Trump Demands Stay Of Sentencing Based On Retroactive Presidential Immunity – Above the Law

(Photo
by
Yuki
Iwamura-Pool/Getty
Images)

On
Friday,
Justice
Juan
Merchan
rejected
Donald
Trump’s
demand
to
delay
his
sentencing
in
the
false
business
records
case.
In
the

order
,
the
judge
excoriated
Trump’s
counsel,
Todd
Blanche
and
Emil
Bove
for
“language,
indeed
rhetoric,
that
has
no
place
in
legal
pleadings.”
Noting
their
inflammatory
characterization
of
the
court’s
rulings
as
lawless
and
unconstitutional,
Justice
Merchan
invoked
Chief
Justice
Roberts’
end
of
year
screed
against
judicial
“intimidation.”

“Dangerous
rhetoric
is
not
a
welcome
form
of
argument
and
will
have
no
impact
on
how
the
Court
renders
this
or
any
other
Decision,”
Justice
Merchan
wrote.

This
morning,
Blanche
and
Bove,
who
are
soon
to
be
leading
the
Justice
Department,

threw
up
two
middle
fingers

to
the
court

again
,
describing
“grave
constitutional
problems
with
this
proceeding
raised
in
our
prior
pleadings,
including
forcing
a
jury
on
the
Defendant
in
record
time
and
without
proper
process.”

Screeching
about
a
“politically-motivated
prosecution
that
was
flawed
from
the
very
beginning,
centered
around
the
wrongful
actions
and
false
claims
of
a
disgraced,
disbarred
serial
liar
former
attorney,
violated
President
Trump’s
due
process
rights,
and
had
no
merit,”
they
added
that
“While
it
is
indisputable
that
the
fabricated
charges
in
this
meritless
case
should
have
never
been
brought,
and
at
this
point
could
not
possibly
justify
a
sentence
more
onerous
than
that,
no
sentence
at
all
is
appropriate
based
on
numerous
legal
errors—including
legal
errors
directly
relating
to
Presidential
immunity
that
President
Trump
will
address
in
the
forthcoming
appeals.”

So
much
for
decorum.

In
today’s
nastygram,
Blanche
and
Bove
demand
that
the
court
stay
all
proceedings
under

Trump
v.
US

to
allow
their
client
to
take
an
immediate
appeal.
As
per
usual,
the
pleading
is
a
bit
muddy
on
the
facts
and
the
law.
In
fact,
this
is
not
a
response
to
last
week’s
ruling,
in
which
the
court
refused
to
adjourn
sentencing
based
on
retroactive
presidential
immunity
that
extends
backward
into
the
presidential
transition
period

or
at
least,

not
really
.
Trump
does
demand
an
automatic
stay
to
litigate
the
claim
of
“absolute
sitting-President
immunity
from
criminal
process,
extended
to
the
President-elect.”
But
his
main
claim
is
that
he’s
entitled
to
a
post-trial
stay
to
appeal
Justice
Merchan’s
December

refusal

to
vacate
the
conviction
because
it
rested
on
evidence
of
official
presidential
acts,
which
should
have
been
excluded.

Blanche
and
Bove
go
to
great
lengths
to
fudge
the
line
between
being
charged

for
official
conduct

and
being
convicted
of
non-official
conduct

based
on
evidence
of
official
acts
.
Justice
Merchan
ruled
that
those
claims
were:
untimely,
because
raised
too
late;
incorrect,
because
the
presumption
of
immunity
was
overcome;
and
irrelevant
because
the
evidence
of
Trump’s
guilt
was
overwhelming
and
so
inclusion
was
harmless
error.

In
essence,
Trump
isn’t
making
an
immunity
claim,
he’s
making
an
evidentiary
one.
This
may
be
a
distinction
without
a
difference

the
law
is
whatever
the
Supreme
Court
says
it
is,
and
these
days
that’s
a
moving
target.
Moreover,
the
purpose
of
a
pretrial
stay
to
litigate
immunity
is
to
spare
officials
from
the
burdens
of
trial

which
is
wholly
irrelevant
at
this
juncture.
But
Blanche
and
Bove
bluster
their
way
through
it,
huffing
that
“undergoing
a
criminal
sentencing
is
the
most
extreme
example
of
‘hav[ing]
to
answer
for
his
conduct
in
court,’

exactly
what
the
doctrine
of
Presidential
immunity
forbids
and
why
an
automatic
stay
is
mandated.”

A
cynical
person
might
suggest
that
Trump’s
lawyers
had
gamed
the
system
by

not

appealing
the
immunity
ruling
in
December
when
it
was
issued,
instead
waiting
until
the
last
possible
second
to
seek
review
in
hopes
of
running
out
the
clock.
That
person
might
also
note
the
inherent
tension
between
the
claims
that
it
violates
presidential
immunity
to
force
Trump
to
litigate
criminal
appeals
after
he’s
sworn
in,
and
the
demand
that
sentencing
be
stayed
to
allow
him
to
litigate
his
criminal
appeals.

Trump
demanded
a
response
from
the
court
by
2pm,
warning
that
he’ll
“file
an
Article
78
proceeding
as
well
as
a
direct
appeal
in
the
Appellate
Division,
First
Department,
seeking
review
of
the
Court’s
two
recent
incorrect
rulings
on
Presidential
immunity”
if
he
doesn’t
get
his
way.
As
of
this
writing,
neither
Justice
Merchan’s
response
nor
any
appeal
has
hit
the
public
docket.





Liz
Dye
 lives
in
Baltimore
where
she
produces
the
Law
and
Chaos substack and podcast.

Biglaw Firm Breaks With Trend, Requires Associates To Be In Office 5 Days A Week – Above the Law

Post-pandemic
(I
guess
I
should
specify
the
COVID
pandemic,
since
we
seem
to
be
gearing
up
for
the
next
(avian
flu)
one),
Biglaw
firms
have
been
balancing
their
in-office
needs
with
those
of
associates.
Because,
while

associates
have
enjoyed

the
flexibility
of
working
from
home
in
a
hybrid
schedule,
firms
have
seen
a

dip
in
associates’
work
product

that
they
attribute
to
working
from
home.
So,
firms
are
trying
to
thread
the
needle,
launching

hybrid
work
schedules

that
generally
require
associates
to
be
in
the
office
three
to
four
days
a
week.
(Often

leaning
on
technology

and
levying

real
consequences

to
ensure
compliance.)

But
Sullivan
&
Cromwell
is
bucking
that
trend.
The
firm
recently
announced
a
full-time
(five
days
a
week)
in-office
policy.

As
Reddit
user
lawschlthrowaway

notes
:

S&C
moves
to
full
RTO,
lawyers
expected
to
be
in
office
5x
a
week
Other
details
of
the
new
policy:

-Remote
work
generally
only
permitted
if
an
associate
is
eligible
to
adopt
a
flexible-time
schedule

-Managing
partner
approval
is
needed
for
remote
work
arrangements.
Max
of
1x
per
week
for
a
maximum
of
6
months.

-Junior
lawyers
“generally
will
not
be
authorized
to
work
remotely”

-Compensation
and
vacation
time
will
be
docked
if
you
work
a
number
of
client
hours
less
than
a
full-time
schedule
while
working
remotely

Even
though
other
firms
have
been
successful
with

the
honey
over
vinegar

method
of
getting
folks
back
to
the
office,
S&C
seems
to
be
going
full
hog
with
the
command
and
control
approach.
As
a
tipster
told
Above
the
Law,
“Associates
are
furious,
many
are
looking
into
quitting.
Morale
could
not
be
worse.”

What’s
your
firm
doing
about
office
attendance?
Please

email
us

(subject
line:
“[Firm
Name]
Office
Attendance”)
or
text
us
at
(646)
820-8477.
We
always
keep
our
sources
on
stories
anonymous.
There’s
no
need
to
send
a
memo
(if
one
exists)
using
your
firm
email
account;
your
personal
email
account
is
fine.
If
a
memo
has
been
circulated,
please
be
sure
to
include
it
as
proof;
we
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post
complete
memos
as
a
service
to
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readers.
You
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take
a
photo
of
the
memo
and
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as
a
picture
if
you
are
worried
about
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in
a
PDF
or
Word
file.
Thanks.




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Rubino
is
a
Senior
Editor
at
Above
the
Law,
host
of

The
Jabot
podcast
,
and
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of

Thinking
Like
A
Lawyer
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Feel
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First Fully A.I. Drafted Complaint Filed In Federal Court And… It’s Hot Garbage! – Above the Law

The
most
charitable
read
one
can
give


Sokolowski
et
al
v.
Digital
Currency
Group,
Inc.
et
al
,
is
that
the
federal
fraud
complaint
trumpeted
as
the
first
OpenAI
o1
pro
guided
litigation

reads
maybe
98.8
percent
like
a
perfectly
professionally
prepared
court
filing.
But
like
the
98.8
percent
genetic
similarity
between
chimps
and
humans,
that
1.2
percent
is
pretty
important
and
it’s
what
transforms
the
complaint
from
a
harbinger
of
a
robot
lawyer
future
into
a
dumpster
fire
begging
to
be
dismissed.

Plaintiffs
Stephen
Sokolowski
and
Christopher
Sokolowski
brought
this
claim
in
the
U.S.
District
Court
for
the
Middle
District
of
Pennsylvania
seeking
fraud
damages
arising
from
their
decision
to
place
“over
ninety
percent
(90%)
of
their
total
net
worth”
with
Genesis
Global
Trading,
a
crypto
outfit
that
filed
for
Chapter
11.
Mike
Dunford
prepared

an
amusing
thread

of
his
live
reaction
to
the
case
announcement
and
complaint
that
gets
into
the
weeds
that
you
should
check
out.

According
to
their
Reddit
post
announcing
the
filing,
the
Sokolowski
boys
decided
to
file
this

pro
se

after
evaluating
the
potential
of
using
artificial
intelligence
to
manage
the
case:

Eventually
though,
Claude
3.5
Sonnet
was
released,
and
it
was
finally
capable
of
evaluating
the
law
(but
it
still
made
errors
in
interpreting
the
precedential
value
of
cases
in
its
training
data.) 
Then,
OpenAI
changed
all
that
with
o1
pro. 
OpenAI’s
o1
pro
is
an
artificial
general
intelligence
(AGI)
system
that
is
smarter
than
any
lawyer
I’ve
talked
to.

You
should
really
talk
to
more
lawyers
then.

It’s
also
worth
noting
that
o1
pro
is
not,
in
fact,
“an
artificial
general
intelligence”
which
is
a
term
for
the
Holy
Grail
of
AI
design
where
the
algorithm
will
overtake
human
reasoning.
Given
that
SkyNet
has
not
driven
the
human
race
to
extinction,
its
safe
to
say
AGI
hasn’t
arrived.

When
o1
was
made
available,
we
quickly
signed
up
and
compared
it
to
Gemini
Experimental
1206. 
We
determined
that
both
were
acceptable
for
moving
forward,
but
o1
was
clearly
superior
in
understanding
case
law
and
anticipating
defenses.

Superior
to…
what?
To
ChatGPT?
Sure.
To
an
attorney?
No.
But
this
is
the
sort
of
brain-fried
nonsense
that
prompts

Elon
Musk
to
say
he
can
feed
“all
court
cases”
into
an
algorithm
and
replace
the
whole
legal
system
.
The
“techbrogentsia”
imagine
law
as
a
middle
school
essay
and
that
a
sufficiently
developed
model
can
take
“the
law,”
apply
a
fact
pattern,
and
get
a
result.

To
some
extent,
this
is
the
fault
of
the

mainstream
media
treating
hallucinations
as
the
obstacle
holding
back
AI
lawyering

instead
of
just
a
moderately
helpful
tool
in
the
hands
of
dumb
lawyers.
Hallucinations
are
inevitable
in
generative
AI,
since
the
whole
purpose
of
the
technology
is
to
guess
words
that
will
make
the
user
happy.
But
hallucinations
are
also
unlikely
to
matter
soon.
Serious
players
in
the
legal
AI
game
(read:
not
Elon)
are
spending
massive
resources
to
shield
the
end
user
from
hallucinations.
Hallucinations
won’t
be
the
problem,
the
problem
will
be
how
to
parse
through
and
select
from
accurate
but
not
necessarily
useful
information…
which
is
one
of
those
1.2
percent
problems
that
a
human
with
a
JD
has
to
handle.

And
this
complaint
cries
out
for
that
JD-trained
editor.
It
carries
on
and
on
offering
preemptive
motion
to
dismiss
responses
that
aren’t
pertinent
at
all
in
an
initial
pleading.
But
this
is
a
product
of
the
plaintiffs’
methodology,
which
asked
the
algorithm
to
review
the
initial
AI
complaint
and
prepare
an
AI
motion
to
dismiss
and
then
pretend
to
be
a
judge
and
evaluate
that
motion
to
dismiss
vs.
the
complaint
and
integrate
it
all
in.

I
ran
this
simulation
many
times,
and
the
last
“judge”
denied
the
motion
0/10
times.

From
context
I
think
he
meant
to
say
“granted
the
motion,”
but
I
will
say
that
I

also

think
the
judge
will
deny
the
inevitable
motion
to
dismiss
“0/10
times.”

But
along
the
way,
the
complaint
highlights
some…
important
facts.
Dunford
asks,
“10:
Oh
my
god,
these
utter
muppets
are
trying
to
reverse-pierce
out
of
their
own
corporate
veil”
and
answers…

See,
now
a
lawyer
might’ve
had
thoughts
about
this
case
based
on
that
allegation.
Or
the
related
reason
why
they
might
want
to
reverse
pierce
their
own
veil…

Generative
AI
could
well
be
a
revolutionary
technology
for
the
legal
industry
but
it’s
not
going
to
do
that
by
replacing
core
lawyer
duties.
Not
just
because
that
raises
serious
ethical
concerns,
but
because
AI
simply

never
going
to
be
smart
enough
to
do
that
.
What
we
see
from
AI
right
now
is

pretty
much
as
good
as
it’s
going
to
get
.
That
doesn’t
mean
it
won’t
get
better
at
executing
tasks
with
refinement,
but
as
the
march
of
technology
goes,
we’re
not
talking
about
getting
from
Kitty
Hawk
to
the
moon,
we’re
talking
about
toilet
paper
being
slightly
softer
than
it
was
in
the
50s.

A
report
prepared
by
Goldman
Sachs

revealed
that
even
AI
enthusiasts
are
admitting
that
linear
improvements
will
require

exponential

increases
in
training
investment.
That’s
not
sustainable
and
not
a
viable
path
to
AI
running
complex
litigation.

Without
some
exogenous
advancement
like
quantum
computing
or
viable
fusion
power
to
cure
the
energy
drain,
generative
AI
may
get
better
at
what
it
does
but
it’s
not
going
to
do
much
more
than
it
does
now…
which
is
still
a
massive,
potentially
indispensable
time-saving
tool
for
trained
lawyers
but
it’s
not
a
replacement.

Nor
is
it
an
access
to
justice
tool
that
will
give

pro
se

litigants
a
free
robot
lawyer.

Maybe
for
routine
traffic
infractions
.
But
the
access
to
justice
potential

for
litigation

in
generative
AI
isn’t
in
helping
people
deal
with
their
legal
problems,
it’s
in
helping
people
realize
that
they
have
legal
problems.
A
lot
of
injustice
happens
because
people
don’t
know
if
they
have
a
case
and
aren’t
willing
to
spend
money
to
find
out.
AI
can
tell
someone
wondering
about
their
plight,
“Yeah,
actually,
that
might
not
be
legal
and
you
should
feel
confident
calling
someone
about
that.”

Unfortunately,
until
we
square
our
expectations
around
what
AI
is
actually
capable
of
accomplishing,
we’re
going
to
see
more
of
this
mess
in
the
courts.


(Complaint
on
the
next
page…)


Announcement
of
the
first
o1
pro
guided
Federal
litigation

[Reddit]


Earlier
:

Generative
AI…
What
If
This
Is
As
Good
As
It
Gets?


Elon
Musk
Feeds
AI
‘All
Court
Cases,’
Promises
It
Will
Replace
Judges
Because
He’s
An
Idiot


For
The
Love
Of
All
That
Is
Holy,
Stop
Blaming
ChatGPT
For
This
Bad
Brief




HeadshotJoe
Patrice
 is
a
senior
editor
at
Above
the
Law
and
co-host
of

Thinking
Like
A
Lawyer
.
Feel
free
to email
any
tips,
questions,
or
comments.
Follow
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on Twitter or

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if
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law,
politics,
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college
sports
news.
Joe
also
serves
as
a

Managing
Director
at
RPN
Executive
Search
.

Legalytics: Big Cases By The Numbers – Above the Law

While
quantifying
case
importance
is
a
subjective
art
at
best,
there
are
some
measurable
elements
that
provide
deeper
than
a
gut
impression
as
a
basis
for
comparison.
Some
possibilities
include
dollar
value
or
companies
involved,
case
complexity,
differences
of
opinion
between
judges,
firms
involved
in
litigating
the
cases,
and
interests
or
implications
for
those
beyond
the
immediate
parties
to
the
matter.

With
these
layers
in
mind,
I
started
out
by
examining
opinions
where
the
following
firms
which
are currently
around
the
top
revenue
generators
 in
U.S.
law
were
counsel:
Gibson
Dunn,
Skadden,
Latham,
Morgan
Lewis,
White
&
Case,
Ropes
&
Gray,
Allen
Overy,
Kirkland
&
Ellis,
DLA
Piper,
and
Sidley
Austin.

The
sample
of
written
opinions
with
at
least
100
words
(a
way
to
attempt
to
exclude
summary
decisions)
based
on
these
parameters
was
136.

Here
are
a
few
ways
to
break
down
the
numbers.
First
based
on
law
firm:

There
is
quite
a
range
from
37
to
three
decisions
and
large
drops
from
the
first
four
firms
to
the
next
four
and
finally
to
the
last
two.

To
get
a
sense
of
the
lay
of
the
land,
below
are
the
courts
that
issued
these
opinions.

Here
we
see
the
impact
of
the
coasts
as
the
four
courts
with
the
most
decisions
are
SDNY
(New
York),
NDCA
(California),
the
Ninth
Circuit
Court
of
Appeals
(west
coast),
and
the
appellate
divisions
of
the
New
York
Supreme
Court
(the
intermediate
appeals
tribunal
in
New
York).

Next
is
a
quick
way
to
break
down
some
of
the
significant
issues
in
the
cases
based
on
a
dictionary
approach
looking
for
multiple
times
these
terms
arise
in
a
decision.

Many
of
these
cases
(perhaps
not
surprisingly
for
big
firms)
deal
with
financial
implications
and
deals
that
broke
down.
There
are
still
a
nontrivial
number
of
cases
where
the
immediate
concerns
are
not
financial
or
at
least
are
not
predicated
only
on
business
interests.

Lastly
a
look
at
opinion
count
based
on
a
distribution
of
majority
word
counts.

Most
of
these
opinions
are
fairly
short
although
only
six
were
excluded
from
the
analyses
due
to
fewer
than
100
words
in
them.

I
ordered
this
list
of
five
cases
based
on
relative
importance,
mainly
on
dispersed
impact,
but
also
based
on
the
other
factors
I
described
above.


Decision
Link


Court
:
United
States
Court
of
Appeals,
Fifth
Circuit


Decision
Date
:
December
11,
2024


Majority
Opinion
:
Oldham; Dissent:
Higginson


Issue
Areas
:
{housing,
financial,
commerce,
employment,
liability,
fraud,
contracts}


Majority
words
count
:
11,351; Dissent
word
count
:
2,460


Amicus
briefs
:
14


What
it’s
about
:
This
case
centers
around
a
legal
challenge
to
rules
set
by
the
Securities
and
Exchange
Commission
(SEC)
and
Nasdaq
regarding
the
disclosure
of
certain
demographic
information
about
directors
of
public
companies.
Specifically,
the
rules
required
companies
listed
on
Nasdaq
to
disclose
data
about
the
race,
gender,
and
sexual
characteristics
of
their
directors.
The
plaintiffs
AFBR,
argued
that
these
disclosure
requirements
went
beyond
what
is
allowed
under
the
law
and
violated
certain
legal
principles.

At
its
core,
this
case
is
about
whether
government
regulators,
like
the
SEC
and
Nasdaq,
can
require
companies
to
disclose
sensitive
information
about
their
directors
for
the
purpose
of
promoting
transparency,
even
if
such
disclosures
aren’t
directly
related
to
financial
performance
or
investor
protection.


The
Positions
of
the
Two
Sides:


AFBR
(Petitioner):

AFBR,
a
group
representing
certain
companies
affected
by
the
Nasdaq
rule,
argues
that
the
SEC
and
Nasdaq
have
overstepped
their
authority
by
mandating
disclosures
of
information
that
are
not
required
by
law.
The
main
claim
is
that
these
rules
go
against
the
intent
of
the
securities
laws,
which
were
created
to
protect
investors
from
fraud,
manipulation,
and
speculation,
not
to
mandate
social
or
demographic
disclosures.

The
group
argued
that
requiring
such
disclosures
doesn’t
align
with
the
goals
of
the
Securities
Exchange
Act,
which
was
primarily
designed
to
prevent
financial
fraud
and
market
manipulation,
not
to
force
companies
to
reveal
demographic
information
unrelated
to
financial
performance.


SEC
and
Nasdaq
(Respondent):

The
SEC
and
Nasdaq
argue
that
their
rules
are
within
their
authority
and
are
in
line
with
the
objectives
of
the
Securities
Exchange
Act.
They
believe
that
forcing
companies
to
disclose
such
information
is
beneficial
for
investors
and
markets
because
it
improves
transparency
and
could
potentially
enhance
corporate
governance.

They
argued
that
the
rules
are
related
to
the
Exchange
Act’s
goals
of
providing
transparency
and
protecting
investors,
and
that
disclosing
demographic
data
about
company
directors
might
help
investors
make
better-informed
decisions
about
the
companies
they
invest
in.


Key
Legal
and
Policy
Issues:


  1. Jurisdiction
    and
    Standing
    :
    One
    threshold
    issue
    in
    the
    decision
    was
    determining
    if
    AFBR
    had
    the
    right
    to
    challenge
    the
    rule
    in
    court.
    Since
    AFBR
    represented
    companies
    that
    were
    affected
    by
    Nasdaq’s
    rules,
    they
    had
    the
    legal
    standing
    to
    bring
    this
    case.

  2. Authority
    and
    Scope
    of
    the
    SEC
    and
    Nasdaq
    :
    The
    main
    legal
    issue
    was
    whether
    the
    SEC
    and
    Nasdaq
    had
    the
    authority
    to
    require
    companies
    to
    disclose
    personal
    demographic
    information
    about
    their
    directors.
    AFBR
    argued
    that
    this
    wasn’t
    within
    the
    scope
    of
    the
    securities
    laws,
    while
    the
    SEC
    and
    Nasdaq
    argued
    that
    the
    rules
    were
    related
    to
    their
    duties
    to
    ensure
    transparency
    in
    the
    market.

In
this
decision,
the major
questions
doctrine
 
(a
current
hot
topic)
plays
a
central
role
in
limiting
the
scope
of
the
SECs
regulatory
power
over
corporate
governance,
particularly
regarding
the
imposition
of
diversity
requirements
on
corporate
boards.


Major
Questions
Doctrine:

The
doctrine
asserts
that
when
an
administrative
agency,
like
the
SEC,
seeks
to
exercise
power
over
a
matter
of
significant
economic
or
political
importance,
it
must
have
clear
and
explicit
authorization
from
Congress.
This
is
because
such
power,
if
implied
or
unclear,
could
lead
to
significant
changes
in
the
nations
economic
landscape
or
government
structure
without
proper
democratic
oversight.
In
this
case,
the
SEC’s
attempt
to
impose
diversity
requirements
on
corporate
boards
is
seen
as
a
“major
question”
due
to
its
massive
economic
and
political
implications.
In
this
case,
The
SECs
action
of
requiring
Nasdaq-listed
companies
to
adopt
board
diversity
policies
is
characterized
as
a
“major
question”
because
it
affects
the
internal
structures
of
large
corporations,
including
those
with
a
combined
market
value
greater
than
the
GDP
of
the
United
States.
The
court
argues
that,
while
the
SEC
has
broad
powers
under
the
Exchange
Act,
it
cannot
claim
authority
to
reshape
corporate
governance
based
on
vague
statutory
provisions
without
clear
congressional
approval.

The
court
also
highlights
that
this
kind
of
regulation—pertaining
to
diversity
on
corporate
boards—is
traditionally
handled
by
other
agencies
(like
the
Equal
Employment
Opportunity
Commission)
or
state
laws,
not
the
SEC.
Therefore,
applying
the
major
questions
doctrine
here
requires
skepticism
of
the
SEC’s
action,
as
no
clear
congressional
mandate
for
such
regulation
exists
in
the
Exchange
Act.


Holding
:
Ultimately,
the
court
concluded
that
the
SEC’s
power
to
regulate
corporate
governance
did
not
extend
to
imposing
diversity
requirements
on
corporate
boards,
as
such
a
measure
lacks
the
clear
congressional
authorization
required
by
the
major
questions
doctrine.

Main
points
in
the dissent:


  1. Nasdaq’s
    Role
    and
    SECs
    Limited
    Authority
    :
    Nasdaq,
    as
    a
    private
    company,
    proposed
    a
    rule
    (the
    “Disclosure
    Rule”)
    requiring
    companies
    to
    disclose
    their
    board
    diversity.
    The
    dissent
    argues
    that
    the
    SEC’s
    role
    is
    limited
    and
    that
    it
    is
    not
    authorized
    to
    override
    Nasdaq’s
    judgment
    unless
    the
    rule
    violates
    the
    Exchange
    Acts
    requirements.
    The
    SEC’s
    approval
    of
    the
    rule
    aligns
    with
    the
    purpose
    of
    encouraging
    market
    efficiency
    and
    investor
    transparency.

  2. Investor
    Demand
    for
    Diversity
    Information
    :
    The
    dissent
    highlights
    that
    there
    is
    substantial
    evidence
    showing
    that
    investors
    sought
    information
    about
    board
    composition,
    despite
    inefficiencies
    in
    how
    such
    data
    was
    previously
    reported.
    Nasdaq
    responded
    to
    this
    demand
    with
    a
    rule
    that
    standardizes
    board
    diversity
    disclosures,
    aiming
    to
    address
    information
    asymmetries
    between
    large
    and
    small
    investors.

  3. Disclosure
    vs.
    Quota
    :
    The
    dissent
    emphasizes
    that
    the
    Disclosure
    Rule
    is
    focused
    on
    providing
    information,
    not
    imposing
    a
    quota
    system
    for
    board
    diversity.
    This
    aligns
    with
    SEC’s
    finding
    that
    the
    rule
    is
    designed
    to
    remove
    barriers
    to
    market
    efficiency
    rather
    than
    mandate
    hiring
    practices.

  4. Private
    Experimentation
    and
    Limited
    SEC
    Intervention
    :
    The
    dissent
    defends
    the
    concept
    of
    self-regulation
    by
    exchanges
    like
    Nasdaq,
    which
    can
    refine
    their
    rules
    based
    on
    market
    demands.
    The
    SEC’s
    review
    should
    be
    limited
    to
    ensuring
    the
    rule
    doesn’t
    violate
    the
    principles
    of
    the
    Exchange
    Act,
    rather
    than
    imposing
    its
    own
    policy
    preferences.

  5. Consistency
    with
    Existing
    Regulatory
    Practices
    :
    The
    dissent
    notes
    that
    Nasdaq’s
    rule
    aligns
    with
    existing
    disclosure
    requirements,
    such
    as
    those
    enforced
    by
    the
    EEOC
    and
    SEC,
    demonstrating
    consistency
    with
    broader
    regulatory
    practices.


Decision
Link


Court
:
Supreme
Court
of
Montana


Decision
Date
:
December
11,
2024


Opinion
Author
:
Justice
Baker;
Concurrence:
Justice
McKinnon;
Concurrence
and
Dissent:
Justice
Rice


Areas
of
Law
 {employment,
hearing,
insurance,
unconstitutional,
evidence}


Majority
word
count
:
8,211; Concurrence (McKinnon):
1,579; Concurrence
and
Dissent
in
part 
(Rice):
661


Amicus
Briefs
:
2


What
it’s
about
:
This
case
addresses
the
constitutionality
of
Montana
Senate
Bill
99
(SB
99),
a
law
enacted
in
2023
that
restricts
specific
medical
treatments
for
minors
diagnosed
with
gender
dysphoria.
The
Plaintiffs
argued
that
the
law
violates
Montana’s
constitutional
rights,
including
privacy
and
equal
protection.
Here’s
a
summary
of
the
key
issues:


Overview
of
SB
99


  • Purpose
    :
    The
    law
    aims
    to
    protect
    minors
    from
    undergoing
    “harmful,
    experimental”
    treatments
    such
    as
    puberty
    blockers,
    cross-sex
    hormones,
    and
    certain
    surgical
    procedures
    before
    they
    reach
    adulthood.

  • Prohibitions
    :

    • The
      law
      prohibits
      the
      administration
      of
      puberty
      blockers
      and
      hormones
      (e.g.,
      testosterone
      for
      female
      minors,
      estrogen
      for
      male
      minors)
      intended
      to
      affirm
      a
      minor’s
      gender
      identity.
    • Bans
      specific
      surgeries
      (e.g.,
      hysterectomy,
      vaginoplasty)
      performed
      to
      affirm
      a
      gender
      identity
      incongruent
      with
      a
      minor’s
      sex
      assigned
      at
      birth.

  • Exemptions
    :
    These
    procedures
    and
    treatments
    are
    permitted
    if
    they
    are
    not
    aimed
    at
    addressing
    a
    minor’s
    perception
    of
    their
    gender
    identity.

  • Professional
    Penalties
    :
    Health
    professionals
    who
    violate
    the
    law
    face
    disciplinary
    actions,
    including
    suspension
    of
    their
    license
    for
    at
    least
    one
    year,
    civil
    liability,
    and
    exclusion
    of
    insurance
    coverage
    for
    damages.


Plaintiffs’
Arguments


  1. Constitutional
    Violations
    :
    SB
    99
    infringes
    on
    privacy
    and
    equal
    protection
    rights
    guaranteed
    under
    Montana’s
    Constitution.

  2. Medical
    Necessity
    :

    • Treatments
      banned
      under
      SB
      99
      are
      supported
      by
      medical
      standards
      (e.g.,
      WPATH
      Standards
      of
      Care
      Version
      8)
      and
      are
      often
      necessary
      for
      addressing
      gender
      dysphoria.
    • Evidence
      submitted
      indicates
      untreated
      gender
      dysphoria
      can
      result
      in
      severe
      mental
      health
      issues,
      including
      depression
      and
      suicidality.

  3. Expert
    Testimony
    :
    Plaintiffs’
    experts
    attest
    that
    gender-affirming
    care
    is
    safe,
    effective,
    and
    the
    accepted
    standard
    of
    care
    for
    minors
    with
    gender
    dysphoria.


State’s
Defense


  1. Medical
    Concerns
    :

    • The
      State
      argues
      that
      there
      is
      no
      consensus
      within
      the
      medical
      community
      on
      using
      puberty
      blockers
      and
      hormones
      for
      minors
      with
      gender
      dysphoria.
    • It
      asserts
      that
      gender-affirming
      care
      may
      harm
      minors.

  2. Legislative
    Authority
    :
    SB
    99
    reflects
    the
    State’s
    interest
    in
    regulating
    medical
    practices
    to
    protect
    minors.


Holding
:
The
court
decided
to
uphold
the
District
Court’s
preliminary
injunction
against
SB
99,
finding
that
the
plaintiffs
had
shown
a
likelihood
of
success
on
the
merits
of
their
privacy
claim.
The
District
Court
determined
that
SB
99,
which
bans
certain
medical
treatments
for
minors,
violated
the
plaintiffs’
fundamental
right
to
privacy
under
the
Montana
Constitution.
The
court
applied
strict
scrutiny
and
found
that
the
State
had
not
demonstrated
a
compelling
interest
or
that
the
law
was
narrowly
tailored
to
achieve
such
an
interest.


Key
aspects
of
the
decision
include
:


  1. Prima
    Facie
    Case
    Against
    SB
    99
    :
    The
    District
    Court
    concluded
    that
    the
    plaintiffs
    presented
    sufficient
    evidence
    to
    establish
    that
    the
    treatments
    banned
    by
    SB
    99
    are
    not
    harmful
    or
    experimental,
    and
    therefore,
    do
    not
    justify
    the
    State’s
    interference
    under
    the
    Armstrong
    standard.

  2. Strict
    Scrutiny
    Standard
    :
    The
    statute’s
    impact
    on
    individual
    privacy
    rights
    triggered
    strict
    scrutiny,
    requiring
    the
    State
    to
    justify
    the
    law
    with
    a
    compelling
    interest
    and
    show
    that
    it
    was
    narrowly
    tailored.
    The
    State’s
    failure
    to
    demonstrate
    that
    the
    banned
    treatments
    posed
    a
    bona
    fide
    health
    risk
    meant
    it
    could
    not
    meet
    this
    standard.

  3. Preliminary
    Injunction
    Process
    :
    The
    court
    rejected
    the
    State’s
    argument
    that
    the
    District
    Court
    erred
    by
    not
    allowing
    live
    testimony
    or
    cross-examination
    during
    the
    preliminary
    injunction
    hearing.
    It
    found
    that
    the
    District
    Court
    had
    broad
    discretion
    in
    how
    it
    conducted
    the
    hearing
    and
    provided
    both
    parties
    a
    full
    opportunity
    to
    submit
    evidence.

  4. Irreparable
    Harm
    :
    The
    court
    agreed
    that
    the
    plaintiffs
    faced
    irreparable
    harm
    absent
    the
    injunction
    because
    the
    statutory
    restrictions
    prevented
    individualized
    medical
    care
    for
    minors,
    affecting
    their
    fundamental
    rights.

Overall,
the
court
emphasized
that
the
preliminary
injunction
did
not
resolve
the
ultimate
merits
of
the
case,
which
would
be
determined
at
trial.
However,
it
found
no
abuse
of
discretion
in
the
District
Court’s
decision
to
enjoin
SB
99
pending
a
final
determination.


Justice
McKinnon
:
Justice
McKinnon
concurred
with
the
Court’s
decision
to
uphold
the
preliminary
injunction
on
the
plaintiffs’
right
to
privacy
claim
but
emphasized
the
importance
of
addressing
the
equal
protection
claim
as
well.
McKinnon
highlighted
that
Montana’s
constitutional
protections
are
broader
than
their
federal
counterparts,
particularly
in
prohibiting
discrimination
on
the
basis
of
sex,
which
includes
transgender
status.
McKinnon
criticized
the
Court’s
avoidance
of
this
issue,
arguing
that
it
leaves
litigants
and
lower
courts
without
crucial
guidance,
fosters
uncertainty,
and
delays
justice
for
those
impacted
by
SB
99.
McKinnon
underscored
the
necessity
of
recognizing
transgender
persons
as
a
suspect
class
and
applying
strict
scrutiny
to
the
law,
asserting
that
this
case
presents
an
opportunity
to
provide
clarity
on
these
critical
legal
questions
under
Montana’s
Constitution.


Justice
Rice:
 Justice
Rice
concurred
with
upholding
the
preliminary
injunction,
agreeing
that
SB
99’s
restrictions
fail
to
meet
the
high
bar
of
addressing
a
bona
fide
health
risk
but
noted
that
evolving
medical
and
legal
standards
require
ongoing
evaluation.


Decision
Link


Court
:
Supreme
Court
of
Delaware


Decision
Date
:
December
2,
2024


Opinion
Author
:
Justice
Valihura


Areas
of
law
 {conspiracy,
merger,
bargaining,
contract
law,
financial,
torts,
purchasing,
liability,
fraud}


Opinion
word
count
:
26,435


Amicus
brief
:
0


What
it’s
about
:
This
case
revolves
around
the
sale
of
Mindbody,
a
software
company,
to
Vista
Equity
Partners
for
$36.50
per
share
in
2018.
The
lawsuit
focuses
on
whether
the
company’s
CEO,
Rick
Stollmeyer,
and
the
board
of
directors
acted
properly
during
the
sale
process.
Shareholders
claim
that
Stollmeyer
prioritized
his
own
interests
over
securing
the
best
price
for
investors,
including
early
discussions
with
Vista,
favoring
them
over
other
bidders,
and
failing
to
disclose
critical
financial
information
before
the
merger
vote.
The
case
examines
whether
these
actions
violated
fiduciary
duties
to
shareholders
and
influenced
the
sale’s
outcome
unfairly.


Decision
:
CEO
Richard
Stollmeyer,
Vista
Equity
Partners
Management,
LLC,
and
Mindbody
lost
on
several
critical
points,
including:


  1. Breach
    of
    Fiduciary
    Duty
    :
    The
    Court
    found
    that
    Stollmeyer
    breached
    his
    fiduciary
    duty
    of
    loyalty
    by
    failing
    to
    maximize
    the
    company’s
    sale
    price
    for
    stockholders.

  2. Failure
    to
    Ensure
    an
    Informed
    Stockholder
    Vote
    :
    The
    stockholder
    vote
    approving
    the
    merger
    was
    found
    to
    be
    insufficiently
    informed.

  3. Material
    Omission
    in
    Proxy
    Statement
    :
    The
    acquirors
    failure
    to
    include
    important
    information
    regarding
    their
    informational
    advantages
    was
    considered
    material.

Stollmeyer
and
the
acquirer
were
also
found
to
have
waived
their
right
to
seek
settlement
credit
and
the
acquirers
failure
to
correct
material
omissions
did
not
meet
the
“knowing
participation”
element
for
aiding
and
abetting
claims.


What
the
appellants
won:

  1. The
    Delaware
    Supreme
    Court
    reversed
    certain
    aspects
    of
    the
    trial
    court’s
    ruling,
    particularly
    concerning
    the
    acquirors
    responsibility
    for
    aiding
    and
    abetting
    the
    CEOs
    breach
    of
    duty.
  2. The
    Delaware
    Supreme
    Court
    held
    that
    the
    acquirors
    failure
    to
    correct
    the
    proxy
    statement
    did
    not
    fulfill
    the
    “knowing
    participation”
    standard
    needed
    for
    the
    aiding
    and
    abetting
    claim.
    Additionally,
    the
    Court
    found
    that
    the
    acquirors
    contractual
    duty
    did
    not
    create
    an
    independent
    fiduciary
    duty
    of
    disclosure
    to
    the
    stockholders.

The
appellees
(stockholders)
were
the
bigger
winners,
as
they
secured
the
damages
award
and
the
ruling
on
the
breach
of
fiduciary
duty.
The
appellants
(CEO
and
acquiror)
managed
to
secure
partial
reversals,
particularly
on
the
aiding
and
abetting
claims.


Decision
Link


Court
:
N.D.
Ohio,


Decision
Date
:
November
26,
2024


Opinion
Author
:
Judge
Pamela
Barker


Areas
of
Law
 {contract
law,
employment,
liability,
accommodations,
precedent,
religion,
labor,
evidence}


Opinion
Word
Count
:
21,711


Amicus
Briefs
:
0


What
it’s
about
:
This
case
centers
around
an
employee,
Bobnar
who
worked
AstraZeneca,
a
pharmaceutical
company,
and
requested
religious
exemptions
from
the
company’s
COVID-19
vaccine
mandate.
Bobnar
requested
a
religious
accommodation
to
avoid
the
COVID-19
vaccine,
citing
his
religious
beliefs
about
bodily
integrity.
However,
his
request
was
denied,
and
he
was
eventually
terminated
by
AstraZeneca.

Bobnar
also
applied
for
paternity
leave
under
the
Family
and
Medical
Leave
Act
(FMLA),
which
was
granted.
However,
he
faced
issues
during
his
leave,
including
being
contacted
by
coworkers
for
work-related
matters
and
feeling
pressured
to
continue
business
activities
while
on
leave.
He
considered
these
communications
harassment.
Bobnar
was
also
part
of
a
sales
incentive
program
and
was
expecting
a
bonus,
but
his
termination
affected
his
eligibility
to
receive
the
bonus.

The
legal
issues
in
the
case
revolve
around
whether
AstraZeneca
appropriately
handled
the
religious
accommodation
requests
and
whether
Bobnar’s
termination
was
justified,
particularly
in
relation
to
his
leave
and
bonus
eligibility.
The
case
also
touches
on
the
legality
of
AstraZeneca’s
actions
under
employment
law,
including
how
they
managed
the
accommodation
requests,
leave,
and
incentive
pay.


Decision
Parts
:


  1. Title
    VII
    Religious
    Discrimination/Failure
    to
    Accommodate
    (Count
    One)
    :
    The
    Court
    found
    that
    AstraZeneca
    discriminated
    against
    Bobnar
    by
    denying
    his
    request
    for
    a
    religious
    accommodation
    related
    to
    a
    vaccine
    mandate.
    The
    Court
    ruled
    that
    Bobnar’s
    termination
    was
    discriminatory
    and
    granted
    summary
    judgment
    in
    Bobnar’s
    favor
    on
    this
    count.

  2. FMLA
    Interference
    and
    Retaliation
    (Count
    Four)
    :
    The
    Court
    found
    that
    AstraZeneca
    did
    not
    interfere
    with
    Bobnar’s
    FMLA
    leave,
    as
    he
    voluntarily
    performed
    some
    work
    during
    his
    leave.
    The
    Court
    also
    ruled
    that
    there
    was
    no
    retaliation
    for
    taking
    FMLA
    leave,
    granting
    summary
    judgment
    in
    favor
    of
    AstraZeneca
    on
    this
    claim.

  3. Breach
    of
    Contract
    (Count
    Five)
    :
    The
    Court
    ruled
    that
    AstraZeneca
    wrongfully
    denied
    Bobnar
    his
    earned
    bonus
    for
    Q1
    2022,
    as
    his
    termination
    was
    unlawful.
    The
    Court
    granted
    summary
    judgment
    in
    Bobnar’s
    favor
    on
    the
    breach
    of
    contract
    claim,
    stating
    that
    AstraZeneca
    was
    required
    to
    pay
    him
    the
    bonus.

  4. Violation
    of
    Ohio’s
    Prompt
    Pay
    Act
    (OPPA)
    (Count
    Six)
    :
    AstraZeneca’s
    motion
    for
    summary
    judgment
    was
    granted
    on
    this
    claim
    because
    there
    was
    a
    dispute
    over
    whether
    Bobnar
    was
    entitled
    to
    the
    bonus,
    and
    the
    OPPA
    does
    not
    apply
    where
    a
    dispute
    exists
    regarding
    the
    payment
    of
    wages.


Why
was
Bobnar
the
bigger
winner?


  • Key
    Wins
    :
    Bobnar
    succeeded
    on
    the
    two
    claims
    that
    were
    central
    to
    his
    legal
    battle—religious
    discrimination
    under
    Title
    VII
    and
    the
    breach
    of
    contract
    regarding
    the
    unpaid
    bonus.

  • Damages
    and
    Compensation
    :
    The
    breach
    of
    contract
    ruling,
    in
    particular,
    could
    result
    in
    Bobnar
    receiving
    the
    bonus
    he
    earned,
    which
    is
    a
    significant
    financial
    win.

  • Religious
    Discrimination
    :
    The
    courts
    ruling
    on
    the
    Title
    VII
    claim
    implies
    that
    AstraZeneca
    could
    face
    significant
    legal
    and
    financial
    repercussions
    for
    discriminating
    against
    Bobnar
    based
    on
    his
    religious
    beliefs.
  • In
    contrast,
    the
    claims
    that
    AstraZeneca
    successfully
    defended
    against
    (retaliation
    under
    Title
    VII,
    FMLA
    claims,
    and
    OPPA
    violation)
    were
    either
    appear
    less
    financially
    impactful
    in
    comparison
    to
    the
    two
    claims
    Bobnar
    won.


Decision
Link


Court
:
Appellate
Court
of
Illinois,
Second
District


Areas
of
Law
 {insurance,
commerce,
education,
liability,
fraud}


Majority
:
Justice
Mullen; Dissent:
Justice
McLaren


Majority
word
count
:
10,953; Dissent
word
count
:
698


Amicus
brief
:
1


What
it’s
about
:
This
case
centers
on
a
claim
brought
by
plaintiff
Calley
Fausett
against
Walgreen
Company
(doing
business
as
Walgreens),
alleging
that
Walgreens
violated
the
Fair
and
Accurate
Credit
Transactions
Act
of
2003
(FACTA).
Specifically,
the
plaintiff
claims
that
Walgreens
printed
more
than
the
last
five
digits
of
debit
card
numbers
on
receipts
provided
to
customers,
which
is
prohibited
under
section
1681c(g)(1)
of
FACTA.


Positions
of
the
Parties
:


  • Plaintiff
     (Calley
    Fausett):
    Fausett
    argued
    that
    Walgreens
    willfully
    violated
    FACTA
    by
    printing
    too
    many
    digits
    of
    her
    debit
    card
    number
    on
    receipts,
    which
    exposed
    her
    to
    an
    increased
    risk
    of
    identity
    theft.
    She
    asserts
    that
    this
    violation
    is
    sufficient
    to
    bring
    a
    claim,
    even
    though
    she
    did
    not
    suffer
    any
    actual
    injury
    or
    financial
    loss.
    Fausett
    sought
    statutory
    damages,
    punitive
    damages,
    and
    attorneys
    fees,
    and
    moved
    for
    class
    certification
    to
    represent
    others
    affected
    by
    the
    same
    issue.

  • Defendant
     (Walgreens):
    Walgreens
    contended
    that
    the
    claim
    was
    not
    actionable
    because
    Fausett
    had
    not
    demonstrated
    any
    actual
    injury.
    They
    argued
    that
    revealing
    part
    of
    a
    debit
    card
    number
    did
    not
    pose
    a
    significant
    risk
    of
    harm,
    and
    thus
    Fausett
    lacked
    standing
    to
    sue
    under
    Illinois
    law.
    Walgreens
    also
    challenged
    the
    appropriateness
    of
    class
    certification,
    asserting
    that
    the
    violation
    did
    not
    support
    class-wide
    claims.


Legal
Background
:


  • FACTAs
    Truncation
    Requirement
    :
    The
    law
    prohibits
    businesses
    from
    printing
    more
    than
    the
    last
    five
    digits
    of
    a
    debit
    or
    credit
    card
    number
    on
    receipts
    to
    protect
    consumers
    from
    identity
    theft.

  • Standing
    :
    Walgreens
    argued
    that,
    under
    federal
    law,
    a
    plaintiff
    must
    show
    concrete
    harm
    to
    have
    standing.
    However,
    Illinois
    courts
    had
    taken
    a
    more
    liberal
    approach
    to
    standing,
    allowing
    claims
    for
    statutory
    violations
    even
    in
    the
    absence
    of
    actual
    injury.


Court’s
Decision
:
The
court
ruled
in
favor
of
the
plaintiff,
affirming
the
decision
of
the
circuit
court
to
grant
class
certification.
The
court
concluded
that
the
plaintiff
had
standing
to
bring
a
claim
under
FACTA
in
Illinois
state
court.
The
court
rejected
the
defendants
argument
that
the
plaintiff
lacked
standing
due
to
the
absence
of
an
actual
injury,
stating
that
under
Illinois
law,
a
violation
of
statutory
rights,
such
as
a
willful
violation
of
FACTA,
is
sufficient
to
confer
standing.
This
conclusion
was
consistent
with
Illinois
approach
to
standing,
which
does
not
require
proof
of
concrete
harm
or
injury
in
fact.
The
court
emphasized
that
it
was
not
addressing
the
ultimate
success
of
the
plaintiffs
claim,
only
the
issue
of
standing
and
the
propriety
of
granting
class
certification.


Dissent
:
Judge
McLaren
disagreed
with
the
majority’s
decision
to
approve
the
class
certification
(the
ability
of
the
plaintiff
to
represent
a
group
of
people
in
the
lawsuit)
at
this
stage.
The
dissent
argued
that
the
majority
made
an
incomplete
and
speculative
decision
by
addressing
only
one
issue—whether
the
plaintiff
has
standing
to
bring
the
case—while
ignoring
other
important
legal
questions,
such
as
whether
the
plaintiffs
claim
is
valid
or
whether
certain
legal
defenses
apply.
The
dissent
also
criticized
the
majority
for
affirming
the
class
certification
without
fully
reviewing
all
the
necessary
details,
which
the
dissent
believed
should
have
been
handled
by
the
trial
court
before
deciding
on
the
class.
Essentially,
the
dissent
argued
the
majority
was
making
a
premature
decision
without
enough
information
and
should
have
sent
the
case
back
for
further
review
instead
of
addressing
the
class
certification.



Read
more
from
Legalytics
here….




Adam
Feldman
runs
the
litigation
consulting
company
Optimized
Legal
Solutions
LLC.
Check
out
more
of
his
writing
at

Legalytics

and

Empirical
SCOTUS
.
For
more
information,
write
Adam
at [email protected]
Find
him
on
Twitter: @AdamSFeldman.

Start With ‘Yes, If’: How I Help Teams Innovate Without Fear – Above the Law

“No.”
It’s
the
word
that
strikes
dread
into
product
teams
when
they
hear
it
from
legal
counsel.
It
signals
roadblocks,
delays,
and
shelved
ideas.
Early
in
my
career,
I
saw
this
play
out
again
and
again.
Saying
“no”
felt
like
the
safest
choice,
but
it
often
killed
momentum

and
trust.

Then
I
started
shifting
my
approach.
Instead
of
leading
with
“No,
we
can’t,”
I
began
framing
my
feedback
as
“Yes,
if
we
…”
This
subtle
change
unlocked
collaboration
and
innovation
while
still
keeping
the
company
on
solid
legal
ground.
Here’s
how
this
mindset
has
transformed
how
I
work
with
product
teams

and
how
it
can
work
for
you.


Understand
The
‘Why’
Before
You
Respond

Before
shutting
down
an
idea,
ask
why
it’s
on
the
table
in
the
first
place.
What
problem
is
the
team
solving?
What’s
the
goal
behind
the
feature
or
campaign?

Once,
a
team
wanted
to
scrape
publicly
available
data
for
an
AI
project.
Instead
of
saying,
“That’s
too
risky,”
I
asked,
“What’s
the
outcome
we’re
trying
to
achieve?”
Together,
we
explored
alternatives
like
licensing
agreements
or
using
open
datasets.
The
team
still
hit
their
goal,
but
without
the
legal
headaches.

The
takeaway?
Understanding
the
“why”
shifts
the
conversation
from
risk
avoidance
to
goal
achievement.


Frame
Risks
As
Design
Challenges

Every
risk
is
also
a
design
opportunity.
Legal
boundaries,
when
approached
creatively,
can
lead
to
smarter,
more
innovative
solutions.

For
example,
when
a
rewards
program
risked
violating
state
lottery
laws,
I
didn’t
say
no
outright.
Instead,
I
suggested
tweaks
to
the
structure

like
skill-based
competitions

that
met
legal
exceptions.
The
final
program
was
not
only
compliant
but
also
more
engaging
for
users.

What
I’ve
learned
is
simple:
legal
constraints
don’t
have
to
stifle
creativity.
They
can
inspire
it.


Always
Offer
A
Path
Forward

Teams
need
solutions,
not
just
red
flags.
If
you
spot
a
problem,
pair
it
with
a
way
to
move
forward.

For
instance,
a
startup
team
wanted
to
use
customer
testimonials
in
ads.
Saying
“That’s
risky

it
could
be
misleading”
would
have
shut
the
idea
down.
Instead,
I
said,
“Yes,
if
we
verify
the
claims
and
include
disclaimers
to
meet
advertising
laws.”
The
team
got
their
campaign,
and
the
company
stayed
compliant.

A
“Yes,
if
we
…”
approach
builds
momentum
instead
of
stopping
it
cold.


Weigh
The
Risk
Versus
The
Reward

Not
every
risk
is
worth
taking,
but
not
every
risk
is
a
deal-breaker,
either.
Legal
counsel
adds
value
by
helping
teams
evaluate
which
risks
are
worth
it.

When
a
team
wanted
to
launch
a
feature
that
might
invite
regulatory
scrutiny,
I
didn’t
veto
it
outright.
Instead,
we
analyzed
the
potential
rewards

customer
loyalty
and
competitive
advantage

and
paired
them
with
a
mitigation
plan.
The
result?
A
bold
move
that
paid
off.

Balancing
risk
and
reward
is
key
to
helping
teams
innovate
responsibly.


Break
Big
Risks
Into
Small
Steps

When
a
project
feels
overwhelming,
propose
incremental
progress
instead
of
an
all-or-nothing
approach.

For
example,
a
team
launching
a
complex
subscription
model
faced
tricky
tax
regulations.
Instead
of
delaying
the
entire
rollout,
I
suggested
starting
with
simpler
regions
to
test
and
adapt.
Breaking
it
into
smaller
steps
minimized
risk
and
kept
the
momentum
going.

Small
wins
build
confidence

and
trust.


Be
A
Partner,
Not
A
Referee

The
earlier
legal
is
involved,
the
better
the
outcomes.
By
joining
brainstorms
or
design
sessions
early,
you
can
shape
ideas
into
legally
viable
solutions
before
they
become
problems.

When
I
sat
down
with
engineers
to
co-design
a
compliance-heavy
feature,
we
avoided
costly
rewrites
later.
Similarly,
being
part
of
marketing
discussions
helped
guide
bold
campaigns
while
keeping
them
safe
from
legal
pitfalls.

Collaboration
is
how
you
turn
legal
from
a
roadblock
into
a
trusted
ally.


Celebrate
Wins

When
your
guidance
leads
to
a
success,
make
sure
to
celebrate
it.
This
reinforces
your
value
as
a
partner
and
builds
trust
for
future
collaboration.

For
example,
when
our
privacy-first
data
strategy
became
a
customer
favorite,
I
made
sure
the
team
recognized
how
legal
had
contributed.
Wins
like
these
make
teams
eager
to
involve
legal
in
their
next
big
idea.


The
Bottom
Line

Starting
with
“Yes,
if
…”
isn’t
about
ignoring
risks.
It’s
about
showing
your
team
that
you’re
invested
in
making
their
ideas
work.
By
focusing
on
solutions
and
being
a
partner
in
the
process,
you
can
help
teams
innovate
with
confidence

and
without
losing
sleep.

For
more
strategies
on
how
to
balance
innovation
and
risk
as
a
product
lawyer,
check
out
my
book,
Product
Counsel:
Advise,
Innovate,
and
Inspire
.”
It’s
filled
with
practical
insights
and
real-world
examples
to
help
you
lead
with
solutions
and
become
a
trusted
partner
to
your
teams.

Have
you
tried
a
“Yes,
if
we
…”
approach?
I’d
love
to
hear
your
experiences

let’s
keep
the
conversation
going.




Olga MackOlga
V.
Mack



is
a
Fellow
at
CodeX,
The
Stanford
Center
for
Legal
Informatics,
and
a
Generative
AI
Editor
at
law.MIT.
Olga
embraces
legal
innovation
and
had
dedicated
her
career
to
improving
and
shaping
the
future
of
law.
She
is
convinced
that
the
legal
profession
will
emerge
even
stronger,
more
resilient,
and
more
inclusive
than
before
by
embracing
technology.
Olga
is
also
an
award-winning
general
counsel,
operations
professional,
startup
advisor,
public
speaker,
adjunct
professor,
and
entrepreneur.
She
authored 
Get
on
Board:
Earning
Your
Ticket
to
a
Corporate
Board
Seat
Fundamentals
of
Smart
Contract
Security
,
and




Blockchain
Value:
Transforming
Business
Models,
Society,
and
Communities
. She
is
working
on
three
books:



Visual
IQ
for
Lawyers
(ABA
2024), The
Rise
of
Product
Lawyers:
An
Analytical
Framework
to
Systematically
Advise
Your
Clients
Throughout
the
Product
Lifecycle
(Globe
Law
and
Business
2024),
and
Legal
Operations
in
the
Age
of
AI
and
Data
(Globe
Law
and
Business
2024).
You
can
follow
Olga
on




LinkedIn



and
Twitter
@olgavmack.

Top 50 Biglaw Firm Offers Bonuses Up To 130% Above Market For Its Highest Billers – Above the Law

As
they
are
wont
to
do,
Biglaw
firms
have
matched
the
prevailing
market

year-end
 and special
bonus
rates
that
were
first
set
by
Milbank
in
November,
but
some
Biglaw
firms
are
eager
to
go
above
and
beyond
to
financially
compensate
associates
who
have
truly
dedicated
themselves
to
their
work
by
putting
in
a
tremendous
number
of
billable
hours.

Dechert

a
firm
that
brought
in
$1,293,528,000
in
gross
revenue
in
2023,
putting
it
at
No.
39
on
the
Am
Law
100

is
one
of
those
firms.

The
firm

announced
its
Milbank
match

in
November,
including
its
usual
“extraordinary”
bonuses
for
associates
who
hit
2,200
and
2,400
billable
hours,
awarding
them
with
30%
and
40%
above-market
bonuses,
respectively.
But
that’s
not
all
the
firm
is
doing….

Sources
tell
us
that
on
Christmas
Eve,
Mark
E.
Thierfelder
and
David
W.
Forti,
the
firm’s
co-chairs,
sent
out
a
firmwide
memo
thanking
everyone
for
their
had
work
in
2024,
and
letting
attorneys
know
that
Dechert
would
be
offering
additional
“enhanced”
bonuses
to
its
hardest
workers.
Here’s
an
excerpt
from
that
memo:

This
year,
in
addition
to
our
usual
30%
and
40%
above
market
bonuses,
we
have
enhanced
bonuses
up
to
130%
above
the
market
to
thank
those
who
went
well
beyond
our
normal
hours
grid.
For
associates
in
EMEA
who
met
the
U.S.
bonus
targets,
their
bonus
amounts
will
be
commensurate
with
the
U.S.
scale.
This
is
not
setting
a
new
hours
expectation,
but
we
recognize
the
incredible
personal
sacrifices
that
some
of
our
lawyers
have
made
to
deliver
truly
outstanding
client
service.

Wow!
Now
that’s
a
big
bonus!
These
extra-extraordinary
bonuses
will
be
paid
out
by
the
end
of
January.
Congratulations
to
everyone
at
Dechert!


(Flip
to
the
next
page
to
see
the
full
memo.)

Remember
everyone,
we
depend
on
your
tips
to
stay
on
top
of
compensation
updates,
so
when
your
firm
announces
or
matches,
please
text
us
(646-820-8477)
or email
us
 (subject
line:
“[Firm
Name]
Bonus/Matches”).
Please
include
the
memo
if
available.
You
can
take
a
photo
of
the
memo
and
send
it
via
text
or
email
if
you
don’t
want
to
forward
the
original
PDF
or
Word
file.

And
if
you’d
like
to
sign
up
for
ATL’s
Bonus
Alerts
(which
is
the
alert
list
we
also
use
for
salary
announcements),
please
scroll
down
and
enter
your
email
address
in
the
box
below
this
post.
If
you
previously
signed
up
for
the
bonus
alerts,
you
don’t
need
to
do
anything.
You’ll
receive
an
email
notification
within
minutes
of
each
bonus
announcement
that
we
publish.
Thanks
for
your
help!



Staci ZaretskyStaci
Zaretsky
 is
a
senior
editor
at
Above
the
Law,
where
she’s
worked
since
2011.
She’d
love
to
hear
from
you,
so
please
feel
free
to

email

her
with
any
tips,
questions,
comments,
or
critiques.
You
can
follow
her
on BlueskyX/Twitter,
and Threads, or
connect
with
her
on LinkedIn.


Bonus Time

Enter
your
email
address
to
sign
up
for
ATL’s

Bonus
&
Salary
Increase
Alerts
.


CES 2025: Insights For Legal From The World’s Biggest Consumer Electronics Show  – Above the Law

The
Las
Vegas
Convention
Center
during
CES
last
January.
(Photo
by
FREDERIC
J.
BROWN/AFP
via
Getty
Images)



“We
bring
you
the
circus,
pied
piper
whose
magic
tunes
greet
children
of
all
ages,
from
6
to
70,
into
a
tinsel
and
spun-candy
world
of
reckless
beauty
and
mounting
laughter
and
whirling
thrills;
of
rhythm,
excitement
and
grace;
of
blaring
and
daring
and
dance;
of
high-stepping
horses
and
high-flying
stars…It’s
a
fierce,
primitive
fighting
force
that
smashes
relentlessly
forward
against
impossible
odds.
That
is
the
circus.”




Narrator
colloquy
at
the
beginning
of



“The
Greatest
Show
on
Earth”


Ahh,
January.
The
holidays
are
over.
It’s
back
to
reality.


But
in
Las
Vegas
the
first
week
of
January
is
all
about
the
possibilities
and
promises
of
consumer
technology
as
the
annual
gigantic
consumer
electronics
show,



CES
 (sponsored
by
the



Consumer
Technology
Association
),
kicks
off.


Just
as
in
the
past
six
years,
I’ll
be
there.
Just
like
last
year.
I
will
be
covering
the
show
from
a
legal
tech
and
innovation
viewpoint
for



Above
the
Law


The
Greatest
Show
on
Earth


To
call
CES
a
“show”
is
a
bit
of
an
understatement.


As
I
have



said
before
,

it’s
a
massive
conga
line
stretching
from
the
Convention
Center
at
the
north
end
of
the
Strip
to
Mandalay
Bay
at
the
south
end.
It’s
part
computer
science,
part
giant
party,
part
marketing
and
part
schmaltz.


The
spectacle
begins
on
January
5,
with
a
day
and
a
half
of
media
days,
and
then
goes
full
tilt
for
five
days. 


Consider
the
numbers
(according
to



CES
): 


  • Over
    138,000
    attendees,
    60%
    of
    whom
    hold
    jobs
    at
    senior
    positions
    in
    their
    organizations. 

  • Representatives
    of
    309
    Fortune
    500
    companies
    from
    some
    160
    countries.

  • Over
    4312
    exhibitors 

  • 1442
    start-up
    exhibitors
    housed
    in
    the
    basement
    of
    the
    Venetian
    Expo
    convention
    center
    called



    Eureka
    Park
    ,
    where
    you
    find
    people
    pursuing
    their
    passions
    and
    dreams. 

  • Keynote
    addresses
    from
    the
    CEOs
    of
    companies
    such
    as
    Waymo,
    Nvidia,
    Panasonic,
    Volvo,
    Accenture,
    Sirius,
    and
    Delta
    (in
    the
    Sphere,
    followed
    by
    a
    concert
    by
    none
    other
    than



    Lenny
    Kravitz
    ). 

  • Over
    1000
    speakers
    across
    250
    educational
    sessions
    from
    thought
    leaders
    from
    companies
    like
    Meta,
    Vogue,
    Netflix,
    Mitsubishi,
    and
    Mastercard,
    to
    name
    a
    few.


Those
of
us
in
legal
tend
to
think
of
large
conferences
in
terms
of
those
put
on
by
Clio,
ILTA,
LegalWeek,
or
even
TechShow
(of
which
I
am
the
current
co-chair).
But
CES
is
in
an
entirely
different
league
altogether.


To
paraphrase
the
sportswriter



Irvin
Cobb



Until
You
Go
To
CES
With
Your
Own
Eyes,
Behold
CES,
You
Ain’t
Never
Been
Nowhere,
And
You
Ain’t
Seen
Nothin.


CES
2025



Kinsey
Fabrisio
,
the
Consumer
Technology
Association
current
president,
and



John
Kelley
,
the
2025
show
director,
recently
emphasized
in
their
pre-show
presser
that
this
year’s
show
will
focus
on
things
like
how
quantum
computing
will
transform
business,
advances
in
consumer
wearables,
beauty
and
fashion
products,
food
tech,
fitness
and
longevity,
gaming,
and
health
care
and
mobility
tools.


And,
of
course,
the
show
will
focus
heavily
on
machine
learning
and
Gen
AI
and
how
these
tools
will
change
every
profession. 


Among
the
top
10
things
to
look
for
this
year,
according
to



CES


promotional
materials,
are
a
Health
Summit,
new
Innovation
Awards,
vehicle
and
space
tech,
a
“Shark
Tank”
open
call,
and,
last
but
not
least,
an
Indy
car
race
with
full
size
autonomous
vehicles.


Among
the



top
10
products


not
to
miss:
foldable
TVs,
new
HDMIs,
perhaps
laptops
with
wall
displace
capability,
new
vacuum
robots,
smart
home
robots
and
flying
cars.


Other
notables



touted
by
CES


:
how
AI
agents
will
take
over
more
and
more
things
us
humans
now
do
(better,
cheaper,
faster),
as
I



wrote
about


after
attending
the



Summit
AI
New
York


a
few
weeks
ago,
hologram
display
products,
and
cute
“affectionate
Intelligence”
robots.


C
omputing
with
keyboard-less
input.
Glasses
that
display
data
as
you
view
objects
around
you.
Voices
that
talk
the
info
you
request
into
your
earbuds
or
smartphone
on
demand.
Autonomous
vehicles
or
drones
delivering
you
and/or
goods.


All
this
and
more.


What’s
a
Lawyer
Doing
Here?


What
does
all
this
have
you
do
with
legal?
Why
attend
and
write
about
a
Show
directed
toward
consumer
products,
not
products
for
lawyers
and
legal
professionals?
As
I
have



written
before
,
there
are
two
main
reasons:
the
first
is
attitudinal,
and
the
second
is
practical.


It’s
the
‘Tude,
Man


First,
the
attitude.
The
people
and
exhibitors
at
CES
look
at
the
world
and
ask
questions
differently
than
most
lawyers.
They
look
for
ideas
that
could,
might,
or
even
possibly
work
to
address
consumer
pain
points.
Legal
spends
its
time
looking
for
ways
something
won’t
work.
CES
is
the
party
of
yes,
Legal
is
often
the
party
of
no. 


The
people
who
attend
CES
are
motivated
and
rewarded
for
finding
ways
of
doing
things
that
make
what
consumers
do
better,
cheaper,
and
faster.
Legal,
on
the
other
hand,
in
large
part
poo
poos
better,
cheaper,
and
faster,
especially
if
the
better,
cheaper,
faster
could
impact
billable
hours. 


CES
is
a
different
and
refreshing
perspective.
Different
viewpoints
and
perspectives
lead
to
different
approaches
that
could
someday
be
applied
to
law.
But
for
that
to
happen
you
have
to
be
exposed
to
different
perspectives. 


Crossover
Potential


I
have
found
that
CES
has
historically
introduced
tech
that,
in
different
forms,
later
crosses
over
in
one
form
or
the
other
into
legal.
(As
far
back
as
2020,
CES
speakers
were
saying
that
AI
would
permeate
every
facet
of
our
commerce
and
culture.)


Like
everyone
else,
lawyers
are
consumers.
And
when
they
use
consumer
products,
they
look
for
products
that
work,
are
easy
to
use,
and
solve
actual
pain
points.
Inevitably,
those
consumer
products
and
their
uses
will
spill
over
into
legal.
Lawyers
gradually
begin
to
expect
and
demand
products
that
help
them
in
the
same
way
as
the
consumer
products
they
use
in
everyday
(real?)
life.


So,
it’s
important
to
see
what
products
and
trends
in
the
consumer
domain
could
have
implications
for
the
legal
profession.
Understanding
the
relevance
of
these
products
and
trends
is
crucial
for
anticipating
future
challenges
and
opportunities
in
legal. 


The
prime
example:
the
iPhone.
When
it
was
introduced,
most
legal
and
business
people
dismissed
the
iPhone
as
having
no
work-related
significance.
The
common
belief
was
it
would
never
replace
the
BlackBerry.
Yet
the
iPhone
and
similar
smartphones,
ultimately
completely
transformed
how
lawyers
and
legal
professionals
work.


I
have
learned
over
seven
years,
amidst
all
CES
spectacle
are
stories
that
could
affect
legal.
Last
year,
for
example,
I
wrote
about
such
things
as
the



best
use
and
practices


for
AI
that
might
work
for
legal,
how
consumer
electronics
could



impact
client
attrition
and
expectations
,
and
how
the



metaverse
could
be
used


to
train
lawyers.
I
also
wrote
about
a



gallery
of
flops


that
an
exhibitor
identified
and
how
legal
could
take
a
lesson
from
those
flops. 


All
insights
and
perspectives
different
from
what
I
might
have
obtained
by
sticking
with
legal
tech
conferences.
Legal
tech
conferences
all
too
often
turn
into
a
bunch
of
us
sitting
in
a
closet
talking
to
ourselves
too
much,
as
one
of
my
clients
used
to
say.


Stay
Tuned


CES
is
a
blend
of
computer
science,
marketing,
and
pure
revelry
that
turns
Las
Vegas
into
a
giant,
interconnected
stage
for
innovation.
As
I
attend
CES
for
the
seventh
time,
I
hope
to
bring
you
some
insights
and
stories
about
the
experience
and
what
I
discover
and
what’s
relevant
and
important
to
legal.



“And
now
let
us
welcome
the
new
year,
full
of
things
that
have
never
been.”






Rainer
Maria
Rilke




Stephen
Embry
is
a
lawyer,
speaker,
blogger
and
writer.
He
publishes TechLaw
Crossroads
,
a
blog
devoted
to
the
examination
of
the
tension
between
technology,
the
law,
and
the
practice
of
law.

The High Stakes of ACA Subsidies: What’s at Risk for Hospitals and Patients – MedCity News

The
Affordable
Care
Act’s
enhanced
tax
credits

which
were
introduced
during
the
pandemic
to
expand
healthcare
affordability
during
a
time
of
widespread
unemployment

are
at
risk
of
expiration
at
the
end
of
this
year
if
Congress
doesn’t
extend
them.
For
many
Americans,
these
expanded
subsidies
have
meant
the
difference
between
affording
routine
care
for
themselves
and
their
loved
ones
and
skipping
these
visits
entirely. 

But
it’s
not
simply
a
matter
of
affordability
and
access.
This
looming
policy
change
could
also
create
significant
challenges
for
hospitals
already
battling
financial
pressures.

Healthcare
leaders
have
a
number
of
concerns
about
what
could
happen
if
Congress
does
not
renew
the
ACA’s
expanded
tax
credits.
Premiums
could
increase,
a
larger
share
of
Americans
could
become
uninsured,
hospitals
could
be
forced
into
more
bad
debt
and
uncompensated
care,
and
most
worrisome,
American
public
health
would
deteriorate.

Still,
the
hefty
price
tag
of
the
ACA’s
enhanced
tax
subsidies
makes
it
seem
unlikely
that
they
will
be
renewed
by
a
Republican-led
Congress

in
fact,
a
bipartisan
bill
that

was
passed

in
December
to
prevent
a
shutdown
before
Christmas
didn’t
include
it.
An
expert
interviewed
for
this
article
noted
that
these
subsidies
were
established
to
provide
support
during
a
public
health
emergency
that
has
now
expired

and
they
cost
taxpayers

$91
billion

last
year.


What
have
enhanced
tax
credits
meant
for
healthcare
utilization?

When
the
ACA
health
insurance
marketplaces
launched
in
2014,
tax
credits
went
into
effect
to
make
coverage
more
affordable
for
individuals
and
families.
These
tax
credits

which
are
based
on
ACA
shoppers’
income
and
household
size

were
later
expanded
temporarily
under
the
American
Rescue
Plan
Act
in
2021
and
extended
through
the
Inflation
Reduction
Act
in
2022.
This
came
in
the
form
of
larger
subsidies
and
broader
eligibility
criteria​.

When
the
marketplaces
were
first
established,
the
government

provided
subsidies

to
people
earning
100-400%
of
the
federal
poverty
level,
and
individual
premium
contributions
ranged
from
2.07-9.83%
of
their
income. 

The
American
Rescue
Plan
Act
and
its
extension
under
the
Inflation
Reduction
Act

boosted

these
subsidies
by
lowering
premium
contributions
to
0-8.5%
of
income
and
approved
$0
premiums
for
people
earning
100–150%
of
the
federal
poverty
level.
The
changes
introduced
during
the
pandemic
also
allowed
Americans
earning
above
400%
of
the
federal
poverty
level
to
qualify
for
subsidies
if
premiums
exceeded
8.5%
of
their
income. 

Char
MacDonald,
executive
vice
president
of
public
affairs
at
the

Federation
of
American
Hospitals
,
noted
that
these
credits
have
played
a
key
role
in
reducing
the
country’s
uninsured
rate.
Last
year,
the
national
uninsured
rate

reached
an
all-time
low

of
7.9%.

“What
these
tax
credits
have
done
is
make
sure
that
people
have
coverage
for
all
the
services
they
need

not
just
coming
into
the
emergency
room,
but
also
that
they
continue
with
care
that
they
need
for
their
chronic
condition,
for
oncology
care,
for
primary
care.
That’s
where
it’s
really
critical

with
the
patients
that
we’re
seeing,
the
hospital
is
not
the
first
stop,
it’s
not
the
first
entry
into
the
healthcare
system,”
she
explained.

Expanded
subsidies
reduce
patients’
out-of-pocket
costs,
which
makes
them
more
likely
to
do
things
like
book
check-ups
and
preventive
care
appointments,
MacDonald
noted.

Jolene
Calla,
vice
president
of
finance
and
legal
affairs
at

HAP:
The
Hospital
and
Healthsystem
Association
of
Pennsylvania
,
agreed
that
enhanced
ACA
tax
credits
are
a
major
factor
leading
patients
to
seek
preventive
care.

“We
have
seen
people
coming
to
the
hospital
more
because
they
have
coverage,
and
that
is
a
good
thing.
When
I
say
coming
to
the
hospital,
I
mean
for
things
like
preventive
care
services,
access
to
prescription
drugs,
and
getting
early
diagnosis
and
treatment
for
some
of
the
chronic
conditions
that
become
the
most
expensive
when
people
show
up
in
the
ED,”
Calla
remarked.

When
people
don’t
have
affordable
health
insurance,
they
tend
to
delay
care,
skip
primary
care
visits
and
forego
screenings,
she
pointed
out.
This
often
means
that
their
conditions
progress
into
a
less
manageable
state,
resulting
in
more
expensive
and
acute
care
episodes
down
the
road.


Why
tax
credits
“make
good
financial
sense”
for
hospitals

In
Calla’s
view,
ensuring
that
Americans
have
access
to
affordable
healthcare
coverage
“makes
good
financial
sense.”

When
people
have
coverage,
they
are
much
more
likely
to
make
check-up
appointments
to
maintain
their
health
and
visit
an
urgent
care
site
rather
than
a
high-cost
emergency
department,
she
explained. 

“Just
because
you
don’t
have
coverage,
that
doesn’t
mean
you
don’t
get
sick.
These
patients
are
still
going
to
the
hospital,
and
there
is
a
cost
to
that.
That
means
the
hospital
is
going
to
end
up
paying
for
at
least
part
of
that
uncompensated
care

and
that
puts
financial
strain
on
the
hospital
because
they
might
get
some
of
that
back,
but
they’re
generally
not
getting
it
all
back,
so
they
have
to
absorb
that,”
Calla
declared. 

That
means
hospitals
then
have
to
make
tough
decisions,
like
hiring
less
nurses
or
forgoing
new
equipment
they
may
need
to
better
serve
their
patients,
she
remarked.

She
said
that
ACA
tax
credits

along
with
individual
states
expanding
Medicaid
coverage

have
led
to
lower
rates
of
uncompensated
care
at
hospitals.
Last
year,
Pennsylvania’s
uncompensated
care
rate

dropped
to
1.39%
,
Calla
noted.

“But
still,
even
at
that
percent,
that
is
$774
million
that
hospitals
are
not
getting,”
she
stated.
“Coverage
is
a
really
big
deal
for
hospitals,
and
with
the
loss
of
the
[tax
credits],
we
expect
that
the
number
of
insured
patients
is
going
to
rise
dramatically,
and
that’s
going
to
have
a
ripple
effect
on
costs
for
hospitals
and
the
amount
they’re
losing.” 

She
noted
that

more
than
half

of
Pennsylvania
hospitals
had
negative
operating
margins
in
2023.

“It’s
really
bad
timing
for
a
really
bad
development
for
Pennsylvania
patients
and
hospitals,
if
those
[tax
credits]
were
to
go
away,”
Calla
said.


How
many
people
will
lose
coverage
if
enhanced
tax
credits
are
not
renewed?

Another
healthcare
leader
in
Pennsylvania

Devon
Trolley,
executive
director
of

Pennie
,
the
state’s
official
health
insurance
marketplace

noted
that
her
organization
has
seen
a
50%
increase
in
enrollment
since
the
ACA’s
expanded
subsidies
were
introduced.

This
is
because
coverage
is
now
more
affordable
for
a
wide
variety
of
people

such
as
those
with
low
and
moderate
incomes,
self-employed
people,
short-term
contract
workers,
individuals
who
have
recently
lost
their
jobs.

“There’s
a
more
affordable
bridge
from
Medicaid
to
the
private
health
plans
through
the
marketplace.
There’s
also
more
options
for
people
who
are
above
400%
of
the
federal
poverty
level.
Before
this,
they
had
no
tax
credits.
When
they
say
400%
you
may
think
that’s
a
lot
of
money,
but
that’s
$60,000
per
year
for
a
single
person,
so
it’s
not
as
big
as
it
sounds.
This
is
for
people
who
really
find
full
price
coverage
to
be
very
challenging
to
afford,”
Trolley
said.

If
Congress
fails
to
renew
enhanced
ACA
subsidies,
“every
single
enrollee
through
Pennie”

which
is
more
than
435,000
people

would
be
affected,
she
declared.

On
average,
premiums
would
rise
by
81%,
Trolley
remarked.

“It
would
double,
sometimes
even
quadruple,
what
they
are
paying
for
health
coverage
right
now,”
she
said.  

Trolley
said
her
main
concern
about
the
subsidies’
potential
expiration
is
that
this
would
force
thousands
of
families
in
her
state
to
make
difficult
decisions
about
whether
to
maintain
their
health
insurance
coverage.
Given
the
significant
increase
in
out-of-pocket
costs,
many
will
drop
their
plan,
which
would
reverse
the
“incredible
progress”
that’s
occurred
since
the
enhanced
tax
credits
were
put
into
place,
she
stated.

Jeremy
Nordquist,
president
of
the

Nebraska
Hospital
Association
,
also
expressed
worry
that
uninsured
rates
would
increase
significantly
if
expanded
subsidies
are
not
renewed.

He
noted
that
about
120,000
Nebraskans
have
health
coverage
through
its
state
marketplace,
and
“pretty
much
all
of
them”
are
receiving
enhanced
tax
credits.
He
also
said
that
enrollment
in
the
state’s
marketplace
plans
has
increased
by
about
a
third
since
the
subsidies
were
upgraded
through
the
Inflation
Reduction
Act.

“The
generous
subsidies
help
reduce
the
average
premium
for
those
that
are
receiving
subsidies
by
about
50%,
obviously
more
on
the
lower
income
side
than
higher,
but
there’s
a
big
impact
to
those
individuals
getting
coverage.
Without
them,
we
know
more
Nebraskans
are
likely
to
skip
buying
coverage
and
would
remain
uninsured,”
Nordquist
declared.

If
Congress
does
not
renew
the
ACA’s
expanded
tax
credits,
the
nation’s
number
of
uninsured
citizens
would
rise
by
3.8
million
each
year
on
average
from
2026
through
2034,
according
to

estimates

from
the
Congressional
Budget
Office. 

The
agency
predicted
that
gross
benchmark
premiums
would
increase
by
7.9%
on
average
over
the
same
period.

MacDonald
of
the
Federation
of
American
Hospitals
pointed
out
that
robust
enrollment
in
ACA
plans
benefits
the
risk
pool.
The
more
people
enrolled
in
the
marketplace,
the
healthier
the
risk
pool
is,
which
brings
down
premiums
for
everybody,
she
stated.

“If
we
see
the
tax
credits
expire
and
people
are
unable
to
obtain
insurance,
you’re
going
to
see
only
the
sickest
patients
enrolling,
and
that’s
problematic
for
the
risk
pool.
That
means
the
premiums
are
higher
for
everyone
else,
and
it
just
has
an
effect
that
will
continue
and
will
be
negative
for
everyone
out
there,”
MacDonald
explained.


How
would
rural
hospitals
fare
if
enhanced
tax
credits
go
away?

Nordquist
of
the
Nebraska
Hospital
Association
noted
that
the
elimination
of
enhanced
ACA
subsidies
“would
be
really
disastrous”
for
rural
communities
in
particular.

Rural
areas
tend
to
have
a
higher
percentage
of
people
who
are
self-employed
or
employed
by
small
businesses

oftentimes
working
in
agriculture
or
trades
like
woodworking
and
blacksmithing,
he
said. 

He
also
pointed
out
that
rural
hospitals
operate
on

extremely
tight
operating
margins
.
This
is
due
to
a
number
of
factors,
such
as
lower
patient
volumes
and
limited
access
to
specialized
services
that
generate
higher
revenue.

“If
you
now
have
a
10%
uninsured
rate
in
your
community,
as
opposed
to
a
5%
uninsured
rate
or
even
lower,
it
really
makes
the
path
hard
to
figure
out
how
to
break
even
at
the
end
of
the
day,”
Nordquist
declared.

Brock
Slobach,
COO
of
the

National
Rural
Health
Association
,
pointed
out
that
about
half
of
rural
hospitals
are

losing
money

on
operations. 

He
said
this
share
will
grow
significantly
if
expanded
ACA
tax
credits
are
not
renewed,
which
could
force
some
hospitals
to
close
their
doors.

“About
460
rural
hospitals
are
in
danger
of
closing,
according
to
our
statistics,
and
216
of
those
are
highly
vulnerable
to
closure.
So
something
like
this,
for
those
216
highly
vulnerable
hospitals
to
closure,
could
really
produce
some
significant
negative
impact,”
Slobach
remarked.


What
might
some
of
the
downstream
effects
be?

If
enhanced
subsidies
are
not
renewed,
the
negative
impacts
will
be
both
immediate
and
long-term,
Trolley
of
Pennie
pointed
out.

She
highlighted
the
fact
that

about
a
quarter

of
the
U.S.
population
is
between
the
ages
of
45
and
64.
Many
people
in
this
pre-Medicare
age
range
are
early
retirees
or
people
who
have
switched
to
lower-stress
jobs
that
may
not
offer
health
insurance,
she
noted.

Without
affordable
ACA
options,
many
of
these
people
may
opt
to
go
insured
and
wait
until
they
are
eligible
for
Medicare,
Trolley
explained.

“There’s
a
lot
of
focus
on
how
to
make
Medicare
more
effective
and
how
to
curb
some
of
the
cost
increases
there.
If
you
have
people
who
are
uninsured
for
five
years
before
they
hit
Medicare
and
they
haven’t
gotten
preventive
care
or
maintenance
care
for
things
like
diabetes
or
heart
conditions,
they’re
going
to
hit
Medicare
with
unmanaged
chronic
or
serious
conditions
that
are
going
to
cost
a
lot
more
at
that
stage
to
treat
than
if
they
had
gotten
in
early
and
been
able
to
have
that
ongoing
access,”
she
declared.

The
expiration
of
tax
credits
might
also
lead
to
a
renewed
focus
on
price
transparency,
said
Josh
Berlin,
CEO
of

rule
of
three
,
a
healthcare
consulting
firm. 

The
failure
to
renew
these
subsidies
will
make
healthcare
access
even
more
unaffordable,
which
could
ignite
greater
fervor
around
efforts
to
present
pricing
information
transparently,
he
noted. 

“You
might
see
a
reemergence
or
doubling
down
of
the
transparency
requirements,
with
some
political
support
and
maybe
even
bipartisan
support,
that
could
provide
an
emphasis
on
the
way
costs
are
transparently
pushed
out
in
and
across
the
health
system,”
Berlin
stated.


How
likely
is
it
that
Congress
will
renew
the
enhanced
tax
credits?


Last
month,
Congress
passed
a
stopgap
funding
bill
that
included

some
healthcare
provisions,
such
as
extensions
for
Medicare
telehealth
flexibilities
and
the
Acute
Hospital
Care
at
Home
program


but
it
did
not
extend
the
ACA’s
enhanced
tax
credits.

In
an
interview

before
the
stopgap
bill
was
introduced
minus
the
tax
credits
extension

Michael
Abrams,
managing
partner
of

Numerof
&
Associates
,
predicted
that
it
is
not
likely
that
Congress
would
extend
the
subsidies.

“Republicans
have
an
issue
with
the
legislation
in
the
sense
that
they
believe
that
the
subsidies
distort
the
use
of
the
program
by
extending
it
to
people
who
don’t
need
it.
Now,
that
may
not
have
been
true
during
the
pandemic,
but
the
question
is,
is
it
still
true
now?”
he
remarked.

The
ACA
subsidies
were
expanded
during
the
pandemic

a
time
when
many
Americans
unexpectedly
lost
their
jobs,
Abrams
pointed
out.
Now,
the
U.S.
unemployment
rate
is

4.2%
,
which
is
“about
as
close
to
full
employment
as
we’re
going
to
get,”
he
said.

In
Abrams’
view,
Congress
will
probably
use
this
logic:
tax
credits
were
expanded
in
response
to
a
public
emergency,
and
now
that
that
emergency
is
over,
it’s
time
to
wind
these
credits
down.

“The
ACA
itself
should
not
be
competing
with
alternatives
that
are
available
to
individuals
through
employment,”
he
declared.
“It’s
hard
to,
I
think,
justify
the
continuation
of
a
program
that
was
a
Band-Aid
for
a
particular
point
in
time.”

He
also
pointed
out
that
“too
many
people”
are
focused
on
the
fact
that
enhanced
tax
credits
have
increased
ACA
enrollment.

“For
them,
more
enrollment
in
the
ACA
is
an
end
in
and
of
itself,
but
it
shouldn’t
be.
The
ACA
is
a
safety
net
kind
of
program,
and
not
that
there
is
no
place
for
it,
but
whether
it
thrives
or
not
is
really
a
measure
of
strength
of
our
economy.
And
if
the
economy
is
getting
stronger,
it’s
only
logical
that
the
use
of
the
safety
net
program
shrinks,”
Abrams
explained.

If
Congress
takes
this
stance,
“there
is
no
question”
that
hospitals
will
suffer
negative
financial
consequences,
which
is
why
both

hospital

and

commercial
insurance

lobbies
are
working
hard
to
keep
enhanced
subsidies
alive,
he
said.
But
at
the
end
of
the
day,
he
has
serious
doubts
their
efforts
will
be
successful.


Photo:
Niyazz,
Getty
Images

The High Stakes of ACA Subsidies: What’s at Risk for Hospitals and Patients – MedCity News

The
Affordable
Care
Act’s
enhanced
tax
credits

which
were
introduced
during
the
pandemic
to
expand
healthcare
affordability
during
a
time
of
widespread
unemployment

are
at
risk
of
expiration
at
the
end
of
this
year
if
Congress
doesn’t
extend
them.
For
many
Americans,
these
expanded
subsidies
have
meant
the
difference
between
affording
routine
care
for
themselves
and
their
loved
ones
and
skipping
these
visits
entirely. 

But
it’s
not
simply
a
matter
of
affordability
and
access.
This
looming
policy
change
could
also
create
significant
challenges
for
hospitals
already
battling
financial
pressures.

Healthcare
leaders
have
a
number
of
concerns
about
what
could
happen
if
Congress
does
not
renew
the
ACA’s
expanded
tax
credits.
Premiums
could
increase,
a
larger
share
of
Americans
could
become
uninsured,
hospitals
could
be
forced
into
more
bad
debt
and
uncompensated
care,
and
most
worrisome,
American
public
health
would
deteriorate.

Still,
the
hefty
price
tag
of
the
ACA’s
enhanced
tax
subsidies
makes
it
seem
unlikely
that
they
will
be
renewed
by
a
Republican-led
Congress

in
fact,
a
bipartisan
bill
that

was
passed

in
December
to
prevent
a
shutdown
before
Christmas
didn’t
include
it.
An
expert
interviewed
for
this
article
noted
that
these
subsidies
were
established
to
provide
support
during
a
public
health
emergency
that
has
now
expired

and
they
cost
taxpayers

$91
billion

last
year.


What
have
enhanced
tax
credits
meant
for
healthcare
utilization?

When
the
ACA
health
insurance
marketplaces
launched
in
2014,
tax
credits
went
into
effect
to
make
coverage
more
affordable
for
individuals
and
families.
These
tax
credits

which
are
based
on
ACA
shoppers’
income
and
household
size

were
later
expanded
temporarily
under
the
American
Rescue
Plan
Act
in
2021
and
extended
through
the
Inflation
Reduction
Act
in
2022.
This
came
in
the
form
of
larger
subsidies
and
broader
eligibility
criteria​.

When
the
marketplaces
were
first
established,
the
government

provided
subsidies

to
people
earning
100-400%
of
the
federal
poverty
level,
and
individual
premium
contributions
ranged
from
2.07-9.83%
of
their
income. 

The
American
Rescue
Plan
Act
and
its
extension
under
the
Inflation
Reduction
Act

boosted

these
subsidies
by
lowering
premium
contributions
to
0-8.5%
of
income
and
approved
$0
premiums
for
people
earning
100–150%
of
the
federal
poverty
level.
The
changes
introduced
during
the
pandemic
also
allowed
Americans
earning
above
400%
of
the
federal
poverty
level
to
qualify
for
subsidies
if
premiums
exceeded
8.5%
of
their
income. 

Char
MacDonald,
executive
vice
president
of
public
affairs
at
the

Federation
of
American
Hospitals
,
noted
that
these
credits
have
played
a
key
role
in
reducing
the
country’s
uninsured
rate.
Last
year,
the
national
uninsured
rate

reached
an
all-time
low

of
7.9%.

“What
these
tax
credits
have
done
is
make
sure
that
people
have
coverage
for
all
the
services
they
need

not
just
coming
into
the
emergency
room,
but
also
that
they
continue
with
care
that
they
need
for
their
chronic
condition,
for
oncology
care,
for
primary
care.
That’s
where
it’s
really
critical

with
the
patients
that
we’re
seeing,
the
hospital
is
not
the
first
stop,
it’s
not
the
first
entry
into
the
healthcare
system,”
she
explained.

Expanded
subsidies
reduce
patients’
out-of-pocket
costs,
which
makes
them
more
likely
to
do
things
like
book
check-ups
and
preventive
care
appointments,
MacDonald
noted.

Jolene
Calla,
vice
president
of
finance
and
legal
affairs
at

HAP:
The
Hospital
and
Healthsystem
Association
of
Pennsylvania
,
agreed
that
enhanced
ACA
tax
credits
are
a
major
factor
leading
patients
to
seek
preventive
care.

“We
have
seen
people
coming
to
the
hospital
more
because
they
have
coverage,
and
that
is
a
good
thing.
When
I
say
coming
to
the
hospital,
I
mean
for
things
like
preventive
care
services,
access
to
prescription
drugs,
and
getting
early
diagnosis
and
treatment
for
some
of
the
chronic
conditions
that
become
the
most
expensive
when
people
show
up
in
the
ED,”
Calla
remarked.

When
people
don’t
have
affordable
health
insurance,
they
tend
to
delay
care,
skip
primary
care
visits
and
forego
screenings,
she
pointed
out.
This
often
means
that
their
conditions
progress
into
a
less
manageable
state,
resulting
in
more
expensive
and
acute
care
episodes
down
the
road.


Why
tax
credits
“make
good
financial
sense”
for
hospitals

In
Calla’s
view,
ensuring
that
Americans
have
access
to
affordable
healthcare
coverage
“makes
good
financial
sense.”

When
people
have
coverage,
they
are
much
more
likely
to
make
check-up
appointments
to
maintain
their
health
and
visit
an
urgent
care
site
rather
than
a
high-cost
emergency
department,
she
explained. 

“Just
because
you
don’t
have
coverage,
that
doesn’t
mean
you
don’t
get
sick.
These
patients
are
still
going
to
the
hospital,
and
there
is
a
cost
to
that.
That
means
the
hospital
is
going
to
end
up
paying
for
at
least
part
of
that
uncompensated
care

and
that
puts
financial
strain
on
the
hospital
because
they
might
get
some
of
that
back,
but
they’re
generally
not
getting
it
all
back,
so
they
have
to
absorb
that,”
Calla
declared. 

That
means
hospitals
then
have
to
make
tough
decisions,
like
hiring
less
nurses
or
forgoing
new
equipment
they
may
need
to
better
serve
their
patients,
she
remarked.

She
said
that
ACA
tax
credits

along
with
individual
states
expanding
Medicaid
coverage

have
led
to
lower
rates
of
uncompensated
care
at
hospitals.
Last
year,
Pennsylvania’s
uncompensated
care
rate

dropped
to
1.39%
,
Calla
noted.

“But
still,
even
at
that
percent,
that
is
$774
million
that
hospitals
are
not
getting,”
she
stated.
“Coverage
is
a
really
big
deal
for
hospitals,
and
with
the
loss
of
the
[tax
credits],
we
expect
that
the
number
of
uninsured
patients
is
going
to
rise
dramatically,
and
that’s
going
to
have
a
ripple
effect
on
costs
for
hospitals
and
the
amount
they’re
losing.” 

She
noted
that

more
than
half

of
Pennsylvania
hospitals
had
negative
operating
margins
in
2023.

“It’s
really
bad
timing
for
a
really
bad
development
for
Pennsylvania
patients
and
hospitals,
if
those
[tax
credits]
were
to
go
away,”
Calla
said.


How
many
people
will
lose
coverage
if
enhanced
tax
credits
are
not
renewed?

Another
healthcare
leader
in
Pennsylvania

Devon
Trolley,
executive
director
of

Pennie
,
the
state’s
official
health
insurance
marketplace

noted
that
her
organization
has
seen
a
50%
increase
in
enrollment
since
the
ACA’s
expanded
subsidies
were
introduced.

This
is
because
coverage
is
now
more
affordable
for
a
wide
variety
of
people

such
as
those
with
low
and
moderate
incomes,
self-employed
people,
short-term
contract
workers,
individuals
who
have
recently
lost
their
jobs.

“There’s
a
more
affordable
bridge
from
Medicaid
to
the
private
health
plans
through
the
marketplace.
There’s
also
more
options
for
people
who
are
above
400%
of
the
federal
poverty
level.
Before
this,
they
had
no
tax
credits.
When
they
say
400%
you
may
think
that’s
a
lot
of
money,
but
that’s
$60,000
per
year
for
a
single
person,
so
it’s
not
as
big
as
it
sounds.
This
is
for
people
who
really
find
full
price
coverage
to
be
very
challenging
to
afford,”
Trolley
said.

If
Congress
fails
to
renew
enhanced
ACA
subsidies,
“every
single
enrollee
through
Pennie”

which
is
more
than
435,000
people

would
be
affected,
she
declared.

On
average,
premiums
would
rise
by
81%,
Trolley
remarked.

“It
would
double,
sometimes
even
quadruple,
what
they
are
paying
for
health
coverage
right
now,”
she
said.  

Trolley
said
her
main
concern
about
the
subsidies’
potential
expiration
is
that
this
would
force
thousands
of
families
in
her
state
to
make
difficult
decisions
about
whether
to
maintain
their
health
insurance
coverage.
Given
the
significant
increase
in
out-of-pocket
costs,
many
will
drop
their
plan,
which
would
reverse
the
“incredible
progress”
that’s
occurred
since
the
enhanced
tax
credits
were
put
into
place,
she
stated.

Jeremy
Nordquist,
president
of
the

Nebraska
Hospital
Association
,
also
expressed
worry
that
uninsured
rates
would
increase
significantly
if
expanded
subsidies
are
not
renewed.

He
noted
that
about
120,000
Nebraskans
have
health
coverage
through
its
state
marketplace,
and
“pretty
much
all
of
them”
are
receiving
enhanced
tax
credits.
He
also
said
that
enrollment
in
the
state’s
marketplace
plans
has
increased
by
about
a
third
since
the
subsidies
were
upgraded
through
the
Inflation
Reduction
Act.

“The
generous
subsidies
help
reduce
the
average
premium
for
those
that
are
receiving
subsidies
by
about
50%,
obviously
more
on
the
lower
income
side
than
higher,
but
there’s
a
big
impact
to
those
individuals
getting
coverage.
Without
them,
we
know
more
Nebraskans
are
likely
to
skip
buying
coverage
and
would
remain
uninsured,”
Nordquist
declared.

If
Congress
does
not
renew
the
ACA’s
expanded
tax
credits,
the
nation’s
number
of
uninsured
citizens
would
rise
by
3.8
million
each
year
on
average
from
2026
through
2034,
according
to

estimates

from
the
Congressional
Budget
Office. 

The
agency
predicted
that
gross
benchmark
premiums
would
increase
by
7.9%
on
average
over
the
same
period.

MacDonald
of
the
Federation
of
American
Hospitals
pointed
out
that
robust
enrollment
in
ACA
plans
benefits
the
risk
pool.
The
more
people
enrolled
in
the
marketplace,
the
healthier
the
risk
pool
is,
which
brings
down
premiums
for
everybody,
she
stated.

“If
we
see
the
tax
credits
expire
and
people
are
unable
to
obtain
insurance,
you’re
going
to
see
only
the
sickest
patients
enrolling,
and
that’s
problematic
for
the
risk
pool.
That
means
the
premiums
are
higher
for
everyone
else,
and
it
just
has
an
effect
that
will
continue
and
will
be
negative
for
everyone
out
there,”
MacDonald
explained.


How
would
rural
hospitals
fare
if
enhanced
tax
credits
go
away?

Nordquist
of
the
Nebraska
Hospital
Association
noted
that
the
elimination
of
enhanced
ACA
subsidies
“would
be
really
disastrous”
for
rural
communities
in
particular.

Rural
areas
tend
to
have
a
higher
percentage
of
people
who
are
self-employed
or
employed
by
small
businesses

oftentimes
working
in
agriculture
or
trades
like
woodworking
and
blacksmithing,
he
said. 

He
also
pointed
out
that
rural
hospitals
operate
on

extremely
tight
operating
margins
.
This
is
due
to
a
number
of
factors,
such
as
lower
patient
volumes
and
limited
access
to
specialized
services
that
generate
higher
revenue.

“If
you
now
have
a
10%
uninsured
rate
in
your
community,
as
opposed
to
a
5%
uninsured
rate
or
even
lower,
it
really
makes
the
path
hard
to
figure
out
how
to
break
even
at
the
end
of
the
day,”
Nordquist
declared.

Brock
Slobach,
COO
of
the

National
Rural
Health
Association
,
pointed
out
that
about
half
of
rural
hospitals
are

losing
money

on
operations. 

He
said
this
share
will
grow
significantly
if
expanded
ACA
tax
credits
are
not
renewed,
which
could
force
some
hospitals
to
close
their
doors.

“About
460
rural
hospitals
are
in
danger
of
closing,
according
to
our
statistics,
and
216
of
those
are
highly
vulnerable
to
closure.
So
something
like
this,
for
those
216
highly
vulnerable
hospitals
to
closure,
could
really
produce
some
significant
negative
impact,”
Slobach
remarked.


What
might
some
of
the
downstream
effects
be?

If
enhanced
subsidies
are
not
renewed,
the
negative
impacts
will
be
both
immediate
and
long-term,
Trolley
of
Pennie
pointed
out.

She
highlighted
the
fact
that

about
a
quarter

of
the
U.S.
population
is
between
the
ages
of
45
and
64.
Many
people
in
this
pre-Medicare
age
range
are
early
retirees
or
people
who
have
switched
to
lower-stress
jobs
that
may
not
offer
health
insurance,
she
noted.

Without
affordable
ACA
options,
many
of
these
people
may
opt
to
go
insured
and
wait
until
they
are
eligible
for
Medicare,
Trolley
explained.

“There’s
a
lot
of
focus
on
how
to
make
Medicare
more
effective
and
how
to
curb
some
of
the
cost
increases
there.
If
you
have
people
who
are
uninsured
for
five
years
before
they
hit
Medicare
and
they
haven’t
gotten
preventive
care
or
maintenance
care
for
things
like
diabetes
or
heart
conditions,
they’re
going
to
hit
Medicare
with
unmanaged
chronic
or
serious
conditions
that
are
going
to
cost
a
lot
more
at
that
stage
to
treat
than
if
they
had
gotten
in
early
and
been
able
to
have
that
ongoing
access,”
she
declared.

The
expiration
of
tax
credits
might
also
lead
to
a
renewed
focus
on
price
transparency,
said
Josh
Berlin,
CEO
of

rule
of
three
,
a
healthcare
consulting
firm. 

The
failure
to
renew
these
subsidies
will
make
healthcare
access
even
more
unaffordable,
which
could
ignite
greater
fervor
around
efforts
to
present
pricing
information
transparently,
he
noted. 

“You
might
see
a
reemergence
or
doubling
down
of
the
transparency
requirements,
with
some
political
support
and
maybe
even
bipartisan
support,
that
could
provide
an
emphasis
on
the
way
costs
are
transparently
pushed
out
in
and
across
the
health
system,”
Berlin
stated.


How
likely
is
it
that
Congress
will
renew
the
enhanced
tax
credits?


Last
month,
Congress
passed
a
stopgap
funding
bill
that
included

some
healthcare
provisions,
such
as
extensions
for
Medicare
telehealth
flexibilities
and
the
Acute
Hospital
Care
at
Home
program


but
it
did
not
extend
the
ACA’s
enhanced
tax
credits.

In
an
interview

before
the
stopgap
bill
was
introduced
minus
the
tax
credits
extension

Michael
Abrams,
managing
partner
of

Numerof
&
Associates
,
predicted
that
it
is
not
likely
that
Congress
would
extend
the
subsidies.

“Republicans
have
an
issue
with
the
legislation
in
the
sense
that
they
believe
that
the
subsidies
distort
the
use
of
the
program
by
extending
it
to
people
who
don’t
need
it.
Now,
that
may
not
have
been
true
during
the
pandemic,
but
the
question
is,
is
it
still
true
now?”
he
remarked.

The
ACA
subsidies
were
expanded
during
the
pandemic

a
time
when
many
Americans
unexpectedly
lost
their
jobs,
Abrams
pointed
out.
Now,
the
U.S.
unemployment
rate
is

4.2%
,
which
is
“about
as
close
to
full
employment
as
we’re
going
to
get,”
he
said.

In
Abrams’
view,
Congress
will
probably
use
this
logic:
tax
credits
were
expanded
in
response
to
a
public
emergency,
and
now
that
that
emergency
is
over,
it’s
time
to
wind
these
credits
down.

“The
ACA
itself
should
not
be
competing
with
alternatives
that
are
available
to
individuals
through
employment,”
he
declared.
“It’s
hard
to,
I
think,
justify
the
continuation
of
a
program
that
was
a
Band-Aid
for
a
particular
point
in
time.”

He
also
pointed
out
that
“too
many
people”
are
focused
on
the
fact
that
enhanced
tax
credits
have
increased
ACA
enrollment.

“For
them,
more
enrollment
in
the
ACA
is
an
end
in
and
of
itself,
but
it
shouldn’t
be.
The
ACA
is
a
safety
net
kind
of
program,
and
not
that
there
is
no
place
for
it,
but
whether
it
thrives
or
not
is
really
a
measure
of
strength
of
our
economy.
And
if
the
economy
is
getting
stronger,
it’s
only
logical
that
the
use
of
the
safety
net
program
shrinks,”
Abrams
explained.

If
Congress
takes
this
stance,
“there
is
no
question”
that
hospitals
will
suffer
negative
financial
consequences,
which
is
why
both

hospital

and

commercial
insurance

lobbies
are
working
hard
to
keep
enhanced
subsidies
alive,
he
said.
But
at
the
end
of
the
day,
he
has
serious
doubts
their
efforts
will
be
successful.


Photo:
Niyazz,
Getty
Images

The High Stakes of ACA Subsidies: What’s at Risk for Hospitals and Patients – MedCity News

The
Affordable
Care
Act’s
enhanced
tax
credits

which
were
introduced
during
the
pandemic
to
expand
healthcare
affordability
during
a
time
of
widespread
unemployment

are
at
risk
of
expiration
at
the
end
of
this
year
if
Congress
doesn’t
extend
them.
For
many
Americans,
these
expanded
subsidies
have
meant
the
difference
between
affording
routine
care
for
themselves
and
their
loved
ones
and
skipping
these
visits
entirely. 

But
it’s
not
simply
a
matter
of
affordability
and
access.
This
looming
policy
change
could
also
create
significant
challenges
for
hospitals
already
battling
financial
pressures.

Healthcare
leaders
have
a
number
of
concerns
about
what
could
happen
if
Congress
does
not
renew
the
ACA’s
expanded
tax
credits.
Premiums
could
increase,
a
larger
share
of
Americans
could
become
uninsured,
hospitals
could
be
forced
into
more
bad
debt
and
uncompensated
care,
and
most
worrisome,
American
public
health
would
deteriorate.

Still,
the
hefty
price
tag
of
the
ACA’s
enhanced
tax
subsidies
makes
it
seem
unlikely
that
they
will
be
renewed
by
a
Republican-led
Congress

in
fact,
a
bipartisan
bill
that

was
passed

in
December
to
prevent
a
shutdown
before
Christmas
didn’t
include
it.
An
expert
interviewed
for
this
article
noted
that
these
subsidies
were
established
to
provide
support
during
a
public
health
emergency
that
has
now
expired

and
they
cost
taxpayers

$91
billion

last
year.


What
have
enhanced
tax
credits
meant
for
healthcare
utilization?

When
the
ACA
health
insurance
marketplaces
launched
in
2014,
tax
credits
went
into
effect
to
make
coverage
more
affordable
for
individuals
and
families.
These
tax
credits

which
are
based
on
ACA
shoppers’
income
and
household
size

were
later
expanded
temporarily
under
the
American
Rescue
Plan
Act
in
2021
and
extended
through
the
Inflation
Reduction
Act
in
2022.
This
came
in
the
form
of
larger
subsidies
and
broader
eligibility
criteria​.

When
the
marketplaces
were
first
established,
the
government

provided
subsidies

to
people
earning
100-400%
of
the
federal
poverty
level,
and
individual
premium
contributions
ranged
from
2.07-9.83%
of
their
income. 

The
American
Rescue
Plan
Act
and
its
extension
under
the
Inflation
Reduction
Act

boosted

these
subsidies
by
lowering
premium
contributions
to
0-8.5%
of
income
and
approved
$0
premiums
for
people
earning
100–150%
of
the
federal
poverty
level.
The
changes
introduced
during
the
pandemic
also
allowed
Americans
earning
above
400%
of
the
federal
poverty
level
to
qualify
for
subsidies
if
premiums
exceeded
8.5%
of
their
income. 

Char
MacDonald,
executive
vice
president
of
public
affairs
at
the

Federation
of
American
Hospitals
,
noted
that
these
credits
have
played
a
key
role
in
reducing
the
country’s
uninsured
rate.
Last
year,
the
national
uninsured
rate

reached
an
all-time
low

of
7.9%.

“What
these
tax
credits
have
done
is
make
sure
that
people
have
coverage
for
all
the
services
they
need

not
just
coming
into
the
emergency
room,
but
also
that
they
continue
with
care
that
they
need
for
their
chronic
condition,
for
oncology
care,
for
primary
care.
That’s
where
it’s
really
critical

with
the
patients
that
we’re
seeing,
the
hospital
is
not
the
first
stop,
it’s
not
the
first
entry
into
the
healthcare
system,”
she
explained.

Expanded
subsidies
reduce
patients’
out-of-pocket
costs,
which
makes
them
more
likely
to
do
things
like
book
check-ups
and
preventive
care
appointments,
MacDonald
noted.

Jolene
Calla,
vice
president
of
finance
and
legal
affairs
at

HAP:
The
Hospital
and
Healthsystem
Association
of
Pennsylvania
,
agreed
that
enhanced
ACA
tax
credits
are
a
major
factor
leading
patients
to
seek
preventive
care.

“We
have
seen
people
coming
to
the
hospital
more
because
they
have
coverage,
and
that
is
a
good
thing.
When
I
say
coming
to
the
hospital,
I
mean
for
things
like
preventive
care
services,
access
to
prescription
drugs,
and
getting
early
diagnosis
and
treatment
for
some
of
the
chronic
conditions
that
become
the
most
expensive
when
people
show
up
in
the
ED,”
Calla
remarked.

When
people
don’t
have
affordable
health
insurance,
they
tend
to
delay
care,
skip
primary
care
visits
and
forego
screenings,
she
pointed
out.
This
often
means
that
their
conditions
progress
into
a
less
manageable
state,
resulting
in
more
expensive
and
acute
care
episodes
down
the
road.


Why
tax
credits
“make
good
financial
sense”
for
hospitals

In
Calla’s
view,
ensuring
that
Americans
have
access
to
affordable
healthcare
coverage
“makes
good
financial
sense.”

When
people
have
coverage,
they
are
much
more
likely
to
make
check-up
appointments
to
maintain
their
health
and
visit
an
urgent
care
site
rather
than
a
high-cost
emergency
department,
she
explained. 

“Just
because
you
don’t
have
coverage,
that
doesn’t
mean
you
don’t
get
sick.
These
patients
are
still
going
to
the
hospital,
and
there
is
a
cost
to
that.
That
means
the
hospital
is
going
to
end
up
paying
for
at
least
part
of
that
uncompensated
care

and
that
puts
financial
strain
on
the
hospital
because
they
might
get
some
of
that
back,
but
they’re
generally
not
getting
it
all
back,
so
they
have
to
absorb
that,”
Calla
declared. 

That
means
hospitals
then
have
to
make
tough
decisions,
like
hiring
less
nurses
or
forgoing
new
equipment
they
may
need
to
better
serve
their
patients,
she
remarked.

She
said
that
ACA
tax
credits

along
with
individual
states
expanding
Medicaid
coverage

have
led
to
lower
rates
of
uncompensated
care
at
hospitals.
Last
year,
Pennsylvania’s
uncompensated
care
rate

dropped
to
1.39%
,
Calla
noted.

“But
still,
even
at
that
percent,
that
is
$774
million
that
hospitals
are
not
getting,”
she
stated.
“Coverage
is
a
really
big
deal
for
hospitals,
and
with
the
loss
of
the
[tax
credits],
we
expect
that
the
number
of
uninsured
patients
is
going
to
rise
dramatically,
and
that’s
going
to
have
a
ripple
effect
on
costs
for
hospitals
and
the
amount
they’re
losing.” 

She
noted
that

more
than
half

of
Pennsylvania
hospitals
had
negative
operating
margins
in
2023.

“It’s
really
bad
timing
for
a
really
bad
development
for
Pennsylvania
patients
and
hospitals,
if
those
[tax
credits]
were
to
go
away,”
Calla
said.


How
many
people
will
lose
coverage
if
enhanced
tax
credits
are
not
renewed?

Another
healthcare
leader
in
Pennsylvania

Devon
Trolley,
executive
director
of

Pennie
,
the
state’s
official
health
insurance
marketplace

noted
that
her
organization
has
seen
a
50%
increase
in
enrollment
since
the
ACA’s
expanded
subsidies
were
introduced.

This
is
because
coverage
is
now
more
affordable
for
a
wide
variety
of
people

such
as
those
with
low
and
moderate
incomes,
self-employed
people,
short-term
contract
workers,
individuals
who
have
recently
lost
their
jobs.

“There’s
a
more
affordable
bridge
from
Medicaid
to
the
private
health
plans
through
the
marketplace.
There’s
also
more
options
for
people
who
are
above
400%
of
the
federal
poverty
level.
Before
this,
they
had
no
tax
credits.
When
they
say
400%
you
may
think
that’s
a
lot
of
money,
but
that’s
$60,000
per
year
for
a
single
person,
so
it’s
not
as
big
as
it
sounds.
This
is
for
people
who
really
find
full
price
coverage
to
be
very
challenging
to
afford,”
Trolley
said.

If
Congress
fails
to
renew
enhanced
ACA
subsidies,
“every
single
enrollee
through
Pennie”

which
is
more
than
435,000
people

would
be
affected,
she
declared.

On
average,
premiums
would
rise
by
81%,
Trolley
remarked.

“It
would
double,
sometimes
even
quadruple,
what
they
are
paying
for
health
coverage
right
now,”
she
said.  

Trolley
said
her
main
concern
about
the
subsidies’
potential
expiration
is
that
this
would
force
thousands
of
families
in
her
state
to
make
difficult
decisions
about
whether
to
maintain
their
health
insurance
coverage.
Given
the
significant
increase
in
out-of-pocket
costs,
many
will
drop
their
plan,
which
would
reverse
the
“incredible
progress”
that’s
occurred
since
the
enhanced
tax
credits
were
put
into
place,
she
stated.

Jeremy
Nordquist,
president
of
the

Nebraska
Hospital
Association
,
also
expressed
worry
that
uninsured
rates
would
increase
significantly
if
expanded
subsidies
are
not
renewed.

He
noted
that
about
120,000
Nebraskans
have
health
coverage
through
its
state
marketplace,
and
“pretty
much
all
of
them”
are
receiving
enhanced
tax
credits.
He
also
said
that
enrollment
in
the
state’s
marketplace
plans
has
increased
by
about
a
third
since
the
subsidies
were
upgraded
through
the
Inflation
Reduction
Act.

“The
generous
subsidies
help
reduce
the
average
premium
for
those
that
are
receiving
subsidies
by
about
50%,
obviously
more
on
the
lower
income
side
than
higher,
but
there’s
a
big
impact
to
those
individuals
getting
coverage.
Without
them,
we
know
more
Nebraskans
are
likely
to
skip
buying
coverage
and
would
remain
uninsured,”
Nordquist
declared.

If
Congress
does
not
renew
the
ACA’s
expanded
tax
credits,
the
nation’s
number
of
uninsured
citizens
would
rise
by
3.8
million
each
year
on
average
from
2026
through
2034,
according
to

estimates

from
the
Congressional
Budget
Office. 

The
agency
predicted
that
gross
benchmark
premiums
would
increase
by
7.9%
on
average
over
the
same
period.

MacDonald
of
the
Federation
of
American
Hospitals
pointed
out
that
robust
enrollment
in
ACA
plans
benefits
the
risk
pool.
The
more
people
enrolled
in
the
marketplace,
the
healthier
the
risk
pool
is,
which
brings
down
premiums
for
everybody,
she
stated.

“If
we
see
the
tax
credits
expire
and
people
are
unable
to
obtain
insurance,
you’re
going
to
see
only
the
sickest
patients
enrolling,
and
that’s
problematic
for
the
risk
pool.
That
means
the
premiums
are
higher
for
everyone
else,
and
it
just
has
an
effect
that
will
continue
and
will
be
negative
for
everyone
out
there,”
MacDonald
explained.


How
would
rural
hospitals
fare
if
enhanced
tax
credits
go
away?

Nordquist
of
the
Nebraska
Hospital
Association
noted
that
the
elimination
of
enhanced
ACA
subsidies
“would
be
really
disastrous”
for
rural
communities
in
particular.

Rural
areas
tend
to
have
a
higher
percentage
of
people
who
are
self-employed
or
employed
by
small
businesses

oftentimes
working
in
agriculture
or
trades
like
woodworking
and
blacksmithing,
he
said. 

He
also
pointed
out
that
rural
hospitals
operate
on

extremely
tight
operating
margins
.
This
is
due
to
a
number
of
factors,
such
as
lower
patient
volumes
and
limited
access
to
specialized
services
that
generate
higher
revenue.

“If
you
now
have
a
10%
uninsured
rate
in
your
community,
as
opposed
to
a
5%
uninsured
rate
or
even
lower,
it
really
makes
the
path
hard
to
figure
out
how
to
break
even
at
the
end
of
the
day,”
Nordquist
declared.

Brock
Slobach,
COO
of
the

National
Rural
Health
Association
,
pointed
out
that
about
half
of
rural
hospitals
are

losing
money

on
operations. 

He
said
this
share
will
grow
significantly
if
expanded
ACA
tax
credits
are
not
renewed,
which
could
force
some
hospitals
to
close
their
doors.

“About
460
rural
hospitals
are
in
danger
of
closing,
according
to
our
statistics,
and
216
of
those
are
highly
vulnerable
to
closure.
So
something
like
this,
for
those
216
highly
vulnerable
hospitals
to
closure,
could
really
produce
some
significant
negative
impact,”
Slobach
remarked.


What
might
some
of
the
downstream
effects
be?

If
enhanced
subsidies
are
not
renewed,
the
negative
impacts
will
be
both
immediate
and
long-term,
Trolley
of
Pennie
pointed
out.

She
highlighted
the
fact
that

about
a
quarter

of
the
U.S.
population
is
between
the
ages
of
45
and
64.
Many
people
in
this
pre-Medicare
age
range
are
early
retirees
or
people
who
have
switched
to
lower-stress
jobs
that
may
not
offer
health
insurance,
she
noted.

Without
affordable
ACA
options,
many
of
these
people
may
opt
to
go
insured
and
wait
until
they
are
eligible
for
Medicare,
Trolley
explained.

“There’s
a
lot
of
focus
on
how
to
make
Medicare
more
effective
and
how
to
curb
some
of
the
cost
increases
there.
If
you
have
people
who
are
uninsured
for
five
years
before
they
hit
Medicare
and
they
haven’t
gotten
preventive
care
or
maintenance
care
for
things
like
diabetes
or
heart
conditions,
they’re
going
to
hit
Medicare
with
unmanaged
chronic
or
serious
conditions
that
are
going
to
cost
a
lot
more
at
that
stage
to
treat
than
if
they
had
gotten
in
early
and
been
able
to
have
that
ongoing
access,”
she
declared.

The
expiration
of
tax
credits
might
also
lead
to
a
renewed
focus
on
price
transparency,
said
Josh
Berlin,
CEO
of

rule
of
three
,
a
healthcare
consulting
firm. 

The
failure
to
renew
these
subsidies
will
make
healthcare
access
even
more
unaffordable,
which
could
ignite
greater
fervor
around
efforts
to
present
pricing
information
transparently,
he
noted. 

“You
might
see
a
reemergence
or
doubling
down
of
the
transparency
requirements,
with
some
political
support
and
maybe
even
bipartisan
support,
that
could
provide
an
emphasis
on
the
way
costs
are
transparently
pushed
out
in
and
across
the
health
system,”
Berlin
stated.


How
likely
is
it
that
Congress
will
renew
the
enhanced
tax
credits?


Last
month,
Congress
passed
a
stopgap
funding
bill
that
included

some
healthcare
provisions,
such
as
extensions
for
Medicare
telehealth
flexibilities
and
the
Acute
Hospital
Care
at
Home
program


but
it
did
not
extend
the
ACA’s
enhanced
tax
credits.

In
an
interview

before
the
stopgap
bill
was
introduced
minus
the
tax
credits
extension

Michael
Abrams,
managing
partner
of

Numerof
&
Associates
,
predicted
that
it
is
not
likely
that
Congress
would
extend
the
subsidies.

“Republicans
have
an
issue
with
the
legislation
in
the
sense
that
they
believe
that
the
subsidies
distort
the
use
of
the
program
by
extending
it
to
people
who
don’t
need
it.
Now,
that
may
not
have
been
true
during
the
pandemic,
but
the
question
is,
is
it
still
true
now?”
he
remarked.

The
ACA
subsidies
were
expanded
during
the
pandemic

a
time
when
many
Americans
unexpectedly
lost
their
jobs,
Abrams
pointed
out.
Now,
the
U.S.
unemployment
rate
is

4.2%
,
which
is
“about
as
close
to
full
employment
as
we’re
going
to
get,”
he
said.

In
Abrams’
view,
Congress
will
probably
use
this
logic:
tax
credits
were
expanded
in
response
to
a
public
emergency,
and
now
that
that
emergency
is
over,
it’s
time
to
wind
these
credits
down.

“The
ACA
itself
should
not
be
competing
with
alternatives
that
are
available
to
individuals
through
employment,”
he
declared.
“It’s
hard
to,
I
think,
justify
the
continuation
of
a
program
that
was
a
Band-Aid
for
a
particular
point
in
time.”

He
also
pointed
out
that
“too
many
people”
are
focused
on
the
fact
that
enhanced
tax
credits
have
increased
ACA
enrollment.

“For
them,
more
enrollment
in
the
ACA
is
an
end
in
and
of
itself,
but
it
shouldn’t
be.
The
ACA
is
a
safety
net
kind
of
program,
and
not
that
there
is
no
place
for
it,
but
whether
it
thrives
or
not
is
really
a
measure
of
strength
of
our
economy.
And
if
the
economy
is
getting
stronger,
it’s
only
logical
that
the
use
of
the
safety
net
program
shrinks,”
Abrams
explained.

If
Congress
takes
this
stance,
“there
is
no
question”
that
hospitals
will
suffer
negative
financial
consequences,
which
is
why
both

hospital

and

commercial
insurance

lobbies
are
working
hard
to
keep
enhanced
subsidies
alive,
he
said.
But
at
the
end
of
the
day,
he
has
serious
doubts
their
efforts
will
be
successful.


Photo:
Niyazz,
Getty
Images