health care

  • September 16, 2015

    by Nanya Springer

    In the New Republic, Simon Lazarus of the Constitutional Accountability Center examines Judge Rosemary Collyer’s decision to entertain an unrealistic effort by House Speaker John Boehner aimed at destroying the Affordable Care Act.

    In The New York Times, Noam Scheiber reports that as more men feel entitled to take time off for family reasons, the number of fathers filing discrimination lawsuits against their employers is increasing.

    Amy Goldstein, Jeff Guo and Lazaro Gamio report in The Washington Post’s Wonkblog that while nine million people have gained health care coverage since 2013, wages and poverty levels have remained stagnant and income inequality remains high.

  • March 3, 2015

    by Caroline Cox

    At MSNBC, Ari Melber argues that the lawsuit against the Affordable Care Act in King v. Burwell is a charade.

    Sahil Kapur writes for Talking Points Memo that if the Supreme Court rules against the Affordable Care Act, dysfunction in the Republican-led Congress will lead to healthcare chaos.

    At the Huffington Post, Jonathan Cohn examines the path of lawsuit against the Affordable Care Act and its dubious basis.

    Simon Lazarus reviews the new book from Robert A. Katzmann at Democracy and considers how King v. Burwell will show whether conservative justices will “follow common-sense principles” or side with those who hope to rationalize “politically driven, legally flimsy results.”

    Noah Feldman takes a look at the recent Arizona redistricting case at Bloomberg View and asserts that the founders would approve of the state’s referendum model of redistricting.

    At The Nation, Ari Berman asserts that racism, inequality, and segregation persist fifty years after Selma.

  • July 23, 2014
    Guest Post

    by Timothy S. Jost, the Robert L. Willett Professor of Law, Washington and Lee University School of Law

    July 23, 2014 was a momentous day in the history of the Affordable Care Act. Shortly after 10 a.m., a three-judge panel of the District of Columbia Court of Appeals issued a split 2-1 decision striking down an Internal Revenue Service rule that permits federally facilitated exchanges to issue premium tax credits.  Two hours later, the Fourth Circuit Court of Appeals in Richmond released a unanimous decision upholding the IRS rule.

    The ACA authorizes the IRS to issue premium tax credits to uninsured lower and moderate income Americans through exchanges.  The ACA requests that the states establish exchanges, and sixteen states have done so.  The ACA also, however, authorizes the federal government to establish fallback exchanges in states that fail to set up their own exchanges, and it has done so in 34 states.  The IRS regulation allows premium tax credits to be awarded to eligible individuals by both state-operated exchanges and federally facilitated exchanges.

    Two subsections of the ACA, however, seem to provide that tax credits are available for months in which an individual is enrolled in a qualified health plan “through an Exchange established by the State under 1311” of the ACA. The plaintiffs argue that federal exchanges cannot issue premium tax credits tax credits to individuals who enroll through federal, as opposed to state-operated exchanges.

    The majority of the D.C. Circuit ruled for the plaintiffs, focusing narrowly on the “established by the State” language, but finding nothing in the ACA to clearly contradict the plaintiffs’ reading of the law. The Fourth Circuit found the law ambiguous, and thus under the Supreme Court’s Chevron rule, deferred to the IRS and its interpretation of the law.

  • June 4, 2014
    Guest Post

    by Reuben A. Guttman, Director, Grant & Eisenhofer; Member, ACS Board of Directors

    Certain things in life are predictable. A kid tilts the gumball machine when the candy does not roll out.  A soda machine is kicked when the pop gets stuck. A baseball manager is fired when a team fails to make the playoffs. And, oh yes, don’t forget this one: politicians threaten to give away government functions when they do not work right. In recent days, with word of veterans waiting in line to get health care services, the big boys on Capitol Hill were once again doing their own form of “soda machine kicking” with calls for the privatization of Veterans Administration Health care services. 

    The rational for outcries to privatize are traced to the purported justification that the private sector is more efficient and works better than government. Really? Do the names Tyco, WorldCom, Enron, and, more recently, General Motors mean anything? What about the hospital chains like Hospital Corporation of America or the drug companies like Pfizer, GlaxoSmithKline, Abbott, and Amgen that over the years engaged in conduct that drew the ire of the Department of Justice? 

    Setting aside the list of bad actors that could fill a few notebooks, maybe there is something to be said about the idea that the private sector does it better. But is that really true when the private sector contracts with the government, or is a government contract merely a license to steal? Consider this: once government services are contracted out and long term civil service employees are displaced with contractors, there is—as Eddie Murphy might say—“no going back."  And some contractors have such a grip on their relationship with government agencies, it is virtually impossible for the government to keep them in line through any form of adult supervision. Take the case of Lockheed Martin Corporation. It has approximately $37 billion in government contracts currently. In other words, at the same time the United States Department of Justice is pursing Lockheed for violations of the False Claims Act, it is rewarding it with hundreds of millions of dollars in government contracts.

  • August 1, 2013
    Guest Post

    by Reuben Guttman, Director and Head of False Claims Group, Grant & Eisenhofer.

    Over the past several years, we have had the privilege of representing whistleblowers who have successfully pursued False Claims Act cases against some of the largest pharmaceutical manufacturers in the world. Cases against Pfizer, GlaxoSmithKline, Abbott Labs, Amgen, and most recently Wyeth which was acquired by Pfizer, resulted in the companies returning over $7 billion to government healthcare payors.   

    Viewed from the optics of the black letter law, these cases are about whether false or fraudulent statements cause the government to pay for drugs that doctors would not have otherwise prescribed. Yet, in human terms, these cases raise the question of whether corporate marketing goals are influencing medical decisions.