The Patient Protection and Affordable Care Act or Affordable Care Act (ACA) was enacted in 2010 with the goal of increasing health insurance coverage for the uninsured and helping improve the American health-care system. A fundamental feature of the statute is the requirement that most health insurance plans cover pre-existing conditions and provide minimum essential health coverage, i.e., provision of ten essential health benefits, including pregnancy, maternity, and newborn care; services for mental health and substance use disorders; and preventive, wellness, and chronic disease services. By requiring minimum essential health coverage, the ACA aimed to increase access to health care and encourage preventive care for the nation. Of course, not everyone will agree on what “essential coverage” should require. Some believe it should include only the most basic health insurance coverage necessary to ensure the population’s health. Others would demand more, insisting that “essential coverage” should broaden physical and mental wellness support, expand health-care accessibility and affordability, and reduce the burdens individuals experience when accessing health care.
The GW Health Law Initiative chose the name “Essential Coverage” for our new blog because the term is so central to the structure of the ACA and because it captures several themes. First, it underscores the importance of health law and how laws and regulations are central in shaping access to and delivery of health care. Second, it highlights the importance of grappling with difficult questions about what is essential or necessary in our health-care system. And third, the play on words expresses our goal of covering pressing issues in health law, not only to showcase the work of our health law students and faculty, but also to underscore the importance of public understanding of various issues in health law.
Modern events highlight the importance of this last goal and health law itself. The COVID-19 pandemic has shown us how public misinformation can cost lives. The overruling of Roe v. Wade and the disenfranchisement of reproductive rights across the country has tentacles that reach many aspects of life that may not be readily evident to the public. Social structures and laws seemingly unrelated to health can support or undermine health equity, access, and outcomes, particularly for marginalized communities. Consider, for example, that many factors—including variations in the quality of health care, structural racism, and implicit biases—result in three times the incidence of pregnancy-related deaths in Black women as compared to White women in the US. The affordable housing crisis also impacts the health of our population in detrimental and inequitable ways. Antitrust laws can affect health care markets and the price of health care. Religious liberty under the First Amendment can limit patient access to care from certain providers or institutions who may have religious objections. And, of course, the scope of the FDA’s authority and its regulations determine which drugs come to market. Health law, in short, is a vast and complex field that addresses the myriad of ways that law and social policies influence health care, health delivery, and health itself.
“Essential Coverage” is dedicated to bringing to light contemporary and emerging issues in health law to foster dialogue among students, faculty, practitioners, and the public and to inspire interest in the discipline among GW Law students. It will build upon GW Law’s commitment to health law and serve as a medium for generating discussions about timely and important matters. In short, it creates an “essential” space for education and advocacy on issues important to the GW health law community.
Sonia M. Suter
Sonia M. Suter is the Kahan Family Research Professor of Law, Henry St. George Tucker III Dean’s Research Professor of Law, the Founding Director of the Health Law Initiative, and a former genetic counselor.