Washington and Lee law professor Timothy Jost has published an article in the New England Journal of Medicine titled, Subsidies and the Survival of the ACA — Divided Decisions on Premium Tax Credits. The article was online published on July 30, 2014.
In rapid succession on July 22, two federal courts of appeal reached opposite conclusions on the single most important outstanding legal issue affecting the Affordable Care Act (ACA): whether the federally facilitated insurance exchanges that serve two thirds of the states can grant premium tax credits to individuals purchasing health insurance plans.
Professor Jost frequently publishes in the New England Journal of Medicine. Additional articles may be found here.
Washington & Lee law professor Timothy Jost published a new article in the New England Journal of Medicine titled “Obama’s ACA Delays – Breaking the Law or Making it work?” (with S. Lazarus). The article, published on April 2, 2014, discusses the legality of the Obama administration’s Affordable Care Act implementation delays.
Professor Jost also recently presented on the topic of health policy and the Affordable Care Act at the University of Pennsylvania, Harvard Medical School, Yale University, the National Conference of Insurance Legislators and The National Association of Insurance Commissioners.
Read Professor Jost’s contributions to Health Affairs Blog for his current analysis of implementing health reform.
Washington & Lee law professor Timothy Jost has published an article in the New England Journal of Medicine. Professor Jost’s article Beyond Repeal – A Republican Proposal for Health Care Reform was published online February 12, 2014.
By voting repeatedly to repeal the Affordable Care Act (ACA) over the past 4 years, Republicans have risked being identified as a party without a positive health policy agenda. On January 27, 2014, however, three Republican senators — Orrin Hatch (UT), Tom Coburn (OK), and Richard Burr (NC) — unveiled a proposal that would not only repeal the ACA, but also replace it with comprehensive legislation based on Republican health policy principles.1 Although the proposal recycles long-standing Republican prescriptions, it also offers new ideas.
Read more of Professor Jost’s work here.
Washington and Lee law professor Tim Jost has published a new article at Health Affairs, the leading journal of health policy thought and research. Prof. Jost has published a number of articles at Health Affairs dealing with the debate and implementation of the Affordable Care Act. He is also active on the Health Affairs blog, where his posts have been included among the top-read pieces each year.
His new article is titled “Implementing Health Reform: Four Years Later.” Prof. Jost, a supporter of health care reform, begins the article by acknowledging the troubling launch of the health care reform and asks “How did things go so wrong? Why is there so much bad news? When can we expect the news to get better?”
Going forward, one of the most important challenges facing the ACA will be whether its benefits become apparent quickly and dramatically enough to offset the problems that are currently dominating the news coverage of the health reform law. Even more important may be the question of how much it will matter that the greatest beneficiaries of the ACA are likely to be low-income Americans, who are less likely to be politically active than many of the higher-income Americans who will be adversely affected by higher insurance premiums and taxes.
Washington and Lee law professor Tim Jost has a new article out on health care reform, cross published by the New England Journal of Medicine and the Harvard Business Review. The article, titled “Regulating Private Health Insurance to Promote High-Value Health Care,” looks at how Title 1 of the Affordable Care Act impacts previous efforts to encourage the creation of high-value health care. In conclusion, Prof. Josts writes:
In adopting the ACA, Congress embraced an ambitious agenda of regulation and public reporting to encourage private insurers to improve the value of health care. Congress tried to encourage insurers to pursue activities that some were already pursuing and to emulate value-purchasing initiatives in the Medicare and Medicaid program. HHS [Health and Human Services] seems, however, to have made private insurance value purchasing a low priority. It is likely to be several years before we learn whether the ACA provisions that address private insurers will in fact improve the value of health care.
The article is available for download from the NEJM website.
Here is the beginning of a post by W&L Law Professor Tim Jost at the Health Affairs Blog regarding the Obama Administration’s recent announcement of a delay in implementation of the Affordable Care Act’s employer mandate:
Late in the day on July 2, 2013, Mark Mazur, Assistant Secretary for Tax Policy at the Department of the Treasury, announced in a memorandum ironically entitled “Continuing to Implement the ACA in a Careful, Thoughtful Manner” that implementation of the Affordable Care Act’s employer mandate would not be implemented on time, but rather delayed until 2015. Valerie Jarrett released a similar statement from the White House.
The Administration has been under tremendous pressure from the business community to delay implementation of ACA provisions affecting employers; it had already delayed the implementation of statutory provisions prohibiting insured employers from discriminating in favor of highly-compensated employees and requiring large employers to automatically enroll new full-time employees in a health insurance plan, subject to the employee opting out. The Administration has now accommodated business one more time.
The reason given for the delay this time was difficulty in implementing ACA provisions requiring insurers and self-insured health plans to report information regarding individuals whom they cover and requiring large employers to report coverage offered to their full-time employees. The administration asserts that an additional year will give employers and insurers the time they need to adapt to the reporting requirements and give the Departments time to simplify the reporting requirement.
Without reporting, however, enforcing the employer mandate will be impractical, so it is put off for a year. The Administration promises guidance within the next week on how this will work and proposed rules this summer to implement the reporting requirement.
You can read the rest of the post by visiting the Health Affairs Blog.
W&L Law Professor Timothy Jost has published the Seventh Edition of Health Law: Cases, Materials, and Problems with the West Publishing Company. The Health Law casebook has been widely used throughout the United States for teaching health law since the first edition was published in 1987, and is credited as having defined the modern health law discipline. The book, which is over 1800 pages long, is also being published in an abridged (900 page) edition and as three separate “spin-off” books covering bioethics, health care organization and financing, and liability and quality. All books will be available this summer for classes in the fall. Professor Jost wrote chapters dealing with health care cost and access issues, private health insurance regulation, the Affordable Care Act, ERISA, Medicare, Medicaid, and the Children’s Health Insurance Program. These chapters have been extensively rewritten since the sixth edition because of changes made by the Affordable Care Act.
Washington and Lee law professor Timothy Jost has published “The Affordable Care Act and the Constitution: Beyond National Federation of Independent Business v. Sebelius” in The Health Care Case: The Supreme Court’s Decision and its Implications, published by Oxford University Press. The book features well-respected and ideologically diverse authors, some of whom participated in ACA litigation. It is among the first scholarly books to address the healthcare decision, perhaps the most significant decision of the Roberts Court to date, with major implications for constitutional law, the Roberts Court itself, and healthcare. Below is excerpt from Professor Jost’s chapter:
In National Federation of Independent Business v. Sebelius (NFIB), the Supreme Court concluded that Congress had acted within its constitutional authority in adopting the Affordable Care Act (ACA)’s individual responsibility provision (although as an exercise of its taxing power, not its commerce power) but that the ACA’s Medicaid expansion was unconstitutional as written. The chapters in this book address the NFIB decision, its history, meaning, and ramifications for the future.
But the ACA and its implementation raise many other constitutional issues not settled by the NFIB case; issues that have been and continue to be litigated in the federal courts. While these challenges have not attracted the attention the NFIB case garnered, and most have either failed or are likely to fail, they are significant politically. Like the NFIB litigation, most of these other cases have been driven by political considerations. They have given support and encouragement to the ACA’s enemies, offering state officials politically opposed to the ACA reasons to refuse to cooperate in its implementation and opponents in Congress ammunition to call for its repeal. On the other hand, the tables could have been turned had an administration come to power in Washington opposed to ACA implementation, with the ACA’s supporters then resorting to litigation to salvage health reform. This chapter considers a number of constitutional issues presented by the ACA that were not raised in NFIB. Some of these issues have been decided by the courts, while others continue to be litigated with no decision yet, and others could have been raised had President Barack Obama not been reelected in November 2012, and might still be relevant as ACA implementation moves forward.
The book is available now from the Oxford Press website.
Washington and Lee Law Professor Tim Jost has published a new article in the Journal of Health Economics, Policy and Law, published by Cambridge University Press. The article, titled “The Affordable Care Act and the Supreme Court: American health care reform inches forward despite dysfunctional political institutions and politics,” discusses the political landscape of that enabled the ACA to become law. Beginning with the law’s passage in early 2010, Jost examines the various challenges and court decisions that occurred over the next 2.5 years, evaluating the legal arguments and developments during the run-up to the decision by the U.S. Supreme Court upholdng the law.
The article is available from the Cambridge Press Website.
Washington and Lee law professor Tim Jost has been named a contributing editor for Health Affairs, the nation’s leading health policy journal. Jost has been a regular contributor to the Health Affairs blog this year, authoring over thirty posts on the Affordable Care Act covering implementation issues and legal challenges.
Jost’s look at the 2012 election and the implementation of the Affordable Care Act in its aftermath topped the list of most-read Health Affairs Blog posts for November 2012. His posts previously captured three spots on Health Affairs 2011 Most Read List. An archive of Jost’s posts can be found here: http://healthaffairs.org/blog/author/jost/.
In addition, a perspective column Jost wrote on the litigation challenging the Affordable Care Act requirement that insurers and group health plans cover contraception was published recently in the New England Journal of Medicine. That column can be found here: http://www.nejm.org/doi/full/10.1056/NEJMp1214605?query=featured_home