Posts Tagged ‘Affordable Care Act’

Is a Corporation Religious?

June 23rd, 2014 No comments

By: Joseph Chirdon

Blog Category: Race & Religion

The Supreme Court will soon decide whether for-profit corporations can deny female employees contraception based on religious beliefs. The lead plaintiff, Hobby Lobby, believes it should be exempt from providing certain contraception that they would be mandated to provide under the Affordable Healthcare Act (AHA), including IUDs and morning-after pills. One argument is that “the court has never found a for-profit company to be a religious organization for purposes of federal law.” The Justice Department argues that exempting corporations from commonly applied law would cause havoc with ramifications to child labor laws and mandates to serve racially diverse groups.

In 1990, the Supreme Court decided that as long as a generally applied law is neutrally applied it is constitutional despite religious opposition. In response Congress passed the Religious Freedom Restoration Act (RFRA). Under the RFRA, if the law imposes a substantial burden on the exercise of religion, it must meet a high threshold for justification. Hobby Lobby’s burden – opting out of the AHA – comes with a 26 million dollar penalty. However, 26 million is less than it currently pays for employee healthcare insurance. Assuming the justices apply the RFHA test, they must decide whether the AHA penalty imposes a substantial burden on Hobby Lobby and whether sexual discrimination or other arguments made by the Justice Department meet the high threshold for justification.

Of the various arguments made, the writer found the argument of former Clinton administration Solicitor General, Walter Dellinger, most persuasive:

“Here the 13,000 employees of the Hobby Lobby corporate enterprise aren’t and should not be expected to share the religious beliefs of the Greens. What you really have is one family attempting to utilize their economic leverage to impose their religious beliefs on others.”

The opinions expressed herein are strictly those of the author and do not necessarily reflect the opinions of the Widener Journal of Law, Economics & Race.


Nina Totenberg, Hobby Lobby Contraceptive Case Goes Before Supreme Court, NPR (Mar. 25, 2014, 3:18 AM), available at

Women of Color and the “Gender Gap” Troubling for Republicans

May 26th, 2014 No comments

By: Stephen McLendon

Blog Category: Race & Religion

Women of color have recently been nicknamed the “gender gap” and have been a source of trouble for conservative Republicans.  This title has been derived from their alleged swing vote resulting from differing candidates’ stance on religious issues, such as abortion and birth control.  However, this “gender gap” ideal assumes that women of color vote solely based on issues dealing with their reproductive rights.   The truth is that their vote extends past issues solely of race and religion.

Women of color, single, and low-income women are directly affected by Republican policies extending beyond race and religion.  The largest issue for these groups of women is healthcare and what the new Affordable Care Act (“Obamacare”) has to offer.  These groups of women also vote based on education and job policies.  So, the next time Republicans alter their policies based on this “swing vote” group, they will need to change their stance on more than just issues of race and religion.

The opinions expressed herein are strictly those of the author and do not necessarily reflect the opinions of the Widener Journal of Law, Economics & Race.  


Zerlina Maxwell, Black Voters, Not the ‘Gender Gap,’ Won Virginia for McAuliffe, (November 1, 2013), available at

Impact on Minority Populations of State Refusals to Expand Medicaid under the Affordable Care Act

April 7th, 2014 No comments

By: Aaron Kostyk

Blog Category: Race & Healthcare

The recent Supreme Court decision in National Federation of Independent Businesses v. Sebelius struck down federal penalties on states that refuse to expand their Medicaid programs under the Affordable Care Act (“ACA”). The Court held that these penalties exceeded the scope of the government’s spending powers. This made the expansion of Medicaid programs essentially voluntary on a state by state basis. Not surprisingly, some states don’t want to accept federal funds to expand their programs. As of October 22, 2013, twenty six states were moving forward with Medicaid expansion and twenty four were not.

Refusal to accept federal funding for Medicaid expansion creates a “gap” in coverage between existing Medicaid programs and subsidies under the ACA and minorities account for a significant portion of the persons in this gap. Minority populations are more likely to be uninsured than the White population (13%), as compared with nonelderly Hispanics (32%), followed by American Indians/Alaska Natives (27%), Blacks (21%), and Asians/Pacific Islanders (18%). These populations are also more likely to have issues accessing affordable healthcare. Furthermore, given that roughly six out of ten Medicaid recipients are persons of color, minorities are more likely to be disproportionately affected by state refusals to expand their Medicaid programs. People in the gap who fall between one hundred percent of the federal poverty level (the current level of Medicaid coverage) and one hundred and thirty eight percent of the federal poverty level (the level at which ACA subsidies apply) will again be without options if states refuse to accept the money to cover them. The ACA has the potential to improve access to healthcare for historically under served populations. Furthermore, it is important to note that the majority of Medicaid recipients are children. In conclusion, states should set aside ideology and act in the best interest of their most vulnerable populations by expanding Medicaid.

The opinions expressed herein are strictly those of the author and do not necessarily reflect the opinions of the Widener Journal of Law, Economics & Race.


Nat’l Fed’n of Indep. Bus. v. Sebelius, 132 S. Ct. 2566, 2607 (2012).

Health Coverage by Race and Ethnicity: The Potential Impact of the Affordable Care Act, The Henry J. Kaiser Family Foundation, available at, (publication #8423).

Samantha Artiga & Jessica Stephens, The Impact of Current State Medicaid Expansion Decisions on Coverage by Race and Ethnicity, The Henry J. Kaiser Family Foundation, July 02, 2013, available at, (publication #8450).

Status of State Action on the Medicaid Expansion Decision, as of October 22, 2013, The Henry J. Kaiser Family Foundation, available at (last visited Oct. 26, 2013).

Why the Racial and Political Divide over the Affordable Care Act?

January 20th, 2014 No comments

By: Deanna Watson
Blog Category: Race & Healthcare

The United States is divided racially divided over the Affordable Care Act (ACA) or ObamaCare. In general, research shows that whites are the least supportive of this healthcare reform.[1] Despite not one single Republican voice in Congress, ACA was a major legislative achievement for President Barack Obama.[2] However when Republicans took control of congress in 2010, the Republicans in the House of Representatives symbolically voted unanimously to repeal the law.[3] Among other benefits, ACA extends the age of dependents able to be covered under their parents’ healthcare plan; insurance companies can no longer deny coverage to those with pre-existing conditions; and it extends Medicare benefits for the growing populations of our nation’s senior citizens.

With all of these new or expanded benefits, it is unclear why it is so poorly supported by many whites and Republicans. Already, the Affordable Care Act has benefitted the nearly 85% of Americans who already have insurance: 3.1 million young adults have gained coverage through the parents’ plans; 6.6 million seniors are paying less for prescription drugs; 105 million Americans are paying less for preventative care & no longer face lifetime coverage limits; 13.1 million Americans have received rebates from insurance companies; 17 million children with pre-existing conditions no longer denied coverage or charged extra.[4] Women (as well as the general population) have more access to preventative care and treatment.[5] Logically, when there is more access to prevention, the whole country and globe is better for it.

In reference to race, the ACA will level out the inequalities among races’ access to healthcare. Blacks suffer from higher rates of a range of illnesses as compared to the general population.[6] Blacks have the highest mortality rate of any racial and ethnic group for all cancers combined and for most major cancers, including stomach, liver, prostate, and colon cancers.[7]

An especially interesting provision of ACA is that insurers will be held more accountable. Health insurers must justify any rate increase of 10% or more before the increase takes effect.[8] It is clear that the healthcare system is a broken system. With the rising costs of healthcare, it just does not make sense that this issue polarizes the country the way it has.

The opinions expressed herein are strictly those of the author and do not necessarily reflect the opinions of the Widener Journal of Law, Economics & Race. 

[1] Mollyann Brodie et. al., Regional Variations in Public Opinion on the Affordable Care Act, 36 J. Health Pol. Pol’y & L. 1097, 1101 (2011).

[2] Michael Henderson & D. Sunshine Hillygus, The Dynamics of Health Care Opinion, 2008 – 2010: Partisanship, Self-Interest, and Racial Resentment, 36 J. Health Pol. Pol’y & L. 945, 945 (2011).

[3] Id.

[4] U.S. Dep’t of Health & Human Servs., The Affordable Care Act and African Americans, (last visited Oct. 11, 2013) [hereinafter ACA and African Americans].

[5] U.S. Dep’t of Health & Human Servs., The Affordable Care Act and Women, (last visited Oct. 11, 2013).

[6] ACA and African Americans, supra note 4.

[7] Id.

[8] U.S. Dep’t of Health & Human Servs., Rate Review, (last visited Oct. 11, 2013).

The Limits of the Affordable Care Act and the Impact on Minorities

November 25th, 2013 No comments

By: Chris Pine
Blog Category: Race & Healthcare

State refusals to expand Medicaid through the Affordable Care Act leaves millions without coverage, particularly African-Americans. The Supreme Court’s decision to strike down the ACA’s mandatory Medicaid expansion has left the question of expansion up to the states.  To encourage expansion, the federal government will carry the entire cost of each state’s Medicaid expansion for the first three years.  After 2016, the federal government will continue to cover a minimum of 90% of the costs.

Nonetheless, 26 states have declined to expand Medicaid coverage.  Some of these states have prohibited Medicaid expansion without first gaining legislative approval.  Others have delayed a decision by tasking committees to further study the impact of expansion on their state.  In Maine, the governor vetoed Medicaid expansion. Republican governors and GOP controlled legislatures have been the common denominator among anti-expansion states.

The result is that many poor will find themselves in the void between those who qualify under that state’s current Medicaid standards and those in higher income brackets, who qualify for subsidies.  A disproportionate number of African-Americans will find themselves in this no-man’s-land of ineligibility.  This particularly the case in the Deep South, in states like Mississippi, Alabama, and Georgia, with Arkansas as the loan exception.

The opinions expressed herein are strictly those of the author and do not necessarily reflect the opinions of the Widener Journal of Law, Economics & Race.


Sabrina Tavernise & Robert Gebeloff, Millions of Poor Are Left Uncovered by Health Law, New York Times (Oct. 2, 2013), available at

Status of State Action on the Medicaid Expansion Decision, as of September 30, 2013, The Henry J. Kaiser Family Foundation (Oct. 10, 2013),

Lethal Disparity: Why Are Black Patients Dying More Than Whites?

October 28th, 2013 No comments

By: Jason Gibson
Blog Category: Race and Healthcare

A new study conducted by Justin Dimick and the University of Michigan is trying to help us understand why black patients generally have a higher mortality rate after major surgeries than their white counterparts. A popular theory is that due to racial disparities, black patients are more likely to receive care at poor quality hospitals.  Surprisingly, the authors of this study discovered that black patients are more likely to live near high-quality hospitals with lower mortality rates.  However, these patients tend to forego these hospitals and instead choose to receive care at lower quality hospitals.  But why would anyone make this choice?

Perhaps it’s cultural.  It’s human nature for people to gravitate to those who are similar.  This theory could also be supported by the fact that doctors who work in predominately black communities continue to make referrals to traditional “minority-serving” hospitals.  Another theory is that many of these minority-serving hospitals largely treat those who receive government assistance such as Medicaid.

Whatever the cause of this disparity, this will be one of the many tests of which to grade the Affordable Care Act.  The Act, which is being slowly implemented throughout the country, was designed to address not only racial disparities, but disparities among the impoverished and uninsured as well.  If the disparity in mortality is connected to the uninsured, then we should see a positive shift these statistics.  However, if not, then perhaps the focus should be more on re-educating both the minority communities and health care professionals.

The opinions expressed herein are strictly those of the author and do not necessarily reflect the opinions of the Widener Journal of Law, Economics & Race.


Asahi Shimbun, Racial Disparities In Health Care: Justin Dimick and Coauthors’ June Health Affairs Study, Health Affairs Blog (Jun. 4th, 2013, 2:47 PM),