Thanks to @doritreiss.bsky.social for live posting @nusl.bsky.social #HLC2026, and in particular, our FDA panel!
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: invitation to think bigger and fight the harms.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: raise costs of imposing harms on communities - enough fuss for them not to do that.
Pushing envelope for what can be change.
"configurative legality".
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: problem: unenforceable in courts - at least some. So what's advantage? highlight harms of rural communities, and that these are communities with voice and can argue, force confrontation with corporate power and the courts.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: new causes of action - chemical trespass if you impose chemicals on the body - compensatory, punitive etc'.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: corporations gave rights to sue to new parties -like nature, no interference, strict liability basis.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: these communities took extreme measures.
1. stripping corporations' powers and rights. Local ordinances. E.g. corporations shall not be considered persons protected by constitution (federal/state).
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: some communities go further in face of challenges like treating corporations like people and legislation like right to farm that protects corporation.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: litigation can help serve as a catalyst - draw attention to the problem's existence, get information through discovery, and affect public opinion in ways that spur private activity or litigation.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: some communities don't litigate, other bring cases that track big city litigation, just on smaller scale.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: practices like sledging, commercial farming, harmful product plants are more common in rural areas.
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Says Sarah Swan from @law.rutgers.edu in #HLC2026 by @nusl.bsky.social : some of this connected to opioids and pollutions - causes cancer, heart disease, and more. Access to care is also an issue.
Many rural communities brought lawsuit against opioids and pollutants.
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Says Sarah Swan from @law.rutgers.edu in #HLC2026 by @nusl.bsky.social : even though big cities lawsuit get more attention, in the background rural communities have been active in litigating for goals.
1 in 5 people in U.S. live in rural areas, with their own health challenges.
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Says Sarah Swan from @RutgersLaw in #HLC2026 by @NUSL: government and communities also use litigations to improve public health. Attention mostly to those from state AG or big cities. E.g. Philadelphia suing Glock for epidemic of gun violence.
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Says @francislprof in #HLC2026 by @NUSL: conclusion: will states be too little too late? Only interesting - California - Medicaid pay for helping people stay in the system.
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Says @francislprof in #HLC2026 by @NUSL: interesting suggestions for measuring impact on health. Georgia - will look at frequency of access to primary care. compare costs of hospitalization. Montana - will test diabetes care, COPD, heart failure and more.
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Says @francislprof in #HLC2026 by @NUSL: how to help meeting? states suggested they will help during implementation period. Georgia help people stay eligible.
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Says @francislprof in #HLC2026 by @NUSL: defining engagement: Georgia - includes paid caregiving through Medicaid as qualifying; Iowa - homeschooling children?
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Says @francislprof in #HLC2026 by @NUSL: eligibility determination: Arkansas: system with success coach counts as reporting; Georgia - annual reporting; Iowa just SNAP application; Massachusetts - use existing state data; Montana - veterans with disability rating, foster parents.
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Says @francislprof in #HLC2026 by @NUSL: regulations only come out in July, but looked anyway on all that's out there - not a lot. Some states want to add exemptions - e.g. Arizona - divorce, domestic violence, temporary homelessness, lack of internet/transportation.
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Says @francislprof in #HLC2026 by @nusl.bsky.social : states option: help with eligibility determination, consider more exemptions that help state, consider how to define engagements. Help people meet requirement, and get data to see whether requirements help.
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Says @francislprof in #HLC2026 by @NUSL: no comparable increase in employment.
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Says @francislprof in #HLC2026 by @nusl.bsky.social : least likely to qualify - people on cusp of Medicare (50-64) or rural residents. Suspicion: caregivers, poor health themselves, worse hit. Administrative costs - $1 out of 3 went to healthcare. High, and taking money from healthcare.
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Says @francislprof in #HLC2026 by @NUSL: one state with experience - Georgia - it's sobering. 26,000 applications out of estimated 180,000-200,000, 8,700 actually enrolled. People just aren't showing up since they think they won't meet requirements. Not even trying.
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Says @francislprof in #HLC2026 by @NUSL: why? Charitable: community engagement improves health, increase access to healthcare (how?), improve quality of state workforce, decrease unemployment rate in state.
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Says @francislprof in #HLC2026 by @nusl.bsky.social : there are mandatory exceptions for children, disabled, foster youth, and some optional hardship exceptions. But for most, you need 80 hours a month of qualifying activities.
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Says @francislprof in #HLC2026 by @NUSL: What are states trying/not with respect to work requirements for Medicaid. BBB - from 1 January 2027, for Medicaid expansion or partial expansion - cannot be waived under §1115.
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Says @efusebrown in #HLC2026 by @NUSL: you can check who is on the top of the ownership that controls your doctor.
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Says @efusebrown in #HLC2026 by @NUSL: Last piece - transparency of ownership or control, report ownership changes in a database available to the public. Massachusetts, for example, did that.
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Says @efusebrown in #HLC2026 by @NUSL: laws about corporate practice of medicine - banning corporate entities from owning or controlling medicine.
It does not address corporate control of other entities.
Eroded by corporations through management services organizations (MSO).
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