Health and Food Policy
Clients and collaborators – The health team works with government associations, nonprofit organizations and university-based programs to increase access to health care and nutrition for some of the nation’s most vulnerable citizens. Over the past several years, the team has analyzed community food policy, legal issues related to federal health reform, international tobacco control, and consumer protection in genetic testing. See our recent clients and collaborators here.
Food and nutrition – Obesity rates continue to rise, particularly in young children and low-income areas. Children and adults in low-income areas do not have equal access to fresh fruits and vegetables in their communities and suffer higher rates of obesity and diabetes. We partner with School Food FOCUS, which supports large school districts that want to purchase unprocessed local food. To do so, they must figure out how to adopt a local preference that complies with local, state, and federal procurement law. By June 2013, we will have worked with five school districts. Recent work:
- Geographic Preference Primer – Sandy Han
- Staying Legal on the Cutting Edge of Procurement – presentation slides by Will Thanhauser and Michelle Poncetta
Food and sustainability – As consumers, governmental entities like school districts have the potential to change how food is produced. For example, school districts are working with producers to get antibiotic-free chicken into school meals. School districts that want to expand their food purchasing criteria to include sustainability must ensure they have the legal authority to do so under state law and federal conditions of funding for school meals. We expect to work with FOCUS and school districts in California to launch this project.
State role in reform of health insurance – While the Affordable Care Act (ACA) made significant reforms to health insurance, states are at the forefront of implementing these reforms. With wide discretion on certain policy matters, the approach to regulating insurance under the ACA can vary from state to state. Understanding how and what actions states are taking is a critical step to inform federal and state policymakers of the changing insurance landscape. We have supported organizations like the Center on Health Insurance Reform (CHIR) in its efforts to monitor and analyze state implementation of the ACA.
HIV/AIDS and health reform – State health departments play a vital role in providing access to testing and treatment for HIV/AIDS and viral hepatitis; they receive a majority of funding from federal and state governments. The Affordable Care Act expands eligibility for Medicaid and private insurance to previously uninsured Americans including individuals living with HIV/AIDS. However, with more HIV/AIDS clients eligible for insurance, federal and state funding may be cut. State health departments are assessing the capacity to bill third parties like Medicaid and private insurance for the services they provide, but they need to know whether state law limits their legal ability to do so. Partnering with the National Alliance for State and Territorial AIDS Directors (NASTAD), we have provided an overview of five states and their laws related to state health department billing. We plan on continuing our partnership with NASTAD. Recent work:
- State Health Department Billing for HIV/AIDS and Viral Hepatitis Services: An Analysis of Legal Issues in Five States – Dinesh Kumar and Dean Hendrick
- Insurance Access for Pre-Existing Conditions – Dinesh Kumar and Dean Hendrick
- Immigrants and the Affordable Care Act – Dinesh Kumar and Dean Hendrick
Prescription drug plans – Employers who want to provide a prescription drug plan contract with Pharmacy Benefit Managers (PMBs). Approximately two-thirds of all U.S. prescriptions go through a PBM. PBMs are a multi-billion dollar industry with a concentrated handful of players, which have attracted lawsuits and investigations related to consumer protection and contract violations. In order to help employers understand the complex nature of prescription drug processing and contracting with PBMs, we created a contract negotiating tool to translate common issues that may arise under a PBM-employer contract.
- Contract Negotiating Tool: Information on Contracts with Pharmacy Benefit Managers - Claire Frezza and Sandy Han
Genetic discrimination – People are increasing their use of genetic testing to learn about their dispositions to disease and hereditary traits. In May 2008, the federal government enacted the Genetic Information and Nondiscrimination Act (GINA), which prohibits the use of genetic testing for employment or health insurance. GINA specifically omitted long-term, disability and life insurance, and it left states to regulate this area. Genetic tests marketed directly to consumers can be misleading and potentially harmful to consumers; state governments can take action to prevent these harms by policing the advertising of tests. Recent work:
- State Guide to Genetic Testing- Sara Hoverter and Danielle Perlman