Discussion of Drug Addiction: Is It All About Race?

By: Matthew Ryan

During the Presidential primary season, one public health issue has gotten particular attention: heroin drug addiction. Candidates from both parties have spoken eloquently and passionately about the need to resolve drug addiction with public health solutions. The current language and proposals are far different from tough law-and-order rhetoric from the 1980s during the cocaine addiction epidemic. These differences should not be overlooked: they should inform how race impacts our perceptions as both public health practitioners and policy-makers.

In a post on Medium, Jeb Bush spoke vulnerably about his daughter’s heroin addiction. He wrote, “As a father, I have felt the heartbreak of drug abuse. I never expected to see my precious daughter in jail… She went through hell… and so did I.”

Carly Fiorina has also spoken powerfully about losing her stepdaughter to drug addiction. In an email to supporters, she was emphatic, “If you’re criminalizing drug abuse and addiction, you’re not treating it—and you’re part of the problem.” Continue reading

Kentucky Continues to Inform Health Policy

By Matt Ryan

Following the Supreme Court’s decision in NFIB v. Sebelius, states have had the option whether to expand Medicaid or not. As of this writing, 30 states and the District of Columbia have expanded Medicaid. Kentucky was the only Southern state that decided to expand Medicaid and run their own exchange. The decision brought great success. Under Democratic Governor Steve Beshear, Kentucky saw their uninsured population drop by 10.6% from 2013 to 2014. As Governor Beshear put it, Kentucky was the “poster-child for the implementation of the ACA.”

Last month, Kentucky elected Matt Bevin governor. Mr. Bevin, a Republican, had promised to dismantle Medicaid and the insurance exchange. When asked about Medicaid early in his campaign, Mr. Bevin responded, “No question about it. I would reverse that immediately.” Many feared that Mr. Bevin’s election put Medicaid in critical condition. But since his election, Mr. Bevin has shifted his position.

Continue reading

House of Reps v. Burwell: A Case Worth Following

By Matthew Ryan, Harvard Health Law Society

With the final judgment in King v. Burwell this summer upholding federal subsidies for health insurance, many legal analysts believed that lawsuits against the Affordable Care Act had ended. But the House of Representatives had other plans. In July of 2014, the House of Representatives voted on partisan lines to sue President Obama for overstepping his constitutional bounds. The House alleged that the President did not faithfully execute the Affordable Care Act with regard to two executive actions. First, the Obama Administration authorized payments to insurance companies to assist with cost sharing. The House argued Congress never appropriated these funds. Second, the House alleged that the Obama Administration unlawfully delayed the employer mandate at a $12 billion cost to taxpayers.

In September, the United States District Court for the District of Columbia cleared a major hurdle for the House: the court granted standing to the plaintiffs for their challenge to the Administration authorizing cost sharing funds without Congressional appropriation. The court did not grant standing with regards to the employer mandate implementation. Continue reading

Our Curious Medicare Vaccine Reimbursement System

By George Maliha, Harvard Health Law Society

As flu season begins, we are bombarded by ubiquitous reminders to get our flu shot. So, it is a good opportunity to reflect on how we provide vaccines to our fellow citizens 65 and older. By law, Medicare Part B covers 4 preventive vaccines (flu, two pneumococcal, and hepatitis B for medium-to high-risk patients). Part D picks up the rest, namely shingles, TDaP, and any other commercially available vaccine. But, that’s where the trouble begins.

When Congress passed Part D, the vaccines recommended for those 65 or older were basically covered by Part B. Now, they aren’t. In 2006, the zoster (or shingles) vaccine came onto the market. In 2010, the recommendations for the TDaP (the P for pertussis or whooping cough being the most relevant here) changed to include the elderly.

But, so what, they’re still covered, right? Continue reading

Introducing the Harvard Health Law Society

10689774_809751895714130_4010610321675415773_nThe Harvard Health Law Society (HHLS) is a student organization at Harvard Law School, dedicated to exploring issues at the intersection of health and law while connecting students and experts for active engagement. It is made up of students at Harvard Law, as well as other Harvard students, interested in health policy, health care law, biotechnology, bioethics, health and human rights, and a range of other health and law topics.

We are excited to announce that, as part of an ongoing collaboration with the Petrie-Flom Center, members of the Health Law Society will be contributing bloggers this year. Our first two bloggers will be:

Matt Ryan photo_HLS

Matthew Ryan

HLS Class of 2017

 

 

 

HHLS Blogger Goerge Maliha

George Maliha

HLS Class of 2018

 

 

 

Welcome to Bill of Health, HHLS!