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  Health Care - Legal News


A lawyer for Texas Attorney General Ken Paxton will be in a federal courtroom Tuesday asking three appellate judges to declare the Affordable Care Act unconstitutional, and this time it will be with the full support of the Trump administration.

The U.S. Department of Justice earlier this year announced that the agency, like Paxton, believes the entire law should be struck down, reversing its previous position that certain sections, including a provision allowing states to expand Medicaid, should not be affected by the case.

Opposing them in Tuesday’s oral arguments at the 5th U.S. Circuit Court of Appeals will be lawyers for the U.S. House and 20 Democratic-led states who say striking down the law would wreak havoc on the health care system and put lives at risk.

The showdown will produce a decision that could give the U.S. Supreme Court another crack at deciding whether the 2010 law, a signature achievement of Democratic President Barack Obama, remains in effect.

At stake is health insurance for about 20 million Americans, either directly through the program sometimes called Obamacare or through expanded Medicaid coverage, as well as protection for millions more who have preexisting medical conditions.


Taking a harder line on health care, the Trump administration joined a coalition of Republican-led states Wednesday in asking a federal appeals court to entirely overturn former President Barack Obama’s signature health care law — a decision that could leave millions uninsured.

Congress rendered the Affordable Care Act completely unconstitutional in 2017 by eliminating an unpopular tax penalty for not having insurance, the administration and GOP states told the court.

The “Obamacare” opponents hope to persuade the 5th U.S. Circuit Court of Appeals in New Orleans to uphold U.S. District Court Judge Reed O’Connor’s ruling late last year striking down the law.

If the ruling is allowed to stand, more than 20 million Americans would be at risk of losing their health insurance, re-igniting a winning political issue for Democrats heading into the 2020 elections. President Donald Trump, who never produced a health insurance plan to replace “Obamacare,” is now promising one after the elections.

The Trump administration acknowledged it had changed positions in the case. Early on, the administration argued that only certain key parts of the ACA, such as protections for people with pre-existing medical conditions, should be invalidated. But it said other important provisions such as Medicaid expansion, subsidies for premiums and health insurance markets could continue to stand.

Wednesday, the administration said it had reconsidered in light of O’Connor’s ruling. “The remaining provisions of the ACA should not be allowed to remain in effect — again, even if the government might support some individual positions as a policy matter,” the administration wrote in its court filing.

The Justice Department’s legal brief also seemed to be trying to carve out some exceptions. For example, the administration said the ACA’s anti-fraud provisions should remain in effect.


A divided Supreme Court stopped Louisiana from enforcing new regulations on abortion clinics in a test of the conservative court's views on abortion rights.

The justices said by a 5-4 vote late Thursday that they will not allow the state to put into effect a law that requires abortion providers to have admitting privileges at nearby hospitals.

Chief Justice John Roberts joined the court's four liberals in putting a hold on the law, pending a full review of the case.

President Donald Trump's two Supreme Court appointees, Justices Neil Gorsuch and Brett Kavanaugh, were among the four conservative members of the court who would have allowed the law to take effect.

Kavanaugh wrote a dissenting opinion in which he said the court's action was premature because the state had made clear it would allow abortion providers an additional 45 days to obtain admitting privileges before it started enforcing the law.

If the doctors succeed, they can continue performing abortions, he said. If they fail, they could return to court, Kavanaugh said. The law is very similar to a Texas measure the justices struck down three years ago. Roberts dissented in that case.

But the composition of the court has changed since then, with Kavanaugh replacing Justice Anthony Kennedy, who voted to strike down the Texas law. Trump had pledged during the campaign to appoint "pro-life" justices, and abortion opponents are hoping the more conservative bench will be more open to upholding abortion restrictions.

Louisiana abortion providers and a district judge who initially heard the case said one or maybe two of the state's three abortion clinics would have to close under the new law. There would be at most two doctors who could meet its requirements, they said.

But the federal appeals court in New Orleans rejected those claims, doubting that any clinics would have to close and saying the doctors had not tried hard enough to establish relationships with local hospitals.



The Nebraska Supreme Court has ruled that voters will decide in November whether to expand Medicaid in the state.

The court’s rejection of a Republican-led lawsuit Wednesday is a victory for advocates who say a vote favoring expansion would ensure coverage for about 90,000 low-income residents who earn too much to qualify for regular Medicaid but too little to be eligible for assistance under the Affordable Care Act.

Nebraska’s Republican-dominated Legislature rejected six previous attempts to expand Medicaid. Utah and Idaho have similar ballot measures pending. Maine became the first state to expand Medicaid by ballot measure last year.

The lawsuit was filed by state Sen. Lydia Brasch and former state Sen. Mark Christensen, both Republicans who helped derail similar bills in the Legislature.


In a case that has attracted national attention, Massachusetts' highest court ruled Monday that judges in the state have the authority to order people to remain drug free as a condition of probation and under some circumstances order a defendant jailed for violating the drug-free requirement.

The Supreme Judicial Court ruled unanimously that such a requirement does not violate the constitutional rights of people with substance use disorder or unfairly penalize them because of a medical condition beyond their control.

The court ruled in the case of Julie Eldred, who was jailed in 2016 after she tested positive for the powerful opioid fentanyl days into her probation on larceny charges. Eldred, who has severe substance use disorder, spent more than a week in jail after relapsing until her lawyer could find a bed for her at a treatment facility.

Eldred's lawyer argued before the high court in October that her client's substance use disorder made her powerless to control her desire to use drugs, and that jailing her effectively criminalized relapse - which often happens in the recovery process.

But the justices said the defendant's claims were based partly on untested science.

"Nor do we agree with the defendant that the requirement of remaining drug free is an outdated moral judgment about an individual's addiction," wrote Associate Justice Barbara Lenk. "The judge here did not abuse her discretion by imposing the special condition of probation requiring the defendant to remain drug free."

The court called the actions of two district court judges and the state probation department "exemplary." The justices noted that Eldred had admitted to police that she had stolen to support her drug habit.

Most addiction specialists - including groups such as the National Institute on Drug Abuse and American Society of Addiction Medicine - view substance use disorder as a brain disease that interferes with a person's ability to control his or her desire to use drugs.


A Detroit-area woman seeking custody of as many as 10 frozen embryos is asking a judge to appoint a guardian over them while she clashes with her former partner for control.

Gloria Karungi and Ronaldlee Ejalu have a daughter who has sickle cell disease. Karungi believes if she can bear another child with one of the embryos, bone marrow cells from that sibling could potentially cure the girl's blood illness.

But Ejalu must give his consent, according to a contract with an in vitro fertilization clinic, and he's not interested. Karungi and Ejalu never married and are no longer together.

Oakland County Judge Lisa Langton last year said she didn't have the authority to wade into the embryo dispute; she was simply determining financial support and parenting time for the couple's daughter. But the Michigan appeals court sent the case back to Langton for more work, including an evidentiary hearing if necessary.

Karungi "wants to cure her daughter and is seeking the embryos to that end. ... Without the embryos coming to term, that child has no ability to be cured," the woman's attorney, Dan Marsh, said in a court filing.

Ejalu's lawyer, Dan Weberman, said he'll argue again that a Family Division judge has no role in what's basically a contract quarrel. He also said it's misleading for Karungi to claim that cells from a sibling are the only cure for the 7-year-old girl.

"They want to paint a picture like she's on her death bed," Weberman told The Associated Press. "She's in school. She's a happy girl. She gets treatment once a month."

Ejalu no longer believes that using frozen embryos is a good idea.

"He doesn't feel ethically that a life should be created for human tissue harvesting. That's somewhat mind-boggling," Weberman said.

Under orders from the appeals court, Langton on June 20 again will hear arguments on whether she has jurisdiction over contested property held by unmarried parties. But in the meantime, the judge has scheduled a hearing for Wednesday on Karungi's request to have a lawyer appointed as guardian over the embryos.


A dispute about the size of eye drops has failed to catch the eye of the Supreme Court.

Drug companies including Allergan, Bausch & Lomb, Merck and Pfizer had asked the court to get involved in the case.

The companies were sued by patients using their eye drops to treat glaucoma and other eye conditions. The high court said Monday that it won't take the case.

That means a lower-court decision allowing the lawsuit to go forward will stand.

The patients said that drug companies' bottles dispense drops that are too large, leaving wasted medication running down their faces. The patients said they would pay less for their treatment if their bottles were designed to dispense smaller drops.

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