The Healthcare Policy Podcast ® Produced by David Introcaso

• Healthcare Policy Attorney Alissa Smith Discusses What To Know If/When ICE Knocks

  The Trump administration has made no secret it intends to aggressively enforce immigration laws, made evident by the recent arrest of a Columbia University grad student and green card holder on Columbia’s campus. Since the White House has repeatedly stated it intends to deport roughly all 12 million undocumented immigrants, this presents an immediate problem for healthcare providers who, in part, have legal and ethical obligations to all their patients. This is particularly true ironically for HHS-regulated Federal Qualified Health Centers (FQHCs) who serve 32 million largely racial/ethnic minorities who, because they are largely poor and medically disenfranchised, are disproportionately in need of healthcare. One day after assuming office in January the acting Department of Homeland Security rescinded decades of prior policy that essentially stated the federal government would not take immigration enforcement action in “protected areas” that included healthcare facilities - and schools like Columbia University. Ms. Smith’s most recent writing on the topic, “ICE in your Healthcare Facility? No Need to Freeze,” is at: https://www.dorseyhealthlaw.com/ice-in-your-healthcare-facility-no-need-to-freeze/. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• Alexander Howard Discusses HHS Secretary Kennedy's Richardson Waiver Recission

  Two weeks after being sworn in, last Friday HHS Secretary Robert Kennedy announced, “effectively immediately, the [1971] Richardson Waiver is rescinded and is no longer policy of the Department.” He explained his decision by stating “the extra-statutory obligations of the Richardson Waiver impose costs on the Department and the public, are contrary to the efficient operation of the Department, and impede the Department’s flexibility to adapt quickly to legal and policy mandates. “ The waiver, issued by President Nixon’s HEW Secretary, Elliot Richardson, effectively meant HHS would use the 1946 Administrative Procedure Act’s “notice of proposed rule making” (NPRM) process broadly and its “good cause” exception sparingly. (The APA essentially governs the process by which federal agencies develop and issue regulatory rules.) Secretary Kennedy rescinded the waiver citing APA language that exempts rule making, effectively public input, from matters “relating to agency management or personnel or to public policy, loans, grants, benefits or contracts” and permits departments to forgo public comment for “good cause” or when the procedure is “impracticable, unnecessary or contrary to the public interest.” Though Secretary Kennedy’s decision will almost certainly be challenged in court, in the near term HHS can make significant, and now unquestioned, regulatory changes to, for example, the Medicare and Medicaid programs. Sec. Kennedy’s one page, March 3 Federal Register notice is at: https://www.govinfo.gov/content/pkg/FR-2025-03-03/pdf/2025-03300.pdf. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• Prof. John Abraham Discusses Accelerated Ocean Temperature Warming and Heat Content

  Last year was the first calendar year with a global mean temperature of more than 1.5°C above the 1850-1900 average. Since 90% of global warming is occurring in the ocean, due to the earth’s rising energy imbalance resulting from continuing and increasing GHG emissions, not surprisingly research published in “Environmental Research Letters” in late January concluded ocean temperatures for the 450 day period between April ’23 and July ’24 were the warmest ever. Ocean surface temperatures are now warming 40 times faster than 40 years ago. As I’ve noted in previous discussions with Prof. Abraham, because warming oceans/ocean heat content plays a fundamental role in our planet’s energy, water and carbon cycles, warming ocean temperatures disrupt marine life that substantially threaten the availability of food we eat and the oxygen we breathe.The “Environmental Research Letters” article, “Quantifying the Acceleration of Muti-decadal Global Sea Surface Warming Driven by Earth’s Energy Imbalance,” is at: https://iopscience.iop.org/article/10.1088/1748-9326/adaa8a/pdf. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• Hip Hop Caucus' Stephone Coward and Stand.earth's Hannah Saggau Discuss Citi's Contribution to Cancer Alley

  Under the Biden administration the US once again became the world’s largest producer of oil and gas. Because all fossil fuels projects are politically constituted via permitting, etc., it is no surprise that of the nearly $7 trillion of fossil fuel investments since the 2015 Paris Accord, almost $2 trillion has been provided by six US banks including Citi. Cancer alley, the nickname for a stipe of largely Louisiana coastline, is home to over 200 petrochemical plants, refineries and ports. As the name implies, per the EPA, cancer alley residents are exposed to over ten times the level of health risks from resulting air pollution. A recent report by Hip Hop, Stand.earth and others, titled “Citi: Funding Fossil-Fueled Environmental Racism in the Gulf South,” documents Citi’s investment in moreover four liquified natural gas (LNG) export terminals, the GHG emissions they’ll emit and the resulting health harms they’ll inflict on moreover minoritized communities. As likely the frontline example of environmental racism should cause one to recall the prosecutor’s closing argument in the George Floyd case, “if you’re doing something that hurts somebody, and you know it, you’re doing it on purpose.” The report is at: Citi-Funding-Fossil-Fueled-Environmental-Racism-in-the-Gulf-South.pdf.Info on the Hip Hop Caucus is at: https://hiphopcaucus.org/.Info on Stand.earth is at: https://stand.earth/resources/citi-enviro-racism/Info on Rise St. James is at: https://risestjames.org/As for our failure to make any progress in addressing health equity see, e.g., this JAMA-published research in 2019: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2736934 This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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• Attorney Andrea Rodgers Discusses Children's Litigation Efforts to Achieve Climate Justice

  To begin my 14th year podcasting . . . , per the Sabin Center for Climate Change Law at Columbia Unversity, as of last September there were 1,850 climate crisis-related cases filed in the US challenging climate policy under constitutional, federal statutory including securities and financial regulations, state law claims and under several other categories. Law suits have been and will continued to be filed for the simple reason Congressional lawmaking and state legislating have failed to legitimately address the climate crisis, i.e., reduce CO2e emissions. Ms. Rodgers, Deputy Director, US Strategy at Our Children’s Trust, a public interest law firm dedicated to securing children’s legal rights to a healthy climate, discusses the current state of Juliana v the US initially filed in 2015, the 2023 Held v Montana decision in favor of 16 young people and a favorable 2024 settlement agreement resulting form Navahine F in which Hawaii’s DOT agreed to move aggressively to achieve a net zero ground transporation system. Ms. Rodgers also discusses OCT’s ongoing Genesis v the EPA case and the current International Court of Justice effort to reach an advisory opinion regarding climate-related legal obligations. Listeners may recall I interviewed Ms. Rodgers regarding Juliana in February 2020 and most recently, or last June, I spoke again with Michael Burger, CEO of Columbia’s Sabin Center, regarding climate litigation generally. The Sabin Center’s litigation database is at: https://climatecasechart.com/.Our Children’s Trust is at: https://www.ourchildrenstrust.org/.Judge Josephine Staton’s January 2020 dissent in Juliana is at: https://cdn.ca9.uscourts.gov/datastore/opinions/2020/01/17/18-36082.pdf. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

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