- Federal Health Care Policy Analysis, Coalition Building, and Advocacy
CHLPI leads several national coalitions, including the Chronic Illness and Disability Partnership and the HIV Health Care Access Working Group, organized around issues of federal health care access, with a focus on the care and treatment needs of low-income people living with HIV, cancer, diabetes and other chronic health conditions. Current priority issues include challenging Trump Administration proposals to restructure state Medicaid programs by allowing for work requirements or drug testing, or by instituting capitated or block-grant financing systems. CHLPI’s federal health care work also involves promoting federal policy and legislation to ensure comprehensive access to care and treatment, such as efforts to secure widespread access Pre-Exposure Prophylaxis (or PrEP), in an effort to dramatically reduce the transmission of HIV and realize the goals of the recently announced Ending the HIV Epidemic campaign.
- Strengthening Private Health Insurance
The Affordable Care Act and other health reforms have significantly improved the availability of affordable private health insurance through state Marketplaces. Despite this progress, individuals living with chronic illness and disabilities continue to face significant cost and coverage burdens as a result of discrimination in health insurance plan benefit design. Within this project, CHLPI has created a multi-year, multi-state data project that calculates the “value” of a health care plan to a person living with chronic illness and proposes ways this methodology can be used in the enforcement of nondiscrimination law. CHLPI has also conducted state-specific research and advocacy that supports expanded access to health care for vulnerable communities and that encourages state officials to incorporate more rigorous reviews of discriminatory insurance plans.
- Transgender Health Care Rights
Transgender and gender-nonconforming communities regularly face discrimination in health care settings and often lack access to affordable, high-quality health care coverage that includes gender-affirming care. CHLPI is engaged in work to strengthen protections in health care settings (focusing on insurance and state-level administrative protections), pursuing traditional methods of enforcement through advocacy and litigation that eliminate discriminatory insurance policies, and helping to expand access to gender-affirming care in rural areas.
- Hepatitis C Grassroots Advocacy
Newly developed direct-acting antiviral drugs can cure up to 99% of people living with hepatitis C—the number one communicable disease killer in the United States, claiming more lives than the next 60 communicable diseases combined, including HIV. While the price of the cure has dropped dramatically over the past several years, many state Medicaid programs continue to implement unprecedented treatment access restrictions. These restrictions violate federal law. CHLPI partners with the National Viral Hepatitis Roundtable (NVHR) to highlight the extent of the problem and to animate advocacy campaigns to eliminate discriminatory coverage practices in Medicaid and the Corrections health care programs of various states.
- Hepatitis C Impact Litigation
CHLPI is engaged in a state-by-state impact litigation campaign to fight restrictive Hepatitis C Medicaid policies. The work of this project is typified by B.E. v. Teeter, No. C16-227-JCC, 2016 WL 3033500 (W.D. Wash. May 27, 2016), a decision by a federal district court ordering Washington to strike its Medicaid policy of imposing disease severity requirements for HCV treatment. CHLPI continues this campaign with litigation in other states.
- Infectious Disease, the Military, and the Law
CHLPI has partnered with the Hepatitis B Foundation on a campaign to end military practices that discriminate against people living with hepatitis B—a form of liver disease. Although the virus is communicable, there is a vaccine to prevent the transmission of hepatitis B (which all military personnel receive) and treatment that can cure the infection. Still, people living with hepatitis B face outdated military policies that do not reflect current understandings of the virus and its treatment. CHLPI will conduct critical analyses, develop advocacy tools, and work with a coalition of national organizations to drive legislative reform.
- Medically Necessary Care versus Cosmetic Services: Expanding Access to Vitiligo Treatment
Vitiligo is an autoimmune disease that results in the appearance of white spots or patches on the skin. It can be psychologically devastating because of its visible effects, but there are effective treatments that can slow the spread of and even reverse the effects of the disease. CHLPI will work with a state-based partner to advocate for vitiligo treatment to be covered under the policies of a major health insurance company operating in Massachusetts.
- Protecting Public Health in Massachusetts
CHLPI continues its work as a consultant to the Massachusetts Department of Public Health’s Bureau of Infectious Disease and Laboratory Sciences (BIDLS), which encompasses, among others, the state’s HIV, viral hepatitis, tuberculosis, and sexually transmitted infections public health bureaus. This project allows CHLPI to act as an advisor to analyze health care laws, policies, and industry practices that are of interest to the client, and to advance frameworks that promote access to health care and public health in Massachusetts.