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Health Policy by Litigation.

J Law Med Ethics

September 2020

Katie Keith, J.D., M.P.H., is an associate research professor at Georgetown University's Center on Health Insurance Reforms and teaches courses on the Affordable Care Act (ACA) and LGBT health law and policy at Georgetown University Law Center. She specializes in ACA implementation and provides "Following the ACA" rapid response analysis for Health Affairs. She is an appointed consumer representative to the National Association of Insurance Commissioners and maintains an active consulting practice, where she advises nonprofits and foundations on health care issues. Ms. Keith received her law degree from Georgetown University Law Center in Washington, DC and holds a Master's in Public Health from Johns Hopkins University Bloomberg School of Public Health in Baltimore, Maryland. Joel McElvain, J.D., is a partner in the health care practice group of King & Spalding LLP. He previously served as an Assistant Director of the Federal Programs Branch at the U.S. Department of Justice, where he supervised the defense of litigation involving the Department of Health and Human Services. Mr. McElvain participated in the government's defense of numerous cases challenging the constitutionality or implementation of the Affordable Care Act, including National Federation of Independent Business v. Sebelius, 567 U.S. 519 (2012), and King v. Burwell, 135 S. Ct. 2480 (2015). Mr. McElvain received his law degree from Harvard Law School in Cambridge, Massachusetts.

Since its enactment, the Affordable Care Act (ACA) has faced numerous legal challenges. Many of these lawsuits have focused on implementation of the law and the limits of executive power. Opponents challenged the ACA under the Obama Administration while supporters have turned to the courts to prevent the Trump Administration from undermining the law.

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This essay argues that it matters for the fate of health policies challenged in court whether courts consider health merely as a policy goal that must be subordinate to law, or as a legal norm warranting legal weight and consideration. Applying population-based legal analysis, this article demonstrates that courts have traditionally treated health as a legal norm. However, this norm appears to have weakened in recent years, a trend evident in the Supreme Court's first two decisions concerning the Affordable Care Act, and However, in its more recent Affordable Care Act decision, , the health legal norm is once again evident.

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This paper formulates a novel multifactorial Cascade Concept for the pathogenesis of adolescent idiopathic scoliosis (AIS). This Concept stems from the longitudinal findings of Clark et al. (J Bone Miner Res 29(8):1729-36, 2014) who identified leptin body composition factors at 10 years of age associated with a scoliosis deformity found at 15 years.

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5 Division of Pulmonary and Critical Care Medicine and.

Patients with respiratory diseases, critical illness, or sleep disorders who lack health insurance endure disparities in access to care and worse health outcomes. These disparities were partly addressed in the United States in 2010 by passage of the Affordable Care Act. Low- and moderate-income individuals and families with incomes between 138 and 400% of the federal poverty level are eligible for insurance premium subsidies when purchasing policies on the health insurance marketplace exchanges.

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