About

NoHLA’s Impact

Northwest Health Law Advocates is the consumer voice in the health care debate. For 25 years, we’ve been working to improve access to health care for all Washington residents to advance health as a human right. Here are some examples of our recent advocacy efforts:

Refining and Improving Health Reform

NoHLA is 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. Our work includes:

  • Ensuring effective state implementation of the ACA and addressing continuing barriers to access: 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 become – and stay – insured.
  • Advocating to guarantee 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.
  • Spurring improvements in equitable, affordable access for all: NoHLA has been instrumental in the push for the state to adopt policy options such as easier access to Medicaid, coverage for immigrants left out, lower premiums and cost-sharing for health insurance on the Washington Exchange, and reproductive health equity. NoHLA provides input into the policy choices that will create equitable coverage for all. We provided extensive comments as the Medicaid regulations were restructured to adapt to the ACA. We worked toward the creation of a family planning program for immigrants not eligible for Medicaid that was enacted and began in October 2019. More recently during the COVID-19 pandemic, we have engaged with state agencies on simplifying and liberalizing programs so people can gain coverage more easily and can access services via telehealth.
  • Protect and defend our progress: In the face of threats at the federal level to eviscerate health programs – not only those created under the Affordable Care Act (ACA) but Medicaid itself and reproductive health programs – NoHLA has engaged in 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. In 2019, the Washington Legislature passed a bill to incorporate key provisions of the ACA into state law, with NoHLA providing input into the content of the law and then into the regulations that implement the legislation.

Supporting Legislation to Protect Patients from Surprise Medical Bills

NoHLA was a key consumer advocate in long-term efforts to “take consumers out of the middle” – a situation where insurers and health providers cannot reach agreement on payment and the provider ends up sending a bill for the balance of the charges to the patient. A person needing emergency care has no idea that they were seen by an out-of-network health provider, laboratory, etc., and has no ability to change to an in-network provider. They are later surprised by a separate, costly bill that far exceeds their insurance plan’s cost-sharing. A person getting care at an in-network health care facility can be similarly surprised.

After many years, in April 2019, the Washington Legislature enacted a law that prevents “surprise billing” and protects many Washington residents caught in this situation. The legislation limits what consumers are billed to in-network cost-sharing. Insurers and providers must work out payment between themselves. Recently, a federal surprise billing law passed that provides additional protections. NoHLA will continue to provide input as regulators, insurers, and providers take steps toward implementing these consumer protections.

Health Care for Immigrants:
Fighting for Coverage, Combating New Threats

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.)

The ACA did not preserve immigrant coverage that many Washington residents had through the now-expired state Basic Health Program, and in the past four years, federal policies threatened accessing even what does exist. NoHLA was actively involved in efforts to prevent these threats from interfering with immigrants’ access to care, but now that these policies were withdrawn, we are pivoting to more proactive strategies -  supporting to the restoration and expansion of coverage at the state level, especially to the populations disproportionally affected by COVID-19 – immigrant and BIPOC communities.

Huma Zarif

Huma Zarif testifying before the Washington Legislature on a bill addressing reproductive health equity.

Gov. Inslee signs HB 1870

2019 Gov. Inslee signs into law HB 1870 protecting individuals with preexisting conditions and prohibits patients from being dropped from coverage unless fraud is involved.

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. We continue our efforts with state agencies to translate more materials and provide interpreters when needed, including for COVID-19 testing and vaccination information through the Department of Health.

Other Milestones in NoHLA’s Fight for Health Care Justice

NoHLA works to ensure 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 recommended improvements to agency rules and procedures affecting consumer rights have been adopted.

In addition, NoHLA has:

  • Worked with partner organizations to achieve the Medicaid expansion in Washington, protecting against cuts to the program, and improving access to coverage.
  • Reached 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.
  • Monitored the adequacy of health insurance provider networks.
  • Worked in partnership with the Health Coalition for Children and Youth toward Washington’s landmark “Cover All Kids” legislation, now considered a national model.
  • Persuaded 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.

NoHLA’s Work Ahead

Our priorities over the next generation of advocacy include:

  • Representing the interest of consumers as state agencies implement new laws.
  • Eliminating disparities in health care access, ensuring that race, immigration status and language are never barriers.
  • Informing our community and fighting back against threats to equitable health care access.
  • Working toward universal, equitable, affordable health care access for all Washington residents.

Support our work fighting for health care justice in Washington State. Join our email list to stay informed and get engaged!

Staff & Board of Directors

Staff

Executive Director

Janet Varon is the founder and Executive Director of NoHLA. Janet is a member of the Medical-Legal Partnership advisory board and serves on the steering committee of Health Care Is a Human Right -Washington.  She previously chaired the state's Medical Assistance Advisory Committee and has served on the National Health Law Program board and statewide advisory groups. Before starting NoHLA, Janet worked for 13 years as a staff attorney at Evergreen Legal Services. Janet is a graduate of Harvard Law School. Honors include Agent of Change from the Washington Jewish Historical Society and the 2018 Marcia Howery Award from the Washington Healthcare Access Alliance.

Rob Weiner and Janet Varon

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.

Deputy Director

Emily Brice previously served as a Staff Attorney at NoHLA and is pleased to be returning to the organization after serving in government in two states, first as the Senior Health Policy Advisor to Washington State Insurance Commissioner Kreidler and later as the Deputy Chief of Policy & Strategy for the Massachusetts Health Connector, a state-based Marketplace agency. Emily began her career in clinic-based social services as the Chicago Site Director for Health Leads. She is a graduate of the University of Washington School of Law and University of Chicago.

Emily is enjoying being back in the Pacific Northwest after 5 years on the East Coast and looking forward to hiking, volunteering, and snowshoeing with her spouse and toddler in tow!

Senior Attorney

Ann Vining came to NoHLA in 2016 after a career as a legal services staff attorney that began in 1979. Since 1982 her work has included benefits issues, including Medicaid, Medicare, and long-term care services, with a special focus on issues for older adults and people with disabilities. Ann served as law clerk for a federal district court judge in the Eastern District of Washington after graduating from the University of Wisconsin Law School in 1977. Her undergraduate degree is from Harvard University.

Other experiences significant to her work included growing up in the Ozarks, attending Little Rock Central High School after federal authorities secured its desegregation, working with children with 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 disabilities.

Operations

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, hacking, Kettlebells, & vegan cooking with her son.

Senior Policy Advocate

Lee Che P. Leong is NoHLA’s Senior Policy Advocate, bringing extensive experience in public health, higher education, international human rights, youth engagement, and reproductive justice in New York City and Washington state. Lee Che has worked for non-profits at the local, state and national levels including directing the NYCLU’s Teen Health Initiative and collaborating in the launch of two of Washington’s Accountable Communities of Health.  In her spare time, she enjoys the dining & cultural opportunities that living 30 minutes from Canada offers and is proud to volunteer as Mt. Baker Planned Parenthood’s board treasurer.

In 2023 Families USA honored Lee Che with its Health Justice Advocate of the Year Award for Health Coverage for her work on immigrant health expansion in Washington.

Policy and Communications Specialist

Leslie Bennett has more than twenty years of experience in health care policy, advocacy, and communications on both the east and west coasts. Most recently, she was Senior Communications Manager at the Washington Health Alliance, a nonprofit collaborative of purchasers, providers, insurers, and consumers working to improve the quality and reduce the cost of health care across Washington state. Previously, she was the Director of the Commercial Insurance Appeals Project at Health Law Advocates in Boston, Assistant General Counsel at the Massachusetts Health Connector, Assistant Attorney General in the Massachusetts Attorney General’s Office, and Staff Attorney with the Community Health Assets Project, where she represented community interests in nonprofit hospital conversions at Consumers Union in San Francisco, the advocacy effort of the nonprofit publisher of Consumer Reports. Before that, she worked as a radio news reporter at KUOW in Seattle and National Public Radio affiliated stations in New Hampshire and California. Leslie attended Emerson College and Northeastern University Law School.

In her free time, Leslie enjoys gardening, yoga, and all kinds of film.

Board of Directors

President

Lori Buchsbaum has over 30 years of experience working with local, regional and international health and legal programs in the Pacific Northwest, Washington, D.C. and along the U.S.-Mexico border.  She is currently a mediator, facilitator and trainer with Bermuda Associates, LLC, the Center for Dialog & Resolution, the King County Interlocal Conflict Resolution Group and Conflict Intervention Services.

Lori served as Staff Attorney for Northwest Health Law Advocates (NoHLA) from 2006 to 2010.  She has also done legal work for:  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; and the Office of Counsel to the Inspector General, U.S. Department of Health and Human Services. Lori led and contributed to public, community and international health efforts with Development Associates, Project Concern International and many local health organizations based in San Diego, CA.  She received her J.D. in 2004 from American University, Washington College of Law, a Master’s Degree in Public Health in 1991 from San Diego State University, and a BA/BS from University of California, San Diego in 1988.  Lori loves to travel, hike, ski, swim and “explore” with her son Max, husband Steve and their lab Zeus.

Treasurer

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.

Abby Goldy is the managing attorney for the ACLU-WA’s Information and Referral Program. She has worked in public interest organizations serving communities impacted by poverty for almost 20 years beginning with her work at the Northwest Justice Project as a CLEAR attorney and volunteer coordinator. Her work also led her to advising law students seeking public interest law opportunities at the Access to Justice Institute at Seattle University before coming to the ACLU-WA in 2021. Abby lives in Seattle with her spouse and video-ready Frenchie, Po Tater.

 

Cezanne Garcia has more than 30 years serving as a health systems redesign consultant, providing technical assistance and training to diverse health systems.  She served in Olympia as Director of Practice Transformation for Healthier Washington, worked with Public Health- Seattle King County overseeing the safety net clinic network investment, Senior Consultant with the Institute for Patient and Family Centered Care, patient care administrator at UW Medical Center and educator at Seattle Children’s designing programs to improve patient and family partnerships in the care experience, and worked as Senior Health Planner for the Navajo Nation.   She has dedicated her practice to provide capacity building services to care delivery systems convening its many stakeholders - staff, clinicians, and administrative leaders, in partnership with patients and families, to improve health care access, experience of care, equity, access, and quality.

Dedicated volunteer, including founding member of Jewish Women’s Funding Network and Harborview’s Community Service League.  Board member of the Burke Museum and former Board member of Artist Trust, Society of Public Health Education, Washington Health Education Resources Exchange, Alternative and Non-Traditional Employment for Women, and Navajo Nation Family Planning nonprofits.  She currently is lead cook for a team that prepares meals for homeless teens in the University District and has served for over two years outside the release gate of the NW ICE Processing Center in Tacoma, present to welcome released immigrants and support them to reunite with community and loved ones.

Cezanne lives in Seattle with her husband David Grossman and enjoys backpacking, bicycling, gardening, cooking, and spending time with her family. She is recommitting her time to create fused glass and collage art work.

Omid Bagheri Garakani works in the Executive Office of Public Affairs and Equity at the Washington State Department of Health working to advance equity and social justice. He is a Clinical Faculty member at the University of Washington School of Public Health where he teaches anti-racism practice within public health. Omid is organized with organizations and collectives to advance health justice, including the End Police Violence Collective (www.endingpoliceviolence.com) which authored APHA policy statements focused on centering policing and incarceration as public health crises, Public Health Awakened, a national network of public health practitioners working to support social justice movements, and as a Board member for Northwest Health Law Advocates to bring healthcare to all in Washington State. Omid's previous work includes capacity-building services and consulting at JustLead Washington focused on leadership and organizational development for legal advocates and organizations in Washington with a focus on anti-racism. Omid seeks health justice in his work, taking his experience as an Iranian American and familiarity with harms perpetuated by unjust systems, to drive his work to ensure all communities, particularly those structurally marginalized and experiencing the most health inequities, have the resources and power necessary for health.

Michelle Francis is a digital health attorney for Microsoft and works at the intersection of healthcare, technology, and ethics. Prior to Microsoft, she worked for healthcare organizations such as Seattle Children’s Research Institute and the VA Puget Sound Healthcare System. Michelle serves on the board of Legal Voice and is a member of the Washington State bar. Michelle lives in Seattle with her 7-year-old son. In her spare time, you can find her surfing, roller skating, and practicing yoga.

Shirley Prasad has spent more than 10 years working in health policy and advocacy, with a focus on increasing access to health car for low-income and other underrepresented populations. She has worked extensively in both Washington State and Washington, DC. She has engaged in issues that includes behavioral health, data privacy, Medicaid financing, and workforce. She is also an experienced community organizer, working with patients to elevate their voices with state and federal policymakers. Prior to working in health policy, she was an attorney working in tax law.

Shirley earned both her Master of Health Administration and Master of Laws in Taxation from the University of Washington, a Juris Doctor form the University of San Diego, and a Bachelor of Arts from the University of British Columbia. She lives in Seattle and is excited that professional hockey has finally arrived in the city.

Raymond Yeung