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Health Law and Policy Amid Crisis: COVID-19 Response

The Center for Health Law and Policy Innovation of Harvard Law School’s (CHLPI’s) Health Law and Policy Clinic (HLPC) is leading The Center for Health Law and Policy Innovation of Harvard Law School’s (CHLPI) Health Law and Policy Clinic (HLPC) leads policy advocacy efforts to ensure that the care and treatment needs of people with low incomes and people living with chronic conditions are met during the coronavirus disease 2019 (COVID-19) pandemic. Our efforts range from promoting best practices for access to essential care, to ensuring a sound governmental public health response that addresses the social determinants of health and keeps people out of emergency rooms. Below is a sampling of CHLPI’s efforts, resources, and recommendations to help mitigate the risks that people face as a result of this public health crisis. 

National Health Care Policy During the Pandemic

CHLPI works with other national organizations and on-the-ground partners to identify, analyze, and promote policy priorities during the COVID-19 pandemic that best serve people who have low incomes and/or live with chronic conditions. These policy priorities include: 

Ensuring Access to Medication: In coalition with the HIV Health Care Access Working Group and the Chronic Illness and Disability Partnership, CHLPI called on the Trump Administration to promote access to prescription drugs amid social distancing guidance. This includes protections such as requiring Medicare Part D plans to cover prescription drugs in line with CHLPI’s demands for the duration of the emergency. 

Promoting Access to Care through Medicaid: CHLPI advocates for several Medicaid policies, including ensuring coverage for COVID testing and treatment, increasing the federal government’s share of funding, and expanding Medicaid in states that have not yet used federal funding to increase income eligibility levels to 133% of the Federal Poverty Level. Additionally, CHLPI helps advocates navigate emergency waivers (under section 1135 of the Medicaid Act) to streamline Medicaid programs in ways that facilitate workforce capacity, enrollment, and benefits.

Fighting for Hepatitis C (HCV) Treatment: Emerging evidence suggests that individuals with hepatitis C (HCV) may be at a heightened risk for severe illness if they get coronavirus. Despite this danger, many individuals living with HCV continue to face restricted access to the HCV cure. CHLPI is working to remove discriminatory restrictions to HCV care in Medicaid programs and correctional settings. COVID-19 has underscored the responsibility of governmental agencies to both prevent the spread of infectious diseases – such as HCV and COVID-19 – and mitigate its harm for people in its legal custody or insurance responsibility.

Amplifying LGTBQ+ Resources: LGBTQ+ communities face unique challenges and vulnerabilities during this public health emergency. CHLPI is amplifying resources and recommendations to ensure individuals have equitable access to appropriate care and treatment.

Protecting the Affordable Care Act: The COVID-19 pandemic has underscored the need for every individual to have access to affordable, high-quality health care and the importance of the Affordable Care Act in protecting the public’s health.  CHLPI has led advocacy efforts to protect the Affordable Care Act and its health reforms in the courtroom and in the promulgation of federal regulations. 

Identifying Additional Policy Priorities: CHLPI’s other policy priorities during the pandemic include, but are not limited to:

  • Extending no-cost testing and treatment coverage to all parts of the health care system,
  • Initiating a special open enrollment in federally-run marketplaces,
  • Ensuring access to telehealth services,
  • Limiting the impact of health insurance premium increases, and
  • Ensuring our safety net providers receive additional relief.

Public Health Response to COVID-19 in Massachusetts

CHLPI is working in its home state to amplify and advocate for equitable public health responses to COVID-19. CHLPI is a member of the Massachusetts Task Force on Coronavirus & Equity—a coalition of organizations that has come together to respond rapidly to policy priorities—and has been a leading voice on issues described below. CHLPI is also an integral part of other statewide coalitions, including the Massachusetts Transgender Health Coalition.

Protecting Patient Privacy

In March 2020, Massachusetts Governor Charlie Baker issued an emergency order to share the addresses of those who have tested positive for COVID-19 with emergency response dispatchers and, by extension, emergency responders. This strategy was tested during the AIDS epidemic; it contributed toward discriminatory treatment of those who tested positive, and it did not promote public health. CHLPI called on Governor Baker to rescind the dangerous and ineffective emergency order.

Equitable Access to COVID-19 Treatment and Testing

CHLPI is working to ensure that COVID-19 testing and treatment in the Commonwealth are accessible to all who need it. In collaboration with the ACLU of Massachusetts, CHLPI urged the Department of Public Health (DPH) to collect and publish testing data related to race and ethnicity to ensure that equitable response measures are implemented and scarce resources are effectively distributed. DPH has since begun releasing partial data. CHLPI, the ACLU, and the Task Force on Coronavirus and Equity continue to push the government for data collection and reporting to better understand how our response to COVID-19 is creating or exacerbating disparities in Massachusetts and to prioritize action to address inequities.

LGBTQ Resources in Massachusetts

CHLPI worked with members of the Massachusetts Trans Health Coalition to develop resources for people of transgender experience who have faced disruptions in care due to the pandemic. These resources include a series titled, Guiding Principles for Gender Affirming Care in the Time of COVID-19, which have been shared with community centers, health care providers, and health insurers in the Commonwealth. CHLPI continues to engage with key state officials to ensure that state non-discrimination laws are enforced and that public health programs do not implement unnecessary barriers to care. 

Monitoring State Government Response

CHLPI has a special focus on infectious disease and access to health care services that promote public health in Massachusetts. Through this initiative, CHLPI is monitoring and synthesizing steps taken by Massachusetts officials to respond to COVID-19.

Social Determinants of Health

CHLPI is engaged in advocacy and technical assistance activities to support social service organizations that are working to keep people safe and healthy at home during the COVID-19 emergency.

Supporting Social Services and Promoting Integrated Care

CHLPI, through its Health Law Lab initiative, is ensuring that nutrition and housing organizations receive substantive and targeted information about the rapid developments in health care and food policy that affect them and the people they serve. These efforts include:

  • Assisting organizations with becoming designated as essential services in their communities, thus ensuring continued operations in the event of a stay-at-home order;
  • Monitoring the evolution of policies related to the availability of and access to personal protective equipment (PPE) for organizations that are serving people in their homes;
  • Conducting rapid analysis of both federal and state legislation and policy developments that may provide funding opportunities for nutrition and housing organizations;
  • Tracking how the federal government, states, and municipalities are addressing broader food access issues and identifying best practices for improved coordination throughout the social safety net; and
  • Raising awareness of the challenges nutrition and housing providers face.

Leveraging Food is Medicine Interventions During the Pandemic

CHLPI is working with several partners including the national Food is Medicine Coalition and the Food is Medicine Massachusetts Coalition (FIMMA) to address the food and nutrition needs of people living with chronic conditions during the pandemic. These efforts include:

  • Educating food is medicine providers about funding opportunities within the federal stimulus packages that can be utilized to support their services,
  • Advocating for policy changes and funding opportunities that expand access to food is medicine interventions at the state and national level, and
  • Developing case studies illuminating how the COVID-19 crisis has impacted the operations of and demand for Massachusetts community-based food is medicine providers.

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