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SCOTUS Hears Oral Arguments on the Future of the Affordable Care Act

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  • The Supreme Court heard another challenge to the Affordable Care Act (ACA) Tuesday, marking the third time the law has gone to the highest court since it was passed a decade ago.
  • The most recent case, filed by Texas and other Republican-led states, focuses on a provision of the law known as the individual mandate, which requires all Americans to have health insurance or face a penalty.
  • The court had previously upheld the mandate as constitutional, arguing it amounted to a tax, but in 2017, Congressional Republicans lowered the penalty to $0.
  • Now, the Republican-led states argue that the mandate can no longer be considered a tax, and thus both the provision and the entire ACA are unconstitutional.
  • Because the Trump administration has not put forward a comprehensive replacement for the ACA, if the justices repeal the law, more than 20 million Americans would lose their health insurance during a pandemic.

Latest ACA Challenge

The Supreme Court heard oral arguments on Tuesday for the latest challenge to the Affordable Care Act (ACA), marking the start of proceedings that will decide the future of essential healthcare benefits for millions of Americans during a pandemic.

The case marks the third time that the ACA, often called Obamacare, has been brought to the highest court since it was signed into law by former President Barack Obama a decade ago. The first two attempts were rejected by the Supreme Court in 2012 and 2015 respectively.

The most recent challenge, brought by Texas and other Republican-led states and backed by the administration of President Donald Trump, centers around a provision of the law known as the individual mandate, which required all Americans to either have some kind of health insurance or pay a penalty.

That specific provision has been one of the most controversial elements of the law, and when it was brought before the justices in 2012, the court upheld the mandate 5-4 on the grounds that it amounted to a tax and thus fell under Congress’ taxing power.

But in 2017, the Republican-held Congress passed a sweeping tax bill that tweaked the individual mandate by setting the penalty for not having health care to $0. Now, the GOP-led states leading this most recent challenge are arguing that because the mandate is zeroed out and no longer raises revenues, it can no longer a tax and thus is unconstitutional.

What’s more — and this is the key part here — they are also claiming that the individual mandate is so ingrained in the ACA that it cannot be separated from the law without scrapping the whole thing. In other words: the Republican states believe that the entire ACA was rendered unconstitutional when the Republicans Congress zeroed out the mandate.

Now, notably, many legal experts do believe the argument that an entire law should be rolled back because one part is problematic is ambitious, to say the least. While some of the courts conservatives have implied that they are hesitant to get rid of the ACA entirely, the makeup of the court is very different now than it was during the other two Obamacare challenges.

Since taking office, Trump has appointed three justices to the Supreme Court, including the newly-seated Amy Coney Barrett, who has openly criticized the court’s previous rulings on the ACA in the past.

Major Consequences 

The stakes for overturning ACA are higher than ever before because of the ongoing coronavirus pandemic that has already infected over 10 million Americans and claimed over 238,000 lives.

The U.S. is currently experiencing the worst of the pandemic, and health officials believe the situation will only become more dangerous soon. Cases and hospitalization rates are rising all across the country, new daily infections and 7-day averages have been hitting record-breaking highs, and experts now say they expect us to hit 200,000 daily cases as soon as next week.

If the justices scrap Obamacare, more than 20 million Americans — including roughly 12 million low-income Americans — would lose their healthcare overnight.

Those people would very likely be left without health insurance for a while because, despite Trump’s repeated claims for the last four years that his healthcare plan to replace Obamacare is almost ready, at least publicly, the president has proposed close to nothing on this front.

Even if it did, the divided Congress would likely have a very difficult time agreeing on any kind of deal. But the fact that there is no comprehensive program to replace Obamacare if the Supreme Court decides to get rid of it would also have other major impacts for even more Americans.

One of the most notable, of course. is how this affects pre-existing conditions. Under Obamacare, health insurers are required to cover most pre-existing conditions. If the ACA is rolled back, insurers can start denying coverage to the estimated 52 million Americans — roughly 1 out of every 4 — who have pre-existing conditions.

That is especially concerning in regards to the pandemic because is very possible that COVID-19 could become a pre-existing condition. With the ACA in place right now, insurers cannot use a coronavirus case to deny someone coverage or charge them more: it is essentially treated the same as a pre-existing condition.

However, if Obamacare no longer protects that, insurance coverage for COVID-19 will be up in the air.

The reversal of the ACA would also have other far-reaching effects, including forcing older Americans to pay more for prescriptions and cutting young adults off their parents’ healthcare plans before the age of 26, as is the law now.

While experts say it is increasingly unlikely that the court will do away with the ACA in its entirety, it is unclear what a partial repeal would impact the law and the American people.

See what others are saying: (NPR) (The Associated Press) (The Washington Post)

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FDA Authorizes Moderna and J&J COVID Vaccine Boosters, Approves Mix-and-Match Doses

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The approval will allow at-risk Americans who received Pfizer and Moderna vaccines to get any booster six months after their initial series and all Johnson & Johnson recipients 18 and older to do the same two months after their single-shot dose.


New FDA Authorization

The U.S. Food and Drug Administration (FDA) on Wednesday authorized boosters shots of Moderna and Johnson & Johnson COVID-19 vaccines and approved a mix-and-match strategy that will allow people who got one company’s shot to get a booster from a different maker.

The decision paves the way for millions of more at-risk Americans to get extra protection, and not just certain Pfizer recipients as previously approved by the FDA.

Under the authorization, people who received Moderna or Pfizer can get any one of the three booster shots six months after completing their initial series if they are 65 and older, at high risk of severe COVID, or face increased exposure because of their work.

Meanwhile, all J&J recipients 18 and older can get any of the approved vaccines two months after they received the one-shot jab.

Hazy Recommendations, For Now

Notably, the FDA did not recommend a certain combination of vaccines, nor did the agency say whether or not it would be more effective for people to stick with their original vaccine maker for their booster.

The new authorizations draw on a study from the National Institutes of Health (NIH), which found that there are no safety concerns with mixing boosters and that vaccine combinations were at least as effective in stimulating antibodies as matched vaccines.

In the case of J&J recipients, the NIH found that people actually had a higher boost from mixing either Moderna or Pfizer boosters.

However, some of the scientists who worked on the study said it should not be used to recommend one combination over another because the research was limited.

The Centers for Disease Control and Prevention (CDC), which determines vaccine recommendations, could issue more guidance on when and whether people should switch vaccine makers for their booster shots.

An advisory panel for the agency is meeting Thursday to discuss the new FDA authorizations and recommendations.

Once the panel makes its decision, the CDC director has the final say on the guidelines. If the agency agrees with the FDA’s decisions, the booster shots could be rolled out as soon as this weekend.

See what others are saying: (The New York Times) (NPR) (The Washington Post)

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Paris Hilton Urges Lawmakers To Crack Down on Abusive Teen Treatment Facilities

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The heiress alleges that she was a victim of abuse in these types of centers for two years and wants to ensure that no child suffers through the same experience.


Paris Hilton Details Abuse Within “Troubled Teen Industry”

Socialite and entrepreneur Paris Hilton spoke outside of the U.S. Capitol on Wednesday to support the Accountability for Congregate Care Act, which is set to be introduced in the near future.

Hilton joined Rep. Ro Khanna (D-CA), Rep. Adam Schiff (D-CA), Rep. Rosa DeLauro (D-Conn.), and Sen. Jeff Merkley (D-Ore.) to advocate for the legislation, which aims to create a “bill of rights” for children in treatment and behavioral centers.

The heiress has alleged that she spent two of her teenage years in these types of facilities and was subject to rampant abuse. She is far from alone. 

During a press conference, Hilton said that one night when she was 16, she woke up to two large men in her bedroom forcing her out of her house. She said she screamed for help because she thought she was being kidnapped, but her parents watched as she was taken away to a “troubled teen” program. 

“Like countless other parents of teens, my parents had searched for solutions to my rebellious behavior,” she explained in an op-ed for The Washington Post this week. “Unfortunately, they fell for the misleading marketing of the ‘troubled teen industry’ — therapeutic boarding schools, military-style boot camps, juvenile justice facilities, behavior modification programs and other facilities that generate roughly $50 billion annually in part by pitching ‘tough love’ as the answer to problematic behavior.”

Hilton said she was sent to four different facilities where she was “physically and psychologically abused.” 

“I was strangled, slapped across the face, watched in the shower by male staff, called vulgar names, forced to take medication without a diagnosis, not given a proper education, thrown into solitary confinement in a room covered in scratch marks and smeared in blood and so much more,” she explained during the press conference. 

“At Provo Canyon School in Utah, I was given clothes with a number on the tag. I was no longer me, I was only number 127,” she continued. “I was forced to stay indoors for 11 months straight, no sunlight, no fresh air. These were considered privileges.”

Goals of the  Accountability for Congregate Care Act

Hilton claims that a lack of transparency and accountability has allowed this structure of abuse to thrive for decades. In some cases, she said it has taken children’s lives. Now, she wants Congress and President Joe Biden to act. 

“This bill creates an urgently needed bill of rights to ensure that every child placed into congregate care facilities is provided a safe and humane environment,” Hilton said of the Accountability for Congregate Care Act.

“This bill of rights provides protections that I wasn’t afforded, like access to education, to the outdoors, freedom from abusive treatment, and even the basic right to move and speak freely. If I had these rights and could have exercised them, I would have been saved from over 20 years of trauma and severe PTSD.” 

Foster children, children being treated for mental disorders, and other children in youth programs would be impacted by the bill.

Hilton was one of several survivors and advocates who fought for the legislation on Wednesday. Rep. Khanna thanked them for using their stories to fight for change. 

“No child should be subjected to solitary confinement, forced labor, or any form of institutional abuse,” he wrote. “Thanks to Paris Hilton, my colleagues & the survivors & advocates who joined us today to discuss how we can hold the congregate care industry accountable.”

While only Democratic legislators are currently sponsoring the bill, Hilton called for a bipartisan effort to fight for the rights of children. 

Ensuring that children are safe from institutional abuse isn’t a Republican or Democratic issue,” Hilton said. “It’s a basic human rights issue that requires immediate attention.”

See what others are saying: (The Washington Post) (The Hill) (NBC News)

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Surgeons Successfully Test Pig Kidney Transplant on a Human

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The procedure has been hailed as a major scientific breakthrough that could eventually open the door to a renewable source of desperately needed organs.


Groundbreaking Procedure

Surgeons at the NYU Langone Transplant Institute revealed Tuesday that they temporarily attached a kidney from a genetically modified pig to a human patient and found that it worked normally.

The operation was the first of its kind and could one day lead to a vast supply of organs for those who are in severe need. According to the Associated Press, more than 90,000 people in the U.S. are in line for a kidney transplant. Each day, an average of 12 die while waiting.

With the family’s consent, the groundbreaking procedure was performed on a brain-dead patient who was kept alive on a ventilator.

According to the surgeons, the pig used was genetically engineered to grow an organ that wouldn’t produce a sugar that the human immune system attacks, which would then trigger the body to reject the kidney. 

The organ was connected to blood vessels on the patient’s upper leg, outside the abdomen, and it was observed for over 54 hours, with doctors finding no signs of rejection.

Concerns and Hurdles Ahead

While the procedure was successful, this doesn’t mean it’ll be available to patients anytime soon. Several questions about long-term functionality remain, and it will still have to go through significant medical and regulatory hurdles. 

Details of the procedure haven’t even been peer-reviewed or published in a medical journal yet, though there are plans for this. 

Experts are also considering the ethical implications of this type of animal-to-human transplant. For some, raising pigs to harvest their organs raises concerns about animal welfare and exploitation. Such medical procedures have already earned criticism from People for the Ethical Treatment of Animals, or PETA.

“Pigs aren’t spare parts and should never be used as such just because humans are too self-centered to donate their bodies to patients desperate for organ transplants,” PETA said in a statement, according to The New York Times.

On the other side of the debate are people like Dr. Robert Montgomery, the director of the N.Y.U. Langone Transplant Institute who performed the breakthrough procedure in September.

“I certainly understand the concern and what I would say is that currently about 40% of patients who are waiting for a transplant die before they receive one,” he told BBC.

“We use pigs as a source of food, we use pigs for medicinal uses – for valves, for medication. I think it’s not that different.”

See what others are saying: (CNN)(BBC) (The New York Times)

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