Nicholas BagleyOvjeren akaunt

@nicholas_bagley

Law professor at the University of Michigan. Contributor at the Incidental Economist.

Ann Arbor, MI
Vrijeme pridruživanja: studeni 2013.

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    in 1856 congressman Preston Brooks beat a senator nearly to death for criticizing slavery

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    Why are Trump's nonstop lies to Congress during his SOTU speech being treated as less of a breach of "decorum" than 's ripping up of his speech is?

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    On this day that Trump will once more lie about protecting pre-existing conditions, and coauthors also published an article in estimating that ONE-SIXTH of the access gains under the ACA were erased in 2017 alone.

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  5. Oh sweet lord. This is a lie, and it’s the one that probably matters most to the American public. Yet he’ll get a pass on the front page: “Trump Delivers Defiant State of the Union” or some other such nonsense.

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    Also looking at language of guidance & what CMS said after rollout event, seems clear that waiver guidance could apply well beyond expansion group including some low-income parents that could & were covered pre-ACA expansion & could be shifted into block grant/cap waiver.

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  8. This is wonky, even by my standards. But it's really important if you care about the uses and abuses of Medicaid waivers.

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  9. /fin

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  10. It's basically a message from HHS to Congress that all the rules it set up for the expansion population are nice, but they're not really binding, and they agency will ignore them as it sees fit -- even as it dispenses billions in governmental dollars.

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  11. And the legal move is in serious tension with conservatives' professed concern about the legal discretion of federal administrative agencies. If that concern is genuine, and not just a cloak for deregulation, this block grant proposal is an extraordinary abuse of legal power.

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  12. If you think that's an extraordinary legal position, well, it is. And while it's clever, it's not remotely tenable. In the past, courts have allowed HHS to stretch its "expenditure authority" to cover small populations of childless adults. But this? It's categorically different.

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  13. The implication is that HHS has untrammeled legal authority over the entire ACA-expansion population. It could set new eligibility rules, change the match rate, strip away EHB protections -- it could do ANYTHING.

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  14. If they were covered under the state plan, as people in the ACA-expansion are, they'd be subject to statutory rules. But if they're treated as the objects of "expenditure authority," they're not. I know. It's complicated. But bear with me.

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  15. The reason is complicated, but basically the administration thinks that the individuals covered under these quasi-block grants can be treated as beneficiaries who otherwise would be ineligible for Medicaid -- much like childless adults have been included in some waivers pre-ACA.

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  16. Though it's hard to discern from the letter itself, the legal theory on which the administration is operating is *not* that those rules are imposed *as a matter of statute.* They're imposed as a matter of the agency's discretion.

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  17. One small point about 's thoughtful and contrarian take on the new quasi-block grant rules. He says that "the proposed rule is still bound by a web of statutory restrictions." That's not quite right.

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    We don't know the Iowa results. But we do know this: The most caucus-goers said health-care is their No. 1 issue. And they favor and

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  19. No disease outbreak is identical to the last one. But they do rhyme.

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  20. Sweet lord this From is powerful. Bureaucracy matters for pandemic control—and Trump has dismantled the bureaucracy. It’s Michael Lewis’s Fifth Risk come to horrible life.

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