When President Barack Obama signed the Affordable Care Act (ACA) into law in March 2010 decades of efforts to enact national health care reform came to a successful conclusion. This momentous occasion also marked the beginning of HLA’s work to use legal advocacy to make the many benefits of the ACA a reality for low-income Massachusetts residents. As with our other high priority programs, HLA’s National Health Care Reform Initiative is a multi-faceted effort. It includes our unique mix of expertise in: 1) legal representation of low-income clients who are being denied access to health care or who have medical debt, and 2) shaping public policy.
The ACA benefits Massachusetts residents in a multitude of ways. The law grants many new protections for people enrolled in commercial health plans to make sure they get the coverage they pay for. The ACA also prevents hospitals from overcharging patients for care not covered by insurance and expands public health insurance programs for the poor. However, the President’s signature on the ACA did not guarantee full compliance by those entities it regulates or that poor people won’t be unjustly turned away from public insurance. HLA’s job is to represent Massachusetts consumers who aren’t receiving the benefits they should from the landmark ACA and can’t access or pay for health care as a result.
When the ACA was challenged in court, HLA helped defend the law with an amicus brief submitted to the United States Supreme Court on behalf of HLA, Health Care For All, Community Catalyst, Greater Boston Interfaith Organization, the Massachusetts League of Community Health Centers and the Massachusetts Hospital Association. You can read the brief here. The Supreme Court ultimately upheld the ACA on June 28, 2012.
As part of our National Health Reform Initiative, in the fall of 2010, HLA launched its efforts to utilize federal funding authorized by the Affordable Care Act (ACA) to assist consumers needing legal help to obtain coverage for health care services denied by their commercial health plans. Since launching this effort, HLA has assisted more than 550 consumers denied coverage by a commercial health plan.
Since HLA’s inception in 1996, we have assisted consumers in appeals of commercial health plan coverage denials. Funding authorized by the ACA enabled HLA to expand these services. HLA and our partner organization Health Care For All have together established separate partnerships with the Executive Office of Health and Human Services and the Commonwealth Health Insurance Connector Authority to obtain federal funding to help consumers appeal health insurer coverage denials, educate consumers about their rights with respect to health plans, and help people enroll in health insurance. For a copy of HLA’s Guide to Appeals click here.
HLA attorneys are also working to improve access to health care by advocating for public policies to protect the interests of low-income consumers in Massachusetts during the implementation process for the ACA. For example, in 2012, HLA joined with other consumer health care advocates to press regulators to adopt requirements to strengthen protections for mental health treatment and improve requirements for non-profit hospitals to provide free or reduced-cost care to those who are income-eligible.
In 2011, HLA and HCFA produced an informational video detailing the progress of the insurance appeals program and profiling the staff who made the program a success.