HHP 4600 exam1 study guide

Medicaid is a joint

federal-state program

The federal government 

provides funding for a portion of state administrative costs and sets the rules and guidelines that states must follow to operate their Medicaid programs. 

State Government's Role

“administer their own Medicaid programs within broad parameters set by the federal government. In the same way that each state’s program has significant variation in who is covered, what is covered, and how much is paid for care, there is variation in how the program is funded at the state level. The federal government’s contribution also differs from state to state.”

Congressional Budget Office (CBO)

provides information on Costs of bills or mandates (bipartisan politically)

General Accounting Office (GAO)

How tax dollars spent (bipartisan politically)

Forum shopping

Overlap of federal and state jurisdictions. While court must
have jurisdiction, if it overlaps, attorney may try
to find the best forum to improve outcome for a
case.

Is there a Constitutional right to healthcare?

No

Did the ACA give Constitutional right to healthcare?

No

ACA of 2010, elements, funding, cost

The Affordable Care Act (ACA), enacted in 2010, aims to expand healthcare coverage while maintaining fiscal responsibility. Key elements include:

• Tax Credits: Subsidies for low- to moderate-income individuals to lower insurance costs.

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• Medicaid Expansion: Increased coverage for low-income adults and children.

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• Employer Mandates: Employers with 50 or more employees must offer health insurance or pay penalties

Is abortion a fundamental right?

No. Healthcare is not a right. Was overturned based on the 10th amendment

Is speech a fundamental right?

Under the 1st amendment; it is! Only in public areas not in private spaces.

What is a market economy?

People "vote" with their dollars to allocate resources. More efficient, political values may not be affected.. Supply and demand

What is a mixed economy

Elements of planned and market system

What is a planned economy?

Individual or group makes value-based decisions to allocate resources. Struggles to be efficient. Advantage: Input Public goods

Sources of Law

• Statutes created by legislatures and Congress
• Constitutions (Federal and States)
• Regulations
– Authority delegated by legislative to administrative
agency to refine and implement the law
• Judicial Opinion– known as case law
-Courts define and interpret law
-Opinions have force of law
-Enumerate and interprets principles that
become common law

Why law difficult to understand

Many sources, technical language, and overall structure.

Is there a ________________ involved?

Fundamental right

If so, the court will apply _______________ and expect the state to show a _________________ why the law is needed

close scrutiny; compelling interest

If no fundamental right is involved, then the law only need to be ____________________

rational and reasonable

Right to refuse treatment

Patients have the right to refuse treatment, but physicians cannot assist in suicide. A will can also give consent on what a person wants.

Licensing, motor cycle helmets
Licensing, registration, certification

These topics vary by state because of the 10th amendment

What is block funding?

Block grant funding has an allocated set of money that the program uses over time. Block grant funding has the ability to deny people services and enrollment. A major disadvantage of block grant funding is the potential to terminate the program, halting enrollment, and cap program benefits if the program exceeds its allocated funds

What is entitlement funding?

People eligible under an entitlement program cannot be denied services even if the program lacks money to provide them. Entitlement programs are legally not allowed to cap funding and spending. Entitlement programs are usually run through state and federal governments.

Uninsured?

Anyone can become uninsured. People who are low-income or lost a job are most likely to be uninsured

Police Powers is also known as?

States rights or the 10th amendment

“Police Power”

• Constitution grants any authority a state
needs, but not obligates it, to legitimately
preserve order and ensure the public
health, safety, welfare, and morals
• May not conflict with federal role as
identified in the U. S. constitution.
• May not abridge constitutional rights of
individuals

10th Amendment

“The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”

Inherent discrimination in law enforcement

Same crime; different punishment

Jacobson v Massachusetts

Compulsory small pox vaccination for
adults upheld by Supreme Court citing
– States may “enact health laws of every
description” and “such reasonable regulations
established directly by legislative enactment
as will protect the public health and the public
safety.” Only need a “common belief” to do
so.
– Massachusetts had not violated the sphere of
privacy.

EMTALA

ensure public access to emergency services regardless of ability to pay.

Medicare eligibility

U.S. citizens who are 65 and older and citizens who are permanently disabled

Medicaid eligibility

low-income families, pregnant women, people with disabilities, low-income adults, and older adults

Privacy (from Constitution)

Griswold v Connecticut (1965)
– Privacy recognized in the federal Constitution?
– Justice Douglas cites Fourth and Fifth Amendments as right
against all government invasions “of the sanctities of a man’s
home and the privacies of life.”
– Connecticut law prohibiting use of contraceptives invalidated

Eisenstadt v Baird (1973)
1. Fundamental interest to privacy protected by federal court
includes use of contraceptives by married and unmarried
2. Shows willingness of court to examine legislation and discretion
of state closely and suspiciously to see if there is a state
compelling interest and if it has minimal impact on the individual

Supplier induced demand

a supplier of a good or service influences or creates demand for their offering beyond what would naturally exist in the market.

Government role in healthcare

Under the 10th amendment, most healthcare laws are left up to the state unless it crosses state boundaries

The government's role in healthcare is to finance coverage for vulnerable populations, regulate quality and safety standards for providers and products, and protect public health through research, surveillance, and disease prevention programs.

How was the ACA passed?

Democrats had control of House of
Representatives, Senate, and White House
• Managed the threat of interest groups
• Pragmatism of the President

Checks and balances

• Federal judges appointed for life terms,
removable only by impeachment
• Supreme Court determines
constitutionality of Congressional laws
• No appeal of Supreme Court decisions:
The Supreme Court’s interpretation of law
is the ‘Law of the Land’

• Senators and Representatives elected on
staggered terms
• President can veto law
• Presidential veto can be overridden with
2/3 Congressional vote each house

Separation of Powers

Legislative, Judicial, Executive branches. 

What determines outcomes of trials?

judge or jury's assessment of the law and facts presented

Barriers to Healthcare reform in the U.S

Politics 

Executive Orders

a directive issued by the President of the United States that has the force of law and is used to manage the operations of the federal government.

How federal government influences state governments

“The federal government influences state governments primarily through the use of fiscal tools, like grants-in-aid”

ACA reduce or add to deficit?

Reduce

Market economy (healthcare)

“In a pure market-driven healthcare system, prices, services, and resource allocation are determined by supply and demand and the pursuit of profit.”

Planned economy (healthcare)

“In a planned or heavily socialized system, the government typically owns or centrally controls healthcare facilities, employs the staff, and directly funds the system through taxes.”

States participation in Medicaid

Medicaid is voluntary to opt in! Medicare is national health insurance.

Sicko Notes

Before the ACA was passed, 20,000 died from no healthcare and 700,000 went bankrupt due to medical bills

Sicko Notes

CBO said that the ACA should reduce the deficit by $124 billion over 10 years (2012-2022).

Article I

Legislative (Congress: Senate & House of Representatives)

Article II

Executive (President, Vice President, Cabinet)

Article III

Judicial (Supreme Court)

Congress (Match notes)

Make laws Declare war- Regulate interstate and foreign commerce Control federal spending and taxation Impeach and remove officials. Senators have to approve a president appointment

Executive (Match notes)

Enforce laws Command the military Conduct foreign policy and make treaties (with Senate approval)- Appoint federal officials and judges

Judicial (Match notes)

Interpret laws and Constitution Resolve disputes between states Hear cases involving federal law Exercise judicial review (established later)

The senate and the house of representatives need a…

2/3 vote to overturn a president’s veto

House of Representatives term length 

2 years! All 435 seats are up for election every even-numbered year.

Senate term length

6 years! Elections are staggered so that only about one-third of the Senate seats are up for election every two years (in even-numbered years).