As the year winds down, STAT reporters are taking a look at the stories they’re most eager to track in 2018. Find all our “three to watch” series here

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ome of the most hot-button issues in health and medicine will be fought out in courtrooms in 2018.

Cases before federal courts and the U.S. Supreme Court this year have the potential to shape health policy in the U.S. for years or decades to come. And, in at least one case, the outcome could set an important precedent for how taxpayers can hold drug manufacturers responsible.

Here are three cases to watch:

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California’s abortion disclosure law

The U.S. Supreme Court is set to hear a contentious case in 2018 that pits the right to free speech against state regulations that govern medical care.

Lawmakers in California were concerned that in an attempt to discourage abortion, some of the state’s “crisis pregnancy centers” were using “intentionally deceptive advertising and counseling practices that often confuse, misinform and even intimidate women from making fully informed decision,” according to the Los Angeles Times.

So in 2015, lawmakers passed the Reproductive FACT Act, which requires all licensed facilities that provide pregnancy care to tell patients that the state has public programs that provide free or low-cost access to abortion and contraception. Several centers sued, arguing that the law violates their right to free speech.

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Lower federal courts have upheld the law, but in 2018, the Supreme Court is taking up the case.

The current court is divided when it comes to questions of both abortion access and free speech. One key vote to watch: Justice Anthony Kennedy. Kennedy cast a decisive vote in a 5-3 decision last year which determined that a Texas law enacting strict requirements on abortion clinics wouldn’t improve medical care and would impose an “undue burden” on women seeking an abortion. In 2007, though, Kennedy penned a ruling reaffirming a federal ban on a common abortion procedure.

The opioid lawsuits

This is bigger than just one court case. Dozens of cities and states have sued drug makers and pharmacies for their role in the opioid crisis, hoping to recoup some of the costs of combating the epidemic. Hearings in some of those cases are already underway, and the litigation will continue well into 2018.

In one lawsuit, officials in Erie County, N.Y., allege that Purdue Pharma, Johnson & Johnson’s Janssen unit, Teva Pharmaceuticals, and Endo International pushed opioid prescriptions despite being aware of the danger of addiction, costing the county government millions each year to combat the epidemic.

Similar lawsuits have been filed by Chicago, Mississippi, and Orange County in California, among many other local governments. And in Everett, Wash., city officials have taken a different legal approach, claiming Purdue Pharma diverted its painkiller OxyContin to the black market using drug rings and pill mills.

And officials aren’t just going after drug makers.

Cherokee Nation is suing CVS Health, Walgreens, and other drug companies and retailers, alleging the companies didn’t do enough to stop prescription painkillers from flooding the tribal community and creating a crisis of opioid addiction.

And in West Virginia, local officials in four cities filed a class-action lawsuit against the Joint Commission, an influential nonprofit that inspects hospital performance and sets practice standards for doctors. The lawsuit claims the Joint Commission — responsible for accrediting more than 20,000 health organizations nationwide — has spread “misinformation” about the risks of opioid addiction dating back to the early 2000s, including in published materials underwritten by opioid manufacturers.

Free contraception coverage

The Trump administration rolled out new rules in 2017 that could make it much more difficult for women to access free birth control — but it’s not clear yet whether a federal court will allow those rules to stand.

Under the Affordable Care Act, most companies were required to cover birth control in their insurance plans at no added cost to women. Religious organizations could be exempted. A fierce fight over that policy has already made its way to the Supreme Court.

But the Trump administration’s new rules would allow more types of employers, including publicly traded companies, to claim religious exemptions so they don’t have to provide free contraception. And any company that isn’t publicly traded could claim an exemption on moral grounds.

In December, a federal judge in Philadelphia issued a temporary injunction preventing the government from enforcing the new policy. Judge Wendy Beetlestone criticized the policy as “sweeping” and a “proverbial exception that swallows the rule,” according to the Associated Press.

The injunction blocks the rule from being enforced nationwide while the case makes its way through the Pennsylvania court. There are similar lawsuits playing out right now in California, Washington, and Massachusetts too — so expect the battle to continue well into 2018.

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