Northwest Health Law Advocates is the consumer voice in the health care debate. We aim to improve access to health care for all Washington residents in furtherance of health as a human right. Here are some examples of our recent advocacy efforts:
Refining and Improving Health Reform
Ever since the January 2014 launch of Medicaid Expansion and new health insurance marketplace, NoHLA has been at the forefront of efforts to ensure Washington State’s new health system attracts enrollees and that it works for all residents, including those who are low-income. We’ve been working to:
• Implement health reform effectively in Washington: NoHLA has played a key role in advocating for ensuring that people can easily enroll in Washington’s Medicaid expansion and Exchange, leading to better coordination and access and enabling many more people to be insured.
• Ensure full contraceptive coverage in insurance plans: NoHLA issued a groundbreaking “secret shopper” report finding that insurers gave women inaccurate information on contraceptives now covered at no cost. In response, many insurers took corrective action, improving access to coverage.
• Promote state policy options for affordable coverage: NoHLA has been leading the push for the state to adopt policy options such as easier access to Medicaid, better options for pregnant women, a confidential program for pregnant teens, and development of the Basic Health Option. NoHLA provides input into the policy choices that will create equitable coverage for all. Over the past four years, we have provided extensive comments as the Medicaid regulations were restructured to adapt to the ACA.
• Protect and defend our progress: In the face of current threats at the federal level to eviscerate health programs – not only those created under the Affordable Care Act but Medicaid itself – NoHLA is prioritizing defensive work, which includes broadly informing the public and policymakers of the value and impact of these programs for Washington residents, and the importance of building upon them.
Monitoring Health Insurance Coverage Decisions
NoHLA successfully advocated for a searchable database of decisions when consumers appeal health insurers’ denials of coverage. It is now available at oic.wa.gov. We are seeking improvements in the quality of the data to make it even more user-friendly.
Promoting Language Access in the Exchange
When NoHLA learned that Washington’s new Health Benefit Exchange marketplace was not prepared to serve our state’s diverse population, we sprang into action. We partnered with the Washington State Coalition on Language Access to issue a report highlighting the 200 languages spoken in our state and legal obligations to serve all residents. Because of our efforts, the Exchange has developed a Language Access Plan that begins to address the interpretation and translation needs of immigrants. We also worked with the Exchange to develop outreach materials for uninsured immigrants.
Success in Restoring Health Care for Immigrants
In September 2011, NoHLA and co-counsel Riddell Williams, P.S. received a favorable ruling in a
class action suit on behalf of low-income immigrants who challenged their disenrollment from Washington State’s Basic Health program. Federal District Court Judge James Robart issued a preliminary injunction, ordering the State to re-enroll thousands of immigrants whose coverage was terminated in March due to budget cuts. The judge ruled on two constitutional grounds:
• Disenrollment based on immigration status likely violated the plaintiffs’ Equal Protection rights.
• The notice of disenrollment that plaintiffs received was likely inadequate, violating their Due Process rights.
The Health Care Authority immediately restored coverage to all affected immigrants and sent them improved notices describing the new eligibility criteria, in order to give them an opportunity to pay their premiums and demonstrate a “lawfully present” immigration status in order to retain coverage in the future. (The Basic Health Program was superseded in 2014 by the ACA; lawfully present immigrants not eligible for Medicaid were offered QHP subsidized coverage through the Washington Health Exchange).
Teresa Mosqueda, Coalition Chair, WA State Labor Council
Janet Varon (NoHLA’s Executive Director) & Sarah Kwiatkowski, co-chairs of the Low-Income Populations committee
Julie Severson, formerly Neighborhood House, co-chair of the Insurance & Exchange
Some other milestones in NoHLA’s fight for health care justice include:
Ensuring that the Affordable Care Act will be implemented in the best interests of women, vulnerable populations, and consumers generally – providing reproductive and preventive service, language access, appeal rights, and other important protections. Many of NoHLA’s suggested improvements to agency rules and procedures affecting consumer rights have been adopted.
• Working with our Healthy Washington Coalition partners to achieve the Medicaid expansion in Washington.
• Reaching a legal settlement with the Washington Health Care Authority guaranteeing that Basic Health program enrollees are given adequate time to provide renewal documentation and avoid disenrollment.
• Preventing harmful restrictions in the state’s process for determining what health care services are “medically necessary,” by advocating that “evidence-based” rules must be balanced with individualized consideration of patient needs.
• Working in partnership with the Health Coalition for Children and Youth toward Washington’s landmark “Cover All Kids” legislation, now considered a national model.
• Persuading the state to protect Medicaid for newborns children of immigrant women. Based on our legal analysis, the state sued the federal government, who then backed down and reversed its original decision. Thanks to NoHLA’s advocacy, all states may now deem these newborns eligible for a year.
Staff and Board of Directors
Janet Varon is the founder and Executive Director of Northwest Health Law Advocates. She coordinates the statewide legal advocates' Medical Assistance Work Group and serves on the Healthy Washington Coalition Steering Committee. Janet is a member of the boards of the National Health Law Program and the Medical-Legal Partnership for Children. She previously chaired the state's Medical Assistance Advisory Committee and served on the Governor's Certificate of Need Task Force and on the Low-Income Populations Advisory Group to the Joint Select Committee on Health Care Reform Implementation. Before starting NoHLA, Janet worked for 13 years as a staff attorney at Evergreen Legal Services. Janet is a graduate of Harvard Law School.
The National Health Law Program Board President Rob Weiner presents a plaque to NoHLA Executive Director Janet Varon in appreciation of nine years of service on the NHeLP board.
Senior Staff Attorney
Daniel Gross is a Senior Staff attorney at Northwest Health Law Advocates (NoHLA), where he works on a wide array of healthcare-related issues. He serves on the State’s HealthPath Advisory Team, advising the State on its development of an integrated healthcare program for individuals eligible for both Medicaid and Medicare. He is also a member of the Washington Health Benefit Exchange Board's Health Equity Technical Advisory Committee.
Prior to joining NoHLA, Daniel was a member of the Public Interest Law Group in Seattle, a staff attorney at the Washington Protection and Advocacy System (now Disability Rights Washington) and a staff attorney at the Defender Association of Seattle/King County. Daniel was awarded a NYU Public Service Fellowship to advocate for the rights of involuntarily committed psychiatric patients.
Daniel volunteers for the King County Bar Association Nonprofit Law Clinic and with the University of Washington Human Subjects Research Independent Review Board, as a prisoner advocate. Daniel served as a Board member and officer of REACH, a student –run homeless services nonprofit in New York City, and Washington CAN!, Washington State’s largest grassroots community organization.
Huma Zarif is a staff attorney at Northwest Health Law Advocates (NoHLA). She graduated from University of California, Hastings College of the Law with a concentration in Health Law. Prior to law school, Huma worked as a social worker for over eight years, including at Harborview and Swedish Medical Centers. She obtained both her Bachelor in Social Welfare and Master of Social Work from the University of Washington, School of Social Work. Huma believes health care is a human right and is passionate about improved access to health care services.
As her schedule permits, Huma enjoys volunteering and previously served on the Board of Directors of Chaya (now API-Chaya), a Seattle based nonprofit working to end domestic violence in the South Asian, Middle Eastern, and Muslim communities. She also volunteered with HealthRight International where she conducted mental health assessments for asylum applicants. Following college graduation, Huma's interest in both local and global health issues led her to volunteer at an orphanage and maternity hospital in Kabul, Afghanistan.
Ann Vining came to NoHLA in March after a career as a legal services staff attorney that began at Spo-kane Legal Services in 1979. She continued at Evergreen Legal Services and Columbia Legal Services before moving to Northwest Justice Project's Everett office in 2004. Since 1982, her work has focused on benefits issues, including Medicaid, Medicare, and long-term care services, and other issues of con-cern to older adults and people with disabilities. Ann served as a clerked for a federal district court judge in Spokane after graduating from the University of Wisconsin Law School in 1977. Her under-graduate degree is from Harvard University.
Other significant experiences included growing up in the Ozarks, attending Little Rock Central High School after federal authorities secured desegregation there, working with children with profound intellectual challenges, staffing a Wisconsin Governor's Task Force that developed a comprehensive agenda for accessibility for people with disabilities (years before the ADA), and serving as a caregiver for family members with physical, mental health, or cognitive challenges.
Karina Wiener is a Communications Associate at Northwest Health Law Advocates (NoHLA). She graduated from Haverford College as a Pre-Health student with a B.S. in Chemistry in 2015. She spent her summers volunteering with the underserved Mexican-American population in Southern California (where she was born and raised) in various medical settings. With both parents in health care professions, Karina has a long-standing interest in access to care and is excited to use her communications skills to contribute to NoHLA’s mission.
Karina spent a year working as a Program and Communications Fellow in Haverford’s Center for Career and Professional Advising. She moved to Seattle in August where she Stage Managed and Assistant Directed for Ghost Light Theatricals. She recently began working part time as a Social Media Intern with Seattle Translational Tumor Research at Fred Hutchinson. Karina enjoys dancing, baking, and exploring Seattle’s unparalleled nature and dining options.
Administrative Coordinator, Webguru
Hafoc Yates joined the NoHLA staff in August 2006. She holds NoHLA together and keeps it functioning – no small task! She coordinates fundraising, administrative and database management, training, communications and NoHLA trainings, and she provides creative troubleshooting support. Hafoc is NoHLA’s Web Administrator, and specializes in Tech support with a smile.
Hafoc has a long history working with nonprofit organizations. She volunteered and fostered many rescued animals from pets to possums to owls in Portland, OR. Moving to Seattle she volunteered for Seattle’s famous P-Patch program. She enjoys animals, gardening, science fiction/Steampunk, BBC, hacking, and bicycling & vegan cooking with her son.
Board of Directors
Blake Marks-Dias joined NoHLA’s Board in 2013. He is a partner at the Corr Cronin Michelson Baumgardner Fogg & Moore law firm in Seattle, with a practice focusing on complex commercial litigation. He was part of the NoHLA litigation team that protected the rights of more than 11,000 Washington residents faced with termination from the Basic Health program
Blake lives in West Seattle with his wife, Jodie (formerly an attorney with the Northwest Justice Project), their two boys and a Boston Terrier named “Alibi.”In his free time he enjoys spending time with his family, listening to music, and taking advantage of Seattle’s vast and varied dining options.
Lori Buchsbaum has over 20 years experience working with local, regional and international health programs in Seattle, Washington, D.C. and along the U.S.-Mexico border. She is currently a probono attorney with the Northwest Immigrant Rights Project and the King County Housing Justice Project, and is working in mediation.
Ms. Buchsbaum was Staff Attorney for Northwest Health Law Advocates (NoHLA) for four years. Prior to that she worked with the Center for Health Training; the Washington State Department of Health, Tobacco Prevention and Control Programs; Public Health Seattle King County; Medstar/Georgetown University Hospital; the U.S. Senate Committee on Health, Education, Labor and Pensions; the Maryland Court of Special Appeals; the Center for Medicare Advocacy; Sonnenschein, Nath and Rosenthal, LLP; the Office of Counsel to the Inspector General, U.S. Department of Health and Human Services; Development Associates; and Project Concern International. Lori received her J.D. in 2004 from American University, Washington College of Law, and a Master’s Degree in Public Health in 1991 from San Diego State University. Lori loves to travel, hike, ski, swim and “explore” with her son Max and dogs Butch and Sundance.
Audrey Sheffield came to Seattle in 1989 after receiving her MBA from the Yale School of Management. Since then, she has worked in health care management for both Northwest Hospital and Group Health Cooperative. She has also served in a variety of volunteer capacities in connection with the Seattle Public Schools: PTA Treasurer, Annual Fund Chair, Garfield Jazz Foundation Co-President, and girls soccer team manager. She is currently a volunteer college coach for Garfield High School students with College Access Now. Audrey lives in Madrona with her husband, John, a UW faculty physician at Harborview Medical Center, and has two daughters in college.
Charles Mitchell is a civil legal aid attorney at the Northwest Justice Project office in Vancouver, Washington. He has worked for more than 20 years in legal aid, focusing on medical and other public assistance needs of low-income people. Previously he worked in Washington, D.C. as an attorney and lobbyist at the Center for Science in the Public Interest, a non-profit consumer and health policy advocacy organization, concentrating on the effort to pass the federal Nutrition Labeling and Education Act of 1990.
Charlie sings in a choir, does the running leg for one of NoHLA's annual triathlon relay fundraising teams, and is getting used to having one child a college graduate and the other a college sophomore.
Misha Werschkul is the Executive Director for the Washington State Budget & Policy Center and guides the organization’s strategic vision and ensures its position as a leading voice shaping the debate around budget priorities. She previously worked in a range of roles with Service Employees International Union (SEIU) in Washington, DC, and SEIU 775 in Seattle – most recently serving as 775’s legislative and policy director. Misha has a master's degree in public policy and women's studies from George Washington University and held two research fellowships with the Institute for Women's Policy Research in Washington D.C.
Julie Severson has extensive experience in women’s bioethics, patient decision-making and the Affordable Care Act. She co-chaired the Healthy Washington Coalition Insurance & Exchange Committee. Julie holds a Ph.D. in Women’s Studies and a J.D. from the University of Washington. In her free time, she enjoys spending time with her two young children.
Christina Peters is an experienced policy advocate, having been involved with legislative and administrative advocacy to implement the Affordable Care Act in Washington. She served on the Health Benefit Exchange Health Equity and Outreach Technical Advisory Committees, co-chaired the Healthy Washington Coalition Insurance and Exchange Committee, and convened the Health Coalition for Children and Youth. In her spare time, Christina enjoys spending time with her two young children.
Jodi Sullivan joined NoHLA’s Board in 2016. She is a civil legal aid attorney at the Northwest Justice Project in Everett. She formerly worked at the NJP offices in Port Angeles and Seattle. Jodi’s work focuses on legal issues faced by older adults and on medical and public benefits for low-income individuals. Jodi received her J.D. from the University of Washington. She spends her free time reading and enjoying time with her spouse and dogs.
Eulalia (Lili) Sotelo is a Directing Attorney at Columbia Legal Services, where she oversees litigation, legislative advocacy and community outreach for the Economic Justice Project. Prior to working at CLS, Lili was Senior Attorney at the Northwest Justice Project’s Foreclosure Prevention Unit and the Directing Attorney of Consumer Law at the Legal Aid Foundation of Los Angeles. She has presented at numerous CLE trainings across the country on housing and consumer issues and has testified before the Legislature about unfair banking practices. One of her most high-profile cases was against international banks for their role in predatory loan origination and securitization during the height of the subprime crisis. Lili has written resource material on foreclosure for judges and was an adjunct professor at Seattle University School of Law. She graduated from Harvard University and the University of California, Hastings College of the Law.