Health Law Initiative
State attorneys general have a track record of health advocacy. The existing jurisdiction of attorneys general in the area of public health is broad and often underutilized. Although there are attorneys general willing and anxious to help, existing health initiatives too often continue to proceed without the benefit of the voice and the leverage that attorneys general obviously bring. State attorneys general are extraordinary voices for the public good, and it is important to maximize their advocacy on behalf of our nation’s health.
Health Care Reform Resources
As state attorneys general face new challenges presented by health care reform, the Health Project at the National State Attorneys General Program has been compiled resources and material to aid offices meet those challenge.
Below is a link to the resource page that includes a document outlining key areas in health reform that will affect attorney general offices. It will be updated regularly.
For questions or comments, contact the National State Attorneys General Program at firstname.lastname@example.org
Health Care Reform Resources
The Affordable Care Act: Five Questions with Gillian Metzger (March 6, 2015)
Gillian Metzger is a Professor of Law, and faculty director of Columbia Law School’s Center for Constitutional Governance. An expert in administrative and constitutional law, with a specialization in federalism, she and several other professors wrote an amicus brief that says the principles of federalism support the tax subsidies at issue in the widely watched King v. Burwell case. She answers five questions about the March 4 oral arguments before the U.S. Supreme Court.
Idaho Hospital Antitrust Ruling Upheld by 9th Cir. (February 11, 2015)
On February 10th the 9th Circuit Court of Appeals affirmed a ruling by the Federal District Court, District of Idaho, which held the acquisition of Saltzer Medical Group by St. Luke’s Medical Center in 2012 violated Federal antitrust law and Idaho state law. The proposed merger would have resulted in the largest health care provider in its market.
St. Alphonsus Medical Center-Nampa and Treasure Valley Hospital, joined by the Federal Trade Commission and the Idaho Attorney General, asserted that St. Luke’s had violated the Section 7 of the Clayton Act [15 U.S. Code § 18] and the Idaho Competition Act [Idaho Code §§ 48-102(3), -106] when it merged with Saltzer resulting in “anticompetitive effects in the relevant markets for ‘primary care physician services,’ ‘general acute-care inpatient services,’ ‘general pediatric physician services,’ and ‘outpatient surgery services.’”
The 9th Circuit found that the lower court’s factual findings "adequately support its ultimate conclusion that the plaintiffs established 'a prima facie case that the acquisition is anti-competitive.'" The remedy will be a divestiture by St. Luke’s of its Saltzer holdings.
With Hospitals Under Stress, Tennessee’s Governor Pursues Medicaid Expansion ( December 2014)
Under mounting pressure from financially strapped hospitals, Gov. Bill Haslam of Tennessee proposed an alternative plan for expanding Medicaid that he said would bring health coverage to tens of thousands more poor residents of his state without following traditional Medicaid rules.
The tide may also be shifting in states like Utah and Wyoming, where Republican governors proposed their own versions of Medicaid expansion this fall, and in Idaho, where a group formed by Gov. C. L. (Butch) Otter is revising an expansion plan in hopes of winning legislative backing. The conservative governors of North Carolina and, most recently, Alabama, have expressed openness to expanding Medicaid programs if they can fashion their own approach.
U.S. Health Spending Rises at Slowest Pace Since 1960 (December 2014)
U.S. health-care costs grew 3.6 percent to $2.9 trillion in 2013, the smallest increase in more than 50 years and one that probably won’t be matched soon as spending accelerates to meet the needs of millions gaining insurance under Obamacare.
The nation has experienced unusually low health-care spending growth five years in a row as the 2009 recession and the slow economic recovery caused Americans to scale back their use of hospitals and other medical services, actuaries at the Centers for Medicare and Medicaid Services said yesterday in a report published by the journal Health Affairs.
Program Director Tierney and Senior Counsel Lott to Give Presentation on Health Care and Consumer Protection to NAAG (October 2012)
On October 29, Program Director Jim Tierney and Senior Counsel Cindy Lott were on a panel at the National Association of Attorneys General (NAAG) Fall Consumer Protection Seminar with Sharon Clark, Insurance Commissioner of Kentucky, to discuss the role of attorneys general under the affordable care act. The discussion focused on the increased need for interdivision and interagency coordination within states to meet the impending challenges. Below is a list of resources and a memo highlighting specific issues attorneys general should be aware of within consumer protection and how they will interact with areas such as antitrust and charities.
Advance Remarks for the Kentucky NAAG Meeting
Attorneys General and the Patient Protection and Affordable Care Act
Originally written in preparation for a health care conference hosted at the National State Attorneys General Program in December of 2011, the following memo was written to examine the role of the state attorney general in the Patient Protection and Affordable Care Act.
Health Care Reform Implementation and Enforcement:
The Patient Protection and Affordable Care Act (ACA) and Potential State Attorneys General Role
Supreme Court Rules on Health Care Reform Challenge Brought by Attorneys General (June 2012)
Press Release from Director Tierney
Reactions From Attorneys General
Alabama Attorney General Luther Strange
Arizona Attorney General Tom Horne
California Attorney General Kamala D. Harris
Colorado Attorney General John Suthers
Connecticut Attorney General George Jepsen
Florida Attorney General Pam Bondi
Georgia Attorney General Sam Olens
Idaho Attorney General Lawrence Wasden
Indiana Attorney General Greg Zoeller
Iowa Attorney General Tom Miller
Louisiana Attorney General James Caldwell
Maine Attorney General William J. Schneider
Massachusetts Attorney General Martha Coakley
Michigan Attorney General Bill Schuette
Missouri Attorney General Chris Koster
Nebraska Attorney General Jon Bruning
New York Attorney General Eric Schneiderman
North Dakota Attorney General Wayne Stenehjem
Ohio Attorney General Mike DeWine
Oklahoma Attorney General Scott Pruitt
South Carolina Attorney General Alan Wilson
South Dakota Attorney General Marty Jackley
Texas Attorney General Greg Abbott
Virginia Attorney General Ken Cuccinelli
Washington Attorney General Rob McKenna
Wisconsin Attorney General JB Van Hollen
Health Reform Roundtable Discussion (December 2011)
On December 5th, the Health Project at the National State Attorneys General Program hosted a roundtable discussion with designees from sixteen attorney general offices on the implementation of the Patient Protection and Affordable Care Act. The discussion focused on the role of state attorneys general beyond constitutional challenges pending before the Supreme Court. Concentrating on areas where attorneys general have traditional involvement, the discussion highlighted areas expected to see more activity such as insurance market reforms, healthcare marketplace changes, and Medicaid expansion. The Health Project intends to release a resource guide that will reflect the responsibilities tasked to state attorneys general to aid their offices understand and prepare for healthcare reform implementation.
Health Project Tobacco Resources Initiative (May 2011)
Raising awareness of the health risks of tobacco use and curbing cigarette marketing to children is an essential task of state attorneys general, especially following settlements against major cigarette manufacturers in the late 1990s. The National State Attorneys General Program's Tobacco Resources Initiative provides valuable resources for members of attorneys' general offices, regulators, and the public in dealing with tobacco-related legal issues, including information on past lawsuits and public anti-smoking efforts.
Vermont Anti-Obesity Initiative (February 2010)
In February 2010, Vermont Attorney General William H. Sorrell launched an initiative to address the growing problem of obesity in his home state. The initiative convened various stakeholders to identify ways in which the Vermont Attorney General's office can complement the work of the state Departments of Health and Education on the subject of obesity.
Sorrell Discusses State Initiative on AG Program Podcast
Press Release from Vermont Attorney General's Office
Barre Montpelier Times Argus article: "State Targets Obesity"
WCAX.com article: "Vermont Takes On Obesity"
Rudd Center Statistics on Vermont
National State Attorneys General Program at Columbia Law School
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