ABSTRACT
This economic analysis estimates fiscal effects of the quartile adjustments made to Medicare Advantage payments as part of the Patient Protection and Affordable Care Act.
Subject(s)
Economics, Hospital , Government Agencies , Hospital Charges/legislation & jurisprudence , Patient Credit and Collection , Hospital Charges/ethics , Humans , Legislation, Hospital , Patient Credit and Collection/ethics , Patient Credit and Collection/legislation & jurisprudence , Patient Credit and Collection/standards , Patient Credit and Collection/trends , Taxes , United StatesABSTRACT
In 2010, Senate Bill 1309 included language to repeal an existing Arizona law that enables minors younger than 18 years of age to seek diagnosis and treatment of sexually transmitted diseases (STDs) without parental consent. Numerous implications were identified that would have stemmed from parental consent provisions originally proffered in Senate Bill 1309. These implications included diminished access to essential health services among minors, exacerbated existing health disparities, increased health-care spending costs, and thwarted efforts to curb the spread of STDs. Lastly, minors would have been deprived of existing privacy protections concerning their STD-related medical information. This case study describes how collaborative advocacy efforts resulted in the successful amendment of Senate Bill 1309 to avert the negative sexual and reproductive health outcomes among adolescents stemming from the potential repeal of their existing legal right to seek STD treatment without parental consent.
Subject(s)
Adolescent Behavior , Health Services/legislation & jurisprudence , Parental Consent/legislation & jurisprudence , Sexually Transmitted Diseases/therapy , Adolescent , Adult , Arizona , Community Participation , Consumer Advocacy , Female , Human Rights/legislation & jurisprudence , Humans , Male , Minors/legislation & jurisprudence , Privacy/legislation & jurisprudence , Sexually Transmitted Diseases/epidemiology , Young AdultABSTRACT
Among multiple legal challenges to the Patient Protection and Affordable Care Act (PPACA) is the premise that PPACA's "individual mandate" (requiring all individuals to obtain health insurance by 2014 or face civil penalties) is inviolate of Congress' interstate commerce powers because Congress lacks the power to regulate commercial "inactivity." Several courts initially considering this argument have rejected it, but federal district courts in Virginia and Florida have concurred, leading to numerous appeals and prospective review of the United States Supreme Court. Despite creative arguments, the dispositive constitutional question is not whether Congress' interstate commerce power extends to commercial inactivity. Rather, it is whether Congress may regulate individual decisions with significant economic ramifications in the interests of protecting and promoting the public's health. This article offers a counter-interpretation of the scope of Congress' interstate commerce power to regulate in furtherance of the public's health.
