- 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 people with low income and 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. Looking to the future, CHLPI is developing proposed regulatory pathways for future administrations to promote more equitable access to care.
- Strengthening State-Based Health Insurance Coverage
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, that strengthens Medicaid expansion campaigns in states that have yet to take this step, and that encourages state officials to conduct more rigorous reviews of discriminatory insurance plans.
- Policy Support for Health Care System Stakeholders
CHLPI provides policy support to clients across the country who are engaged in projects and initiatives that increase equity in health care delivery and financing and public health infrastructure. Past and present projects have responded to disparities in access to care and quality of care for individuals with a range of health conditions, including lung cancer, breast cancer, prostate cancer, multiple myeloma, cardiovascular disease, multiple sclerosis, and rheumatoid arthritis.
- 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—one of the deadliest communicable diseases in the United States. 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.
- Protecting Public Health in Massachusetts
CHLPI is 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. CHLPI analyzes health care laws, policies, and industry practices that are of interest to BIDLS, and advances frameworks that promote access to health care and public health in Massachusetts.
- Health Care Policy During the Covid-19 Pandemic
CHLPI is working with other national organizations and on-the-ground partners to identify, analyze and promote policy priorities during the COVID-19 pandemic. Focus areas in this portfolio include ensuring access to medication, promoting access to care through Medicaid, amplifying LGBTQ+ resources, and expanding access to telehealth services.
Additionally, CHLPI works in its home state to amplify and advocate for equitable public health responses to COVID-19, including serving as a member of the Massachusetts Task Force on Coronavirus & Equity.
- Reproductive and Sexual Health: Federal and State Advocacy
CHLPI advocates to protect and strengthen reproductive and sexual health care access through a range of strategies, including the provision of technical assistance to reproductive health provider organizations, engaging the federal government on proposed regulations through the public comment process, and providing law and policy analysis and advocacy support to community and clinical partners.