NHeLP Matters – June 2014

NHeLP Matters – June 2014

Executive Summary

Summary of the recent accomplishments of NHeLP, including protecting informed consent, stopping discrimination against people with HIV/AIDS and fighting for immigrant women.

Welcome to the summer edition of NHeLP Matters! Along with a change in seasons, we have exciting changes happening at NHeLP. Learn more about them and some of our tremendous accomplishments below!

Introducing Elizabeth Taylor 
Former DOJ Principal becomes Executive Director 

Last month, Elizabeth Taylor was handed the baton from Emily Spitzer to become NHeLP’s new executive director. After six incredible years of growth with Emily at the helm, NHeLP Board Chair Marc Fleischaker hailed Elizabeth as the “perfect person” to continue our work and see the organization through its next journey.

Elizabeth comes to NHeLP from the Department of Justice (DOJ), where she served as Principal Deputy Associate Attorney General. At DOJ, Elizabeth helped coordinate the government’s litigation strategy in successfully defending the constitutionality of the landmark Affordable Care Act (ACA). She also worked to resolve a number of high-profile lawsuits with large banks, and reviewed the policies of several agencies implementing the Supreme Court’s decision in United States v. Windsor, which found key sections of the Defense of Marriage Act unconstitutional.

Before joining DOJ, Elizabeth was a litigation partner at the D.C. law firm Zuckerman Spaeder, where she tried cases and argued appeals in numerous state and federal courts around the country. Elizabeth began her legal career as a clerk for Judge Frank Coffin on the First Circuit Court of Appeals and for Justice Harry Blackmun on the U.S. Supreme Court, followed by nearly a decade at the Public Defender Service for the District of Columbia. She also served as an associate independent counsel on the investigation of former Secretary of Agriculture Mike Espy.

Please join us in welcoming Elizabeth!


Fighting for Immigrant Women
Immigrant women and families face a number of barriers to accessing health care and, far too often, legal restrictions stand in the way. NHeLP worked closely with the office of New Mexico Congresswoman Michelle Lujan Grisham to tackle these barriers with the Health Equity and Access under the Law (HEAL) for Immigrant Women and Families Act of 2014 (H.R. 4240). The bill would support health coverage for immigrant women and families authorized to live and work in the U.S., and make quality care a reality for those who need it most.

An Eye on Pennsylvania and Indiana
As we near the second anniversary of the Supreme Court’s decision on Medicaid expansion under the ACA, the decision continues to play out at the state level where NHeLP remains committed to full expansion. In Pennsylvania, NHeLP’s comments to the U.S. Department of Health and Human Services (HHS) drew attention to the legal problems in the state’s expansion proposal that would seriously harm enrollees, from serious benefits cuts for current enrollees to illegal premiums and restrictions on family planning in the expansion. In Indiana, NHeLP’s comments to the state identify numerous similar problems – illegal premiums, cost-sharing, benefits cuts – and urge the state to correct these problems prior to final application with HHS.

The Consensus on Premiums and Cost Sharing
Keeping Medicaid affordable is critical to the enrollment and overall health status of Medicaid enrollees, who are low-income and would otherwise be unable to access these services. As covered in NHeLP’s exhaustive review of the literature, the consensus is clear: premiums and cost-sharing should be kept as low as possible for lower-income persons. The brief addresses current Medicaid limits on premiums and cost-sharing and legal and policy implications created when states try to exceed those limits.

Identity Proofing in California
Each applicant using the online Marketplace application must have his or her identity verified though the credit agency, Experian, before even starting an application. This requirement was challenging for people with no credit histories or others who had difficulty verifying their identities. NHeLP worked closely with the Covered California marketplace to tackle these issues, including expanding the list of documents that can be submitted as proof and allowing navigators to verify the identity of consumers who can show them documentation of their ID.


Demanding Informed Consent
Informed consent is standard across medical practice. In light of the history of our country’s government-sanctioned sterilization of low-income women and women of color without their knowledge or consent, informed consent before sterilization takes on particular significance. NHeLP convened a strong coalition of organizations representing women of color to resist current efforts to repeal critical informed consent protections until there has been additional research with impacted women and a meaningful dialogue over the issues posed by this proposal. NHeLP Senior Attorney Deborah Reid covers the long history of eugenic sterilizations and the importance of Medicaid consent requirements in this compelling RH Reality Check piece.

Reproductive Health Battles in Hospital Mergers
The rise of mergers between Catholic and secular hospitals is creating serious ramifications, and in some areas, is eliminating access to reproductive and end of life care. Nearly 15 years ago, NHeLP worked with the California Attorney General Bill Lockyer to create strong laws and regulations to ensure that nonprofit hospital mergers protect access to reproductive health services. In June, NHeLP’s Director of Reproductive Health, Susan Berke Fogel, testified at a California Attorney General hearing on medical standards of care in hospital mergers. NHeLP is also working to expand and enforce these protections and public education on actions to take when local hospitals are threatened by a takeover.


Stopping Discrimination against People with HIV/AIDS
The ACA requires robust consumer protections, and makes it illegal for insurance companies to discriminate on the basis of health status, including HIV/AIDS. The reality on the ground, however, is quite different. In June, NHeLP partnered with The AIDS Institute and filed a complaint with the HHS Office of Civil Rights asking federal officials to investigate and put an end to discrimination by four Florida insurers. The companies are violating the ACA and civil rights protections by placing all HIV drugs, including generics, in their highest cost-sharing tiers to discourage people with HIV/AIDS from enrolling in these plans–a blatantly illegal practice that would have ramifications nationwide.

Holding the Line on Women’s Health
Legal challenges brought by for-profit corporations to the ACA’s birth control benefit are largely stayed pending disposition of the Supreme Court’s decision in Hobby Lobby and Conestoga Wood Specialties, Corp. However, additional challenges brought by nonprofit organizations continue to work their way through the federal courts. These nonprofits argue that their employees should not have access to contraceptive coverage, even if the employers are not paying for it. This runs counter to women’s health needs and standing policy by the Administration allowing employees to get benefits directly from insurers when nonprofit religiously affiliated organizations object. NHeLP has filed five amicus briefs in four circuit courts defending the ability of women to access contraception, as required by the ACA and well-established by medical standards of care.

Leading on Children’s Health
As a leading authority on the laws and policies affecting children’s health coverage, NHeLP produced several key publications discussing the trends in litigation on early and periodic screening, diagnostic and treatment services for children and youth, and the requirement that states ensure needy children have access to nutritional assessments, counseling and services. NHeLP worked with the Centers for Medicare & Medicaid Services on a comprehensive resource for state Medicaid agencies to ensure that eligible children receive the health care services they need: EPSDT-A Guide for State Coverage in the Medicaid Benefit for Children and Adolescents.

Honor Emily and Help Develop the Next Generation of Health Lawyers
To honor Emily Spitzer’s legacy, NHeLP has established the Emily Spitzer Internship Program– an initiative to develop the next generation of health lawyers.

Under Emily’s leadership, NHeLP became the preeminent health law organization serving vulnerable populations. Her outstanding efforts have helped NHeLP become more critical to health care law than at any other time in our nearly 50-year history.

The Emily Spitzer Internship Program will enable NHeLP to give annual paid internships to outstanding law students in each of our three offices – D.C., Los Angeles and Chapel Hill. This will further strengthen NHeLP, as well as lay the groundwork for future lawyers who share our commitment to upholding the rights of millions of people who struggle to access affordable, quality health care across the United States.

We hope that you will join us in making a contribution – both to honor Emily and to provide for the long-term success of future health advocates. You can give by making a donation online, or feel free to contact NHeLP directly at (202) 289-7661.

Please help us pay tribute to Emily and to the populations we serve, by paving the way for more exceptional attorneys dedicated to our important cause.

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