Implementing the Affordable Care Act: Where are States on the 2014 Market Reforms?

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Photo By: Adam Cole/NPR

This post was written by Katie Keith, Assistant Research Professor, Georgetown University Health Policy Institute Center on Health Insurance Reforms.  Any questions or comments about this post can be directed to kmk82@georgetown.edu. 

With many of the legal and political challenges to the Affordable Care Act now over, all eyes will be on the states as they turn to implementing (or not implementing) many of the law’s most significant reforms. In a recent issue brief for the Commonwealth Fund, my colleagues and I studied state progress on implementing seven of the Affordable Care Act’s most critical consumer protections.

The issue brief is part of an ongoing series by CHIR on implementation of the Affordable Care Act in all 50 states and the District of Columbia, and follows our previous studies on state implementation of the early market reforms (which include new consumer protections such as dependent coverage up to age 26 and the coverage of preventive services without cost-sharing) and the availability of child-only coverage.

What does the Affordable Care Act do? The Affordable Care Act includes numerous consumer protections designed to improve the accessibility, adequacy, and affordability of private health insurance. Beginning in 2014, the law ushers in significant changes for insurers that sell coverage in the individual and small group markets, both inside and outside of the exchange. These protections include guaranteed issue; restrictions on the factors that insurers can consider when setting premiums; a prohibition on preexisting condition exclusions; coverage of a defined set of essential health benefits; and limits on out-of-pocket costs for consumers; among others. Read More

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New avenue for Litigating the Right to Health – Optional Protocol to the ICESCR comes into force

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This post was written by Oscar A. Cabrera, Eric Friedman, and Brian Honermann, all from the O’Neill Institute.

On 5 February, 2013, Uruguay – following quickly on the heels of Portugal – became the 10th country to ratify the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights (ICESCR). In accordance with article 18(1) of the Optional Protocol, this means the Optional Protocol will come into force on 5 May, 2013.

The Optional Protocol empowers the Committee on Economic, Social, and Cultural Rights (CESCR) to receive communications (complaints) from individuals or groups of individuals claiming to be victims of violations of their rights as protected by the ICESCR against countries who have ratified the Optional Protocol. As it stands, these are: Argentina, Bolivia, Bosnia and Herzegovina, Ecuador, El Salvador, Mongolia, Portugal, Slovakia, Spain, and Uruguay. In addition, under Articles 10 and 11, ratifying countries may permit the CESCR to receive inter-state complaints against the country and to conduct inquiries into allegations of grave or systemic violations of economic, social, or cultural rights by a state party. Thus far, only El Salvador and Portugal have acceded to these procedures.

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Our Recent Publications in Global Health Law

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2012 was a busy year for us all. Below are some of our most recent publications on Global Health Law. 

Feel free to explore these highlighted works and visit our publications page for additional journals, studies, articles and more.


tfc toolkitO’Neill Institute for National and Global Health Law. 2012. Tobacco Industry Strategy in Latin American Courts: A Litigation Guide. Toolkit (Spanish) Toolkit (English)

The ratification of the WHO Framework Convention on Tobacco Control (FCTC) by 15 countries in Latin America has played a central role in generating momentum for strong tobacco control laws at the municipal, provincial and national levels – even in the few countries that have not yet ratified the treaty.

The tobacco industry has correspondingly stepped up two related efforts. First, it is spending substantial resources to sway lawmakers against passing effective tobacco control laws. Second, where its efforts to dilute or weaken tobacco control laws fail, it turns to the courts, often deploying the same or similar arguments based on certain purported “rights.” These “rights” relate to the advertising and marketing of its products, the “rights” of citizens to consume those products in public or occupational spaces, and the “rights” of proprietors and employers to permit such consumption. Read More

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A Discussion of Global Health and PEPFAR from 2008

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 PEPFARDuring the O’Neill Institute Colloquium in 2008, Ambassador Mark R. Dybul, U.S. Global AIDS Coordinator at the time, addressed current and emerging issues related to President Bush’s Emergency Plan for AIDS Relief (PEPFAR).  In this video, Amb. Dybul presents a historical framework for PEPFAR and discusses the implications of its recent (2008) re-authorization. Read More

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Malaria Elimination and Eradication: A Look Back at Our 2012 O’Neill Institute Colloquium

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In the spirit of looking back and reviewing the work of the O’Neill Institute, we would like to share two presentations with you from our most recent O’Neill Institute Colloquium, David Bowen, “Malaria Elimination: Politics and Practicalities” and Joel Breman, “Eradicating Malaria: The Holy Grail of Tropical Medicine.” Read More

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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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