Access to quality health care is key to maintaining health and well-being, particularly for people living with chronic illness and disabilities (such as HIV and hepatitis C). Even when people have insurance though, cost and coverage barriers can still put necessary treatment and services out of reach. The Center for Health Law and Policy Innovation (CHLPI) works with longstanding community partners to pursue national and state advocacy for legal, regulatory, and policy reforms that help strengthen available health care coverage and ensures that people can access the care they need.
An estimated 53.8 million people in the United States have a declinable pre-existing health condition, such as HIV, diabetes, or cancer.
CHLPI focuses its work on strengthening Medicaid (public insurance for certain people with low incomes or who have certain disabilities) and private health insurance plans (including plans sold on the Marketplace that can be bought with tax credits and subsidies). We pay particular attention to how plans help people living with chronic conditions access the care and treatment they need to live healthy and well lives. This includes how a plan facilitates access to specific prescription drugs, medical benefits, and professional and tailored support (including community health workers). CHLPI uses a multi-faceted approach that pursues both federal- and state-based solutions to the obstacles consumers face in the health care system.
The Medicaid program is a federal-state partnership that provides access to health care for 73.8 million people in the United States, and is the largest source of health care coverage for people living with HIV. Medicaid’s role in providing access to health care for people with low incomes or with certain disabilities is essential to helping prevent and manage chronic conditions and address health disparities seen among racial, ethnic, and socioeconomic divides. While the Affordable Care Act offers significant funding to states who expand their Medicaid eligibility, many states have refused to expand their programs, leaving over two million people within the Medicaid coverage gap.
For more information about CHLPI’s work to strengthen Medicaid plans, please see the following resources:
- Public Comment: MassHealth 1115 Demonstration Extension Request (2022)
- Public Comment: Oregon Health Plan 1115(a) Demonstration Waiver Renewal Application (2022)
- Filling the Medicaid Coverage Gap: A Federal Policy Priority for People Living with HIV (2021)
- Letter to Congress re: Closing the Medicaid Coverage Gap (2021)
- Letter to the Centers for Medicare & Medicaid Services re: Oklahoma Section 1115 Demonstration Waiver (2020)
Health Insurance Marketplace
The Affordable Care Act, passed in 2010, established the Health Insurance Marketplace where most people in the United States can enroll in quality, affordable health care plans. Depending on a person’s income, these plans can be made more affordable with tax credits and subsidies. Plans sold on the Marketplace are subject to quality and nondiscrimination standards, and have served an important role in lowering the nation’s uninsured rate.
For more information about CHLPI’s work to strengthen Marketplace plans, please see the following resources:
- Public Comment on MA Health Connector: Seal of Approval 2023 Policy Development (2022)
- Recommendations for Notice of Benefit and Payment Parameters (NBPP) 2023 (2021)
- HHCAWG’s comments re: NBPP 2022 (2020)
- Groundbreaking Campaign to Enforce Health Care Rights for People Living With HIV In Seven States (2016)