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A Program for All Seasons
Get PDFFrom its beginnings as a modest health care companion to cash welfare assistance, Medicaid has become foundational to the American health care system. Medicaid’s success in insuring the poor while continually evolving in response to countless emerging health needs is the result of its public health character, which represents a fundamental departure from the eligibility and coverage strictures and norms on which other forms of insurance depend
St. Louis Vacancy Collaborative: 2019-2021 Work Plan
Get PDFOur City has a serious vacant property challenge. To effectively address vacancy, we must understand and respond to the factors that cause and perpetuate it. Much of the story of vacancy in our city, like other cities, includes a legacy of racism, disinvestment, and disengagement that has led to a breakdown in trust. We know that vacancy can result from incomplete foreclosure, bankruptcy, prolonged probate or lack of proper probate, investors with little incentive to care, judgment proof owners, bank ownership, lack of resources to repair or redevelop, lack of value, the foreclosure crisis, sprawl and weak markets.1 In St. Louis, other contributing factors include population loss, an aging housing stock, detrimental prior public policies (e.g., redlining, deed restrictions), predatory investors, and other forms of disinvestment.2The challenge is beyond any single institution’s ability to address. Over the past four years, City and neighborhood leaders have made concerted efforts to understand our vacancy challenge and the specific steps needed to address the challenge. As detailed on our website, this effort has produced key foundational reports and numerous recommendations (including, among others, Parcels and Peppers, recommendations from the Center for Community Progress, the Asakura Robinson St. Louis Land Bank Assessment, A Guide to Understanding and Addressing Vacant Property in the City of St. Louis, the St. Louis Planning and Design Agency’s gentrification discussion paper, and Mayor Krewson’s Plan to Reduce Vacant Lots and Buildings in the City of St. Louis).This multi-year effort has grown into what has come to be known as the St. Louis Vacancy Collaborative (VC), a coalition of partners committed to reducing vacant property in St. Louis. Reducing the negative impact of vacancy is a complex strategy that requires coordination to achieve a shared vision. The VC is not a stand-alone entity, but a coalition of community representatives, private and non-profit stakeholders, and local government agencies. The VC helps to coordinate existing vacancy efforts under one umbrella and encourages the public and private sectors to work together toward solutions in a comprehensive and coordinated way
2019--The Struggle for the Soul of Medicaid
No full textMedicaid was the sleeper provision when Congress created Medicare in 1965. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, 1 in 3 children, and 2 in 3 people in nursing homes. Medicaid now provides coverage to 1 in 5 Americans, with enrollment soaring to more than 76 million people since 2014 when the Affordable Care Act expanded eligibility to include all low-income working age adults. It is both the largest source of federal revenues to states and the second largest item in state budgets after education. This symposium explored the future of Medicaid, and the competing visions that struggle to define its future.https://scholarship.law.slu.edu/jhlpsymposia/1005/thumbnail.jp
Environmental Racism in St. Louis
Get PDFThis report calls out environmental racism- the disproportionate impact of environmental hazards on people of color 1-in St. Louis. While these disparities have been part of the long-standing discriminatory and profit-driven policies and practices known too well by black St. Louisans, the issue of environmental racism has rarely been addressed in the City.
At least three recent reports- For the Sake of All,2 Segregation in St. Louis: Dismantling the Divide,3 and Equity lndicators4-document the heavy health, economic, and quality of life burdens that the St. Louis region imposes on its black residents. This report complements those by focusing on the burdens related to environmental factors. It should come as no surprise that black St. Louisans are disproportionately harmed by lead poisoning, asthma, mold, and high energy costs- all of which are associated with factors such as substandard housing conditions and air pollution- due to living near industrial facilities, highways, and building demolitions. In addition, the City\u27s focus on enhancing majority-white areas has left majority-black areas without adequate access to public transit or healthy food, and with high concentrations of vacant properties and illegal trash dumping
Threats to Medicaid and Health Equity Intersection
Get PDFThe year 2017 proved politically tumultuous in the U.S. on many fronts, but perhaps none more so than health care. For enrollees in the Medicaid program, it was a “year of living precariously.” Long-promised Republican efforts to repeal the Affordable Care Act also took aim at Medicaid, with proposals to fundamentally restructure the program and drastically cut its federal funding. These proposals provoked pushback from multiple fronts, including formal opposition from groups representing people with disabilities and people of color and individual protesters. Opposition by these groups should not have surprised the proponents of “reforming” Medicaid. Both people of color and people with disabilities carry disproportionate burdens of ill health and face more significant barriers to accessing quality health care than other groups. As a consequence, the Medicaid program is particularly important to both groups.
Ultimately, defensive strategies by people with disabilities and people of color helped stymy both the efforts at “repeal and replace” and proposed changes to Medicaid. This successful advocacy raises a question about what other health-related concerns people with disabilities and people of color share. Considering these groups’ interests in contemporary Medicaid policy issues is a good place to start. To that end, this Article explores the relevance of race to states’ Medicaid expansion choices and the vulnerability of community-based services for people with disabilities in the event of funding cuts to Medicaid. I also suggest that marginalized groups may share similar concerns relating to Medicaid policy initiatives in two additional areas: growing interest in Medicaid work requirements and experiments with adopting value-based payment models for Medicaid providers. These are areas where collaborative advocacy may enhance the ability of people of color and people with disabilities to protect their common interest
The Corporation Reborn: From Shareholder Primacy to Shared Governance
Get PDFThe consensus around shareholder primacy is crumbling. Investors, long assumed to be uncomplicated profit-maximizers, are looking for ways to express a wider range of values in allocating their funds. Workers are agitating for greater voice at their workplaces. And prominent legislators have recently proposed corporate law reforms that would put a sizable number of employee representatives on the boards of directors of large public companies. These rumblings of public discontent are echoed in recent corporate law scholarship, which has cataloged the costs of shareholder control, touted the advantages of nonvoting stock, and questioned whether activist holders of various stripes are acting in the company’s best interests. Academics who support stronger shareholder rights are accused of pandering to special interest groups or naively seeking a panacea in a plebiscite.As critical theorists have documented over time, the foundations of the shareholder primacy model have always been compromised. In particular, the arguments for a core feature of the modern corporation — the exclusive shareholder franchise — have been revealed as the product of flawed assumptions, misapplied social choice theory, and a failure to hold true to the fundamental precepts of standard economics. It is time to look at such governance features anew, and reorient the literature around the basic purpose of corporations: to provide a legal mechanism for business firms to engage in the process of joint production.In this article, we present a new shared governance model, one that builds on the longstanding theory of the firm as well as a novel theory of democratic participation. These twin arguments, economic and political, both counsel in favor of extending the corporate franchise to employees as well as shareholders, and, importantly, provide a way to distinguish these two constituencies from other corporate stakeholders when it comes to governance rights. We conclude by assessing the current status of a shared governance system in Germany and advocating for further theoretical and empirical inquiry into organizational governance structures that provide for joint shareholder and employee participation
Labor Interests and Corporate Power
Get PDFLabor unions exert significant power through collective bargaining, pension fund investing, and political advocacy. But in each of these areas, unions face inherent structural limitations that severely constrain these powers. Workers need participation rights in corporate governance to overcome the multiplicity of forces arrayed against them. And rather than obviating the need for unions, worker corporate power would facilitate a different kind of labor representation — a transition to labor power that advocates for occupational interests and forms coalitions across the shifting political interests of different worker groups
An Incomplete Masterpiece
Get PDFThe recent wave of popular and academic commentary on Masterpiece Cakeshop sounded a common theme: disappointment, even frustration. Masterpiece was held out as a case that was finally going to explain and resolve the conflicts between free expression, free exercise, and discrimination that were coming up again and again in the lower courts. But Justice Kennedy, the critical consensus went, avoided reaching many of the main First Amendment issues in the case and had instead ruled narrowly, giving us a prime example of judicial minimalism:•
This assessment may be far too generous. In our short Article, we make the case that Masterpiece is a flawed decision because of its fundamental incompleteness, not its minimalism. Despite being held out as an opinion on religious liberty, Kennedy\u27s decision is cursory on the baker\u27s religious beliefs and how they have been burdened-a perhaps forgivable sin-but then simply omits any discussion of whether the state interest might outweigh the baker\u27s religious freedom-a less forgivable sin. The failure to do any balancing makes the religious liberty aspect in Masterpiece unfinished. Indeed, Masterpiece fails to follow the steps that Justice Kennedy himself had set out in his previous opinions on religious liberty. And this leads us to surmise that Masterpiece may not be a religious liberty decision at all, but one about the violation of the baker\u27s due process rights. If this was the case, however, the correct resolution would be not a win for the baker, but a remand for a new hearing (as Justice Kennedy had himself suggested in other opinions): a procedural remedy for a procedural flaw .. But Kennedy doesn\u27t take this route, either. In essence, Masterpiece is not a narrow or minimalist opinion, but rather a collection of false starts, none of which ofter much insight or illumination on the areas of law they purport to address