National Health Law Program

Founded in 1969, the National Health Law Program (NHeLP) protects and advances the health rights of low-income and underserved individuals and families. The oldest nonprofit of its kind, NHeLP advocates, educates and litigates at the federal and state levels. NHeLP’s lawyers and policy analysts stand up for the rights of the millions of people who struggle to access affordable, quality health care.

Eligibility & Enrollment

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  • NHeLP Published E-Newsletter on Hospital Presumptive Eligibility

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    NHeLP: The National Health Law Program (NHeLP) published the latest issue of Lessons from California, focusing on the ACA’s requirement to implement Hospital Presumptive Eligibility (HPE). As of January 2014, HPE allows uninsured individuals who may be eligible for Medicaid to apply at qualified hospitals and receive benefits for up to two months. In California, individuals were incorrectly being HPE because they were previously eligible for coverage and tax credits through Covered California. As a result of NHeLP and other advocates’ actions, CMS has required the state to submit a mitigation plan by the end of the year and develop a manual work around by April to re-determine eligibility for all those who were incorrectly denied HPE in the past.

  • NHeLP Examines California’s Marketplace to Medicaid Transition

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    NHeLP: The National Health Law Program published an issue of Lessons from California examining how Covered California handled newly eligible enrollees transitioning from the Marketplace to Medi-Cal. The brief explains that nearly 30,000 individuals were found newly eligible for Medi-Cal due to decreased projected incomes for 2015. California attempted to make consumers’ transition to Medi-Cal seamless by automatically enrolling them in a Medi-Cal managed care plan as of January 1, 2015. Although this ensured there were no gaps in coverage, the brief is concerned that consumers did not receive sufficient notice of changes. 
  • NHeLP Publishes Lessons From California Focused on State’s Marketplace Renewal Process

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    NHeLP: In this month’s edition of Lessons from California, the National Health Law Program reviews Covered California’s renewal process and how it differs from the FFM renewal process. The newsletter highlights challenges with the renewal process, including limited availability of translated notices for non-English and Spanish speaking populations and coordination between Covered California and Medi-Cal. Despite these challenges, the newsletter predicts most Covered California enrollees will retain coverage with minimal disruption of care in 2015.

  • NHeLP Supports Federal Court Ruling on Tennessee Medicaid Lawsuit

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    NHeLP: The National Health Law Program (NHeLP) issued a press release supporting a federal judge’s decision ordering Tennessee to provide hearings to residents whose Medicaid applications have been unreasonably delayed and certifying the litigation as a class action lawsuit. The lawsuit, originally filed by NHeLP, the Southern Poverty Law Center, and the Tennessee Justice Center, alleges that Tennessee makes it unnecessarily difficult to apply for Medicaid Coverage. Elizabeth Edwards, staff attorney at NHeLP, stated, “We are pleased that Judge Campbell recognized this as a statewide problem. The law requires Medicaid applications to be processed promptly because low-income individuals and people with disabilities often have a brutal need for health care that, without TennCare coverage, they will be unable to afford.”

  • NHeLP Issues Statement on Lawsuit Filed Against State of Tennessee

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    NHeLP: The National Health Law Program (NHeLP) released a statement on the federal class action lawsuit filed against the state of Tennessee by NHeLP, the Southern Poverty Law Center, and the Tennessee Justice Center. The lawsuit, which was filed after CMS sent state officials a letter indicating the state failed to meet six of seven critical Medicaid success factors required by the ACA, alleges that Tennessee makes it harder than any other state to apply for Medicaid coverage. Jane Perkins, legal director for NHeLP stated, “Each day that Tennessee fails to follow the law, the health and lives of more Tennesseans are put at risk. We are monitoring [Medicaid] enrollment in other states, and at this point, Tennessee is among the worst, if not the worst, offenders. The state is doing the least to help its residents obtain health insurance coverage they are qualified for and need.”

  • NHeLP Publishes Lessons from California on the Medi-Cal Application Backlog

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    NHeLP: In the July issue of Lessons from California, the National Health Law Program discussed the backlog of Medicaid applications pending since at least January 2014. The Issue Brief notes that California’s current mitigation plan will only reduce the number of pending applications from 600,000 to 350,000 and, unless the State delays Medi-Cal renewals, the system will become even more strained in the coming months. The Issue Brief highlights  advocates’ work to assist with the backlog including developing proposed mitigation strategies, draft consumer notices language, and policy recommendations including presumptive eligibility.  

  • NHeLP Comments on Annual Redetermination Process for 2015

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    NHeLP: The National Health Law Program submitted comments to CMS on the proposed regulations and sub-regulatory guidance released on annual redeterminations. The comments propose recommendations about renewal processes for individuals enrolled in Qualified Health Plans, propose alternative renewal procedures, and provide guidance on Marketplace renewal notices. KidsWell grantee, Community Service Society of New York (CSS), signed onto the comments. 

  • NHeLP Comments on Draft Marketplace Renewal Issuer Notices

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    NHeLP: The National Health Law Program (NHeLP) sent comments to CMS on its June 26th “Insurance Standards Bulletin Series” which contained draft notices that issuers must provide to Qualified Health Plan (QHP) enrollees as part of the redetermination process. The comments recommend simplifying notice language to be more consumer friendly and separating notices that contain generalized information from those containing personalized information or requiring consumer action. NHeLP also recommended that issuer notices conform with accessibility requirements and that CMS create a notice development checklist for State-Based Marketplaces. KidsWell grantee, Community Service Society of New York (CSS), and other advocates joined the comment letter.  

  • NHeLP Makes Recommendations to Ease the Medi-Cal Application Backlog

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    NHeLP: The National Health Law Program, along with nearly 20 other Health Consumer Alliance partners, sent a letter to California Governor Jerry Brown with recommendations on how the State may alleviate the Medi-Cal application backlog.  The letter recommends: granting presumptive eligibility for applications pending longer than 45 days; providing accelerated eligibility to all children; approving pending applications if income is “reasonably compatible” with available data sources; increasing IT access for county workers; communicating directly with all pending applicants; ceasing renewals for existing beneficiaries and extending their eligibility; and educating Medi-Cal providers.  
  • NHeLP Brief Highlights Medi-Cal Renewal Challenges

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    NHeLP: The National Health Law Program (NHeLP) published a one-pager outlining its concerns with California’s plan to move forward with renewing coverage for hundreds of thousands of Medi-Cal beneficiaries despite the current workload demands on Medi-Cal eligibility workers and the on-going IT system challenges.
  • NHeLP Releases Issue Brief on California’s Streamlined Application

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    NHeLP: The National Health Law Program (NHeLP) published an issue brief highlighting: advocates’ involvement in developing California’s streamlined paper application; delays implementing the interface between Covered California and Medi-Cal’s eligibility systems; and opportunities for advocates’ participation to continue to improve California’s enrollment systems.

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