A joint letter from the National Health Law Program and 22 highly experienced state-based legal advocacy organizations
People enrolled in Medicaid, the federal-state health insurance program for nearly 90 million individuals and families, are in trouble. Many congressional protections that kept people covered and made Medicaid a vital life-line during the pandemic have ended and bureaucratic processes are putting millions of low-income and people with disabilities at risk of losing access to health care.
In the face of this nation-wide challenge, a coalition of Health Law Partnerships (HLPs), made up of the National Health Law Program and 22 highly experienced state-based legal advocacy organizations, is taking action to mitigate and reverse these losses of access to health care. By bringing together our collective experience and knowledge, we are better equipped to address these historic challenges. The individuals and families our partnership network represent are among the four million people, many of them children, who are at risk of losing access to the care they need to treat illnesses like cancer, chronic conditions like diabetes, cystic fibrosis, and HIV, and a host of other complex medical and behavioral health conditions, in addition to routine care.
Medicaid is a vital pillar in our health care system, which makes these threats all the more destabilizing. Over the last five decades, Medicaid has expanded to cover a wider circle of low- and middle-income people. People with disabilities, Black, Indigenous, and People of Color, women, rural communities, and LGBTQ+ folks, in particular, have seen gains in coverage and more positive health outcomes. In early 2020, Congress, with bipartisan support, passed a raft of legislation to address the emerging COVID-19 public health crisis. To ensure access to care for millions, one of the provisions barred state Medicaid agencies from kicking people off the program during the crisis. This proved critical as ongoing and historic inequities made low-income communities more vulnerable to the impacts of COVID-19. But those protections ended this spring, and millions of people have already lost coverage as we approach the half-way point of the 14 month eligibility redetermination process, known as the unwinding.
During the unwinding, each state Medicaid program must redetermine the eligibility of every enrollee. Along with other advocates and stakeholders, we have warned state and federal officials that millions of eligible people are likely to get caught up in a maze of red tape and paperwork and lose access to care – often without due process opportunities to challenge terminations. The impact of these terminations is dire and harmful – and we have seen people cut off of Medicaid midway through chemotherapy or lose access to in-home care for very sick children. The human toll of these bureaucratic mistakes is terrible, but our network of advocates is taking steps to help blunt those harms.
In Nebraska, we urged the state Department of Health Services to improve the mailed redetermination notices so that they were easier to understand and had clearer directions for appeals. In New Hampshire, members of our network trained navigators, community mental health centers, family resource centers, and case managers to help people re-enroll and keep their coverage. And in Michigan, home to the largest Arab-American community in the country, we worked with the state to ensure redetermination information was available not only in English and Spanish, but Arabic as well.
When preventative measures and public outreach are not enough, the National Health Law Program and our Health Law Partnerships are ready to take legal action. Our HLP network emerged during the previous administration to protect Medicaid enrollees from onerous work requirements and other harmful policies, and we are leveraging that network to once again protect access to care. These partnerships allow us to align deep enforcement and litigation expertise with on-the-ground advocates who know the unique landscape of their particular state and the peculiarities of individual state Medicaid programs.
The Florida Health Justice Project and the National Health Law Program just filed a lawsuit against the Florida Agency for Health Care Administration and the Department of Children and Families challenging their use of confusing and inaccurate notifications that have left over 180,000 Floridians without Medicaid coverage and with no opportunity to appeal the terminations. This is the first lawsuit challenging unwinding related terminations, and oral arguments will be heard in court later this fall.
We are proud of our Health Law Partnerships and know that our collective strength makes access to care possible for millions of low-income and underserved individuals and families. Together, the National Health Law Program and partners across the country work to address existing and emerging obstacles to health care access, as we have rallied together to fight the harm of the unwinding.
But the work is ongoing. We need your support now to protect this vital cohort of interconnected advocates. The stability of the Medicaid program and the health of our nation hang in the balance.
Learn more about our work at healthlaw.org/health-law-partnerships.
This letter has been jointly released by the National Health Law Program and all twenty-two of our Health Law Partnerships.
• Elizabeth G. Taylor, Executive Director | National Health Law Program
• James Tucker, Executive Director |Alabama Disabilities Advocacy Program at the University of Alabama
• Drew. P Schaffer, Executive Director | William E. Morris Institute for Justice
• Lee Richardson, Executive Director | Legal Aid of Arkansas
• Bethany Pray, Interim Director | Colorado Center on Law and Policy
• Deborah Dorfman, Executive Director | Disability Rights Connecticut
• Daniel Atkins, Executive Director | Community Legal Aid Society, Inc.
• Alison Yager, Executive Director | Florida Health Justice Project
• Julia Jisticz, Executive Director | Legal Council for Health Justice
• Adam Mueller, Executive Director | Indiana Justice Project
• Kelly Bidelman, Executive Director | Center for Civil Justice
• Vangela M. Wade, President/CEO | Mississippi Center for Justice
• Daniel Glazier, Executive Director | Legal Services of Eastern Missouri
• Becky Gould, Executive Director | Nebraska Appleseed
• Sarah Mattson Dustin, Executive Director | New Hampshire Legal Assistance
• Toussaint Romain, Chief Executive Officer | Charlotte Center for Legal Advocacy
• Katie McGarvey, Executive Director | Legal Aid Society of Columbus
• Michael Figgins, Executive Director | Legal Aid Services of Oklahoma
• Monica Goracke, Executive Director | Oregon Law Center
• Sue Berkowitz, Director | South Carolina Appleseed Legal Justice Center
• Michele Johnson, Executive Director | Tennessee Justice Center
• Adina Zahradnikova, Executive Director | Disability Law Center
• Sarah Brown, Executive Director | Mountain State Justice