Robert Greenwald

Health care policy analysts and medical societies are applauding the budget agreement signed last week by President Donald Trump, citing financial support in several critical areas...Robert Greenwald, JD, clinical professor of law and faculty director of the Center for Health Law and Policy Innovation at Harvard Law School, told Healio Family Medicine, “Now that an agreement has been reached, certain vital health programs are safe for the time being. The Children’s Health Insurance Program, which covers over 9 million children, is funded until 2027 and Community Health Centers, which serve the health needs of our nation’s most vulnerable, are funded for the next two years. Going forward, we must continue to prioritize programs that promote and secure the health of U.S individuals and families.”

Amazon, along with Berkshire Hathaway and JPMorgan Chase, will form an independent health care company for their employees in the United States, the three companies have announced. Amazon, along with Berkshire Hathaway and JPMorgan Chase, will form an independent health care company for their employees in the United States, the three companies have announced...In a statement emailed to Healio.com, Robert Greenwald, faculty director of the Center for Health Law and Policy Innovation and professor at Harvard Law School, said the venture pointed to a systemic issue with American health care. “We have failed as a nation to produce a health care delivery system that affords comprehensive health coverage to everybody, Greenwald wrote.

Montana’s Medicaid program requirements are blocking hepatitis C patients from treatment, according to a national report released Thursday...Robert Greenwald, clinical professor of law at Harvard Law School and the director of the school’s health law center, agreed that the state’s rules around patient sobriety is “medically unfounded” and said it puts others at risk. “Even though the opioid crisis is exacerbating the hepatitis C epidemic, Montana is preventing patients who have used drugs in the past six months, the population most likely to spread this highly communicable disease, from accessing a cure,” Greenwald said.

An op-ed by Robert Greenwald and Judith Solomon. For more than 50 years, Medicaid has been our nation’s health care safety net. Medicaid allows our lowest-income, sickest, and often most vulnerable populations to get care and treatment, and supports the health of more than 68 million Americans today. As an entitlement program, Medicaid grows to meet demand: There is no such thing as a waiting list. This vital health program found itself under fire in 2017, and while there were no major reductions in funding or enrollment, it is far from safe in 2018. Whether by new legislation or actions the Trump administration may take, the threats to Medicaid are not going away anytime soon.

An op-ed by Robert Greenwald and Ryan Clary. The American epidemic of opioid abuse is finally getting the attention it warrants. While policy solutions continue to be inadequate, the decision by President Trump to declare a national opioid emergency has helped to increase discussion about the problem and how the country can solve it. But the conversation also needs to address a dangerous – and largely ignored – interconnected public health crisis wreaking havoc among young Americans.

State Medicaid programs – including Rhode Island – fail to provide enough access to cures for hepatitis C. That’s the conclusion of a new report from Harvard Law School’s Center for Health Law and Policy Innovation and the National Viral Hepatitis Roundtable. The authors say restricting treatment is illegal. New hepatitis C medications are expensive. That’s why state Medicaid programs like Rhode Island’s restrict access. Patients must have a high level of liver damage. And be abstinent from drugs and alcohol. And only specialists can prescribe. All of that is illegal, says Robert Greenwald with the Center for Health Law and Policy Innovation at Harvard Law School. “Medicaid programs have an obligation under the law to provide medically necessary care. And that cost alone cannot be a justification for access to care.”

Over the past two years, state Medicaid programs have done a better job of disclosing information about access to hepatitis C medicines and are also making progress in reducing or eliminating restrictions that pose a barrier to treatment, according to a new preliminary analysis...“We’re making progress, but many state Medicaid programs still limit access due to cost concerns and are dragging their feet,” said Robert Greenwald, who heads the Center for Health Law and Policy Innovation of Harvard Law School, which conducted the analysis and has filed lawsuits against two state programs over restrictions.

...In one way or another, Harvard Law professors helped shape Obama’s legacy. But the relationship between the Law School and the next president has yet to be defined. A trove of emails from Clinton’s campaign chairman John Podesta, leaked by Wikileaks in October, show that a few Law professors have caught the campaign’s attention. And Clinton’s campaign has contacted at least one about serving in her administration if she wins next Tuesday. There is no indication that Trump’s campaign has contacted any Law professors. “I think law is about policy choices so by definition we are always involved in policy choices,” Law professor Christine A. Desan said, referring to her fellow faculty members...fewer Law School faculty members are actively and openly advising either candidate in this election—a noticeable shift from previous elections, said Law Professor and former U.S. Solicitor General Charles Fried.

AIDS Foundation of Chicago ( AFC ), on Sept. 6, filed a formal complaint with the U.S. Department of Health and Human Services' Office for Civil Rights ( OCR ) against Humana, charging that the insurance giant routinely denies coverage for or limits access to HIV medications through prohibitively high cost sharing requirements. AFC filed the complaint in partnership with Harvard Law School's Center for Health Law and Policy Innovation ( CHLPI ), which has partnered with a number of health organizations for complaints against insurance companies in other states. According to the complaint, Humana offers policies on the Affordable Care Act marketplace but regularly refuses to cover lifesaving medications and requires significant cost-sharing from patients with certain conditions such as HIV. Insurance companies on the marketplace cannot refuse to exclude policyholders because of pre-existing conditions..."CHLPI and AFC are using the OCR process to shine a light on discrimination occurring under the cloak of supposedly neutral insurance plan benefit design. When an insurer requires chronically ill patients to pay a disproportionate share of the cost of medication, it violates federal law," said Robert Greenwald, CHLPI's faculty director and clinical professor of law at Harvard Law School. "These are landmark Complaints that will benefit everyone looking to receive equitable, comprehensive health care through the marketplaces by helping to define anti-discrimination law at a time when insurers are covering less and less."

...Within the past three years, new drugs with cure rates surpassing 90 percent have come on the market that have dramatically changed the conversation for hepatitis C patients like Cox. The results are like nothing doctors had seen before: patients’ bodies being effectively rid of the virus within just a few months, rather than living with it for decades. But the drugs’ exorbitant prices keep them out of reach for lots of people...“I don’t want to impute bad motives on the part of insurers,” said Robert Greenwald, a clinical law professor at Harvard Law School and faculty director of its Center for Health Law and Policy Innovation, “but I do think they feel more comfortable than they should about basically condemning a population and many people within that population to sickness, ill health and ultimately, for some, death, for having these kinds of restrictions.”

The long-term health prospects for thousands of Massachusetts residents are about to improve. As of Monday, MassHealth will require private insurers that manage coverage for two-thirds of the state Medicaid plan’s members to loosen rules that cruelly prevent people infected with hepatitis C from receiving drugs that cure the disease...Massachusetts’ limits on hepatitis C medicines have been at odds with US Centers for Medicare and Medicaid Services’ policy, which mandates that Medicaid insurance plans cover the new drugs. MassHealth also has faced scrutiny from health care advocates, who note that the disease is especially prevalent among lower-income residents who don’t have other treatment options, or who are reluctant to seek preventive medical care. “We’re dealing with a population that has a history of exclusion and distrust of the health care system,” says Robert Greenwald, director of Harvard Law School’s Center for Health Law and Policy Innovation, and a prominent critic of limits on hepatitis C coverage.

John Tortelli recently received some good news: The virus that has lurked in his body for nearly four decades, threatening to destroy his liver, can no longer be detected in his blood. Tortelli, a 64-year-old retiree who lives in Arlington, contracted hepatitis C as a young man, from a blood transfusion during heart surgery. Over the years, the virus has led to fatigue, joint aches, mental fogginess — and continual worry that the infection might progress to cirrhosis, as happens to 5 to 20 percent of infected people...The advocates’ position got a big boost last month when a federal District Court judge in Seattle ordered Medicaid in Washington state to start covering the drugs regardless of the condition of the patient’s liver. A few days later, Florida — also facing a suit — adopted a similar policy change....Robert Greenwald, the Harvard Law School professor who sued Washington state, said he sent an e-mail to MassHealth director Daniel Tsai on Thursday, advising that Medicaid rules clearly require coverage. Asked whether he planned to sue Massachusetts, Greenwald said, “I’m not there yet. I have been assured they are working as quickly as they can.” But Greenwald, who directs Harvard Law School’s Center for Health Law and Policy Innovation, said if the state’s process “does not result in access mandated under law,” he will reconsider taking legal action.

California’s revised eligibility rules for hepatitis C drugs appear to be easing Medi-Cal patients’ access to the highly effective medications, according to state data. Yet even with the relaxed guidelines, the vast majority of those on Medi-Cal with hepatitis C still aren't getting the costly drugs, state health officials say..."A really large state took a bold move and really reduced the restrictions, and that was a great first step toward sending the message that, 'we understand how important it is to provide treatment access to people living with [hepatitis C],'" says Robert Greenwald, director of Harvard Law School's Center for Health Law and Policy Innovation.

Two years ago, James Luongo was thrilled to hear about the first new drugs that could rid his body of hepatitis C. The virus had been silently circulating in his blood for years and would likely cause liver disease, perhaps cancer. But he still felt fine. The drugs seemed like a good thing until his Medicaid insurer denied coverage of the treatment. Twice...And they hope, critics say, that they can get away with neglecting a stigmatized population. Hepatitis C can strike anyone - more than one percent of the U.S. population is infected - but is more frequent among low-income people who have injected drugs. "A disenfranchised, vulnerable community was one where they could draw the line," said Robert Greenwald, a Harvard law professor and coauthor of a study last year that found most states were rationing hepatitis C treatment. "A person with Alzheimer's on Medicaid would have family who would not tolerate not getting the cure," he said, if one became available.

Patients infected with hepatitis C are finding that having private health insurance doesn’t always mean they can get the drugs likely to cure them. ...The Center for Health Law and Policy Innovation of Harvard Law School analyzed plans sold on the Massachusetts Health Connector, the state agency for people who buy insurance on their own, most of whom have moderate to low incomes. The center found that in nearly half the plans, patients had to pay a higher percentage of the cost for hepatitis C drugs than for most other drugs. Some insurers require patients to pay half the cost.

How do you justify withholding a wonder drug from patients infected with a liver-killing virus until the disease starts to ravage their bodies? Why, in other words, do they have to become seriously ill before receiving help? Although biomedical advances have given rise to a new class of drugs that can cure hepatitis C, which is often fatal, a basic socioeconomic problem remains to be solved: Because of the high cost of the medicine, many public and private health insurers restrict access to treatment until the onset of liver damage. It’s a short-sighted approach that causes suffering and is at odds with a basic tenet of modern medicine — early intervention...“If there was a cure for Alzheimer’s or multiple sclerosis and we restricted treatment, there would be a huge outcry,” says Robert Greenwald, director of the Center for Health Law and Policy Innovation at Harvard Law School.

Twenty years ago, Larry Day learned two dangerous viruses were circulating in his body, HIV and hepatitis C. Both infections came from needles shared during his years as an injecting drug user. Only one caused him big problems: hepatitis C. That virus destroyed his kidneys, an uncommon complication. Over time, he knew, hepatitis C could lead to cirrhosis and liver cancer. So when drugs came on the market promising to cure him, Day — by then free of illicit drugs — was eager to give them a try. But his Medicaid insurance plan said no. He could get the drugs only if his liver was damaged, and his liver was still in good shape...Robert Greenwald, faculty director of the Center for Health Law and Policy Innovation at Harvard Law School, in February led a class-action lawsuit against the state of Washington, asserting its Medicaid program was illegally rationing hepatitis C drugs. In Massachusetts, he has written MassHealth officials asking to collaborate on ways to make the drugs more available. But state officials have rebuffed him, because, he said, they don’t want to admit “that it’s all about costs....They know that’s not a legitimate grounds on which to deny people treatment.” Greenwald called the state’s approach baffling. The state, he said, pays $10,000 a year to keep a person with HIV healthy for decades, but balks at a one-time $40,000 payment to cure someone of hepatitis C.