573.01 Shaping Law and Policy: Advocacy and the Affordable Care Act

This seminar will discuss how legal advocacy shapes law and public policy at the federal level, with particular emphasis on the last decade of history under the Affordable Care Act (ACA). It will draw upon case histories of public interest litigation, administrative law advocacy, legislative development, and popular opinion strategies to illustrate the legal community’s key levers in shaping recent health policy. Each weekly seminar will focus on one of the health policy issues addressed in the ACA, across its various stages of development and evolution. Topics will include the individual mandate, Medicaid expansion and waivers, insurance exchanges, employer mandates, insurer risk protections, and cost sharing reduction subsidies; as well as broader legal issues involving federalism, administrative rulemaking, standing, severability. and delegation to extra-legislative bodies. After a very brief immersion in the context of health policy history and the tools of the public law trade, the seminar will emphasize how attorneys and their allies can play either offense or defense as the later stages of policy debates shift. The ACA provides an organizing context and means to the broader end of examining how Washington-oriented attorneys and related legal advocates operate, while providing a quick introduction to a host of contemporary issues in health law and policy. Because the best way to be an effective advocate is first to understand the best arguments on both sides of a given issue, the seminar will provide a balanced representation of efforts by ACA defenders, opponents, and those in-between as they engaged in various regulatory and litigation activities to advance, negate, or alter the law’s original intentions. Study of the diverse and often-shifting legal problems encountered by a single industry, particularly one as important and complex as health care, may appeal to students generally interested in public policy and in law and economics, not just health care, as well as those interested in sharpening their skills in legal advocacy through involvement in litigation and administrative rulemaking.   

Fall 2019

Course NumberCourse CreditsEvaluation MethodInstructorMeeting Day/TimesRoom
573.01
Reflective Writing
Research and/or analytical paper(s), 15-20 pages
Class participation
W
10:30-12:20 PM
4044
Sakai site: https://sakai.duke.edu/portal/site/LAW.573.01.F19
Email list: LAW.573.01.F19@sakai.duke.edu
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