has the power under the federal Constitution to enact the minimum coverage requirement (also referred to as the “individual mandate”) was the headlining issue in the lead-up to the oral arguments.  The creation of the minimum coverage requirement has its roots in the fact that, unlike most other industrialized countries, the U.S. relies heavily on the private market to provide health insurance to the population.  However, because this private system resulted in serious market failure (namely, 50 million uninsured Americans), Congress looked in the ACA to remedy the failure while retaining an insurance system heavily reliant on private sellers.  The result: a requirement that all individuals purchase health insurance, with premium subsidies for certain individuals who lack the means to purchase it on their own and financial penalties for those who ignore the requirement.

    As a matter of constitutional law, the minimum coverage requirement raised two questions that divided the lower federal courts (and the Justices at oral argument): whether an individual’s remaining uninsured (either as a matter of choice or for reasons of affordability or access) is the type of activity that Congress can regulate pursuant to its Commerce Clause powers and, if so, whether the ACA’s coverage mandate is a constitutional solution.  In essence, those who argue that Congress exceeded its Commerce Clause authority in passing the coverage requirement argue that while the Constitution allows Congress to regulate commerce, it does not permit the legislature to force individuals to engage in commerce through the purchase of a private-market good.

    At oral argument, the debate broke along two very different views regarding what, exactly, the minimum coverage requirement aimed to do.  On one hand, the more liberal-leaning Justices seemed to view the requirement as a regulation of the overall health care marketplace, and that that marketplace is something in which all Americans already participate (because, at one time or another, everyone needs and uses health care services).  Viewed in this way, the ACA’s coverage requirement is a constitutionally valid regulatory response to an existing market that is functioning poorly and, many would argue, unfairly.  According to this approach, the individual mandate creates a more stable health insurance system that guarantees access to coverage (and thus, for many people, access to care) that is relatively affordable.

    Some of the more conservative-leaning Justices offered up a very different view of the minimum coverage requirement.  To them, the requirement does not regulate individual behavior in the health care marketplace but instead creates a new marketplace and then forces individuals to buy a product sold in that market.  Under this view, the requirement that individuals purchase insurance – i.e., the personal conduct being regulated -- lacks a sufficient connection to commerce to fall inside the scope of congressional Commerce Clause power that the Court has legitimized in the past.  To rule otherwise, according to this perspective, would mean that Congress could in the future create other markets for the purpose of regulating them, and there would exist no standard by which the Court could effectively restrain Congress’s Commerce Clause power.

    Read More

    Topics: Commerce Clause, Constitution, Affordable Care Act (ACA), Author, Congress, health administration, Medicaid, Patient Protection and Affordable Care Act, Supreme Court, Tenth Amendment, Supreme Court Health Reform Decision

    Subscribe to Email Updates

    Recent Posts

    Posts by Topic

    see all