Lisa McKinney

The June 2012 U.S. Supreme Court ruling upholding the constitutionality of the Affordable Care Act, or ACA, one of President Barack Obama’s signature domestic policy initiatives, included a bit of a surprise for states. Writing the majority opinion of the court, Chief Justice John Roberts acknowledged Congress’ ability to incentivize states’ participation in programs under the ACA, such as Medicaid expansion, but with a limit. “What Congress is not free to do is to penalize states that choose not to participate in that new program by taking away their existing Medicaid funding,” he wrote. And with that, a major component of the health care reform legislation became an option for the states, leading to a series of new debates in statehouses across the country.

by Joshua Sharfstein
According to the National Academy of Sciences, the average life expectancy is lower in the United States than in other nations with advanced economies. Within our borders, African-Americans, rural Americans and poor Americans on average die years earlier than others. In fact, for some groups–including poor, white Americans–as a result of suicide, drug addiction and chronic illness, life expectancy is now actually falling. It is no surprise that political leaders across the ideological spectrum increasingly are asking what can be done to protect and promote the health of their communities. In many areas, county and state governments are calling on state and local public health departments to deliver major improvements in health. What does it take to save lives—not one by one through medical treatment, but hundreds of thousands or even millions at a time? This may sound like a crazy question, but it’s the right one to ask. Public health campaigns have in fact saved the lives of millions of people in the United States and around the world from malnutrition, infectious disease, unclean water and air, and other preventable conditions. In the United States, even today, up to half of all premature deaths are preventable.

Vermont Gov. Peter Shumlin attracted national attention more than two years ago when he spent his entire state-of-the-state speech describing what he called “a full-blown heroin crisis” in his state. “In every corner of our state, heroin and opiate drug addiction threatens us,” he said. The number of overdose deaths from heroin in Vermont had doubled from the year before. Another indication of trouble in the state, Shumlin said, was the rise in the number of Vermonters in treatment for opiate addictions—up 770 percent since 2000, numbering 4,300 people in 2012. Fast forward to late March 2016, when President Barack Obama appeared in Atlanta before a national summit of almost 2,000 professionals, advocates and people in recovery to discuss prescription opioid abuse and heroin use. He said 28,000 people in the United States died from opioid drug overdoses in 2014.

Experts discussed the legal arguments for and against the Clean Power Plan, or CPP, during a recent eCademy webcast, “What's Next? Legal Perspectives on the Clean Power Plan,” presented by CSG and the Association of Air Pollution Control Agencies.