Ropes & Gray Helps Safeguard the Rights of Low-Income People Living with HIV in a Case of First Impression under the Affordable Care Act

In The News
March 12, 2014

Working with Lambda Legal, a national organization committed to advancing LGBT rights, and New Orleans-based Phelps Dunbar, a Ropes & Gray pro bono team continues its successful efforts on behalf of low-income people living with HIV. The lawsuit, East v. Blue Cross and Blue Shield of Louisiana, et al., No. 3:14 cv 115 (M.D. La. 2014), is among the first cases filed under the civil rights provisions of the Patient Protection and Affordable Care Act, popularly known as Obamacare or the ACA. This litigation highlights important contours of the ACA, including non-discrimination obligations imposed by the new law.

The case began just three weeks ago on Feb. 20, 2014 with the filing of a class action complaint, led by named plaintiff John East of New Orleans, alleging that all three healthcare insurers participating in Louisiana’s ACA exchange were poised to refuse federal Ryan White premium assistance funds earmarked to help low-income people living with HIV secure healthcare. Mr. East contends that he and others similarly situated cannot afford health insurance without these critical federal funds. On Feb. 24, Chief Judge Brian Anthony Jackson of the U.S. District Court for the Middle District of Louisiana sitting in Baton Rouge entered a temporary restraining order against the defendants based on our papers, enjoining the insurers from refusing Ryan White Fund premium assistance payments. The court later lifted the TRO when all three insurers promised to maintain the status quo voluntarily and to accept Ryan White funds past the preliminary injunction hearing set by the court for March 10.  

At the March 10 hearing, our team presented arguments and evidence to the court to support preserving the status quo beyond the close of the ACA’s first open enrollment period on March 31, 2014, and until the court could hold a full trial on the merits. During a break in the proceeding, each defendant agreed to continue accepting federal Ryan White funds until at least Nov. 15, 2014, on the exchange and off, for any current or newly enrolled insured individuals eligible for such assistance. Nov. 15 kicks off the next ACA exchange open-enrollment period. In the meantime, the parties expect that the Centers for Medicare & Medicaid Services (CMS) will enact a rule bearing on the issues raised by this case. Once published, the rule could affect not only this matter’s final resolution, but also health insurers nationwide in their policies toward low-income people living with HIV.

In the wake of the March 10 proceeding before Chief Judge Jackson, Mr. East and other low-income people living with HIV and eligible for Ryan White assistance can now participate in the Louisiana insurance exchange with confidence that their healthcare coverage and critical medical care will not be interrupted due to a refusal of those funds.

The Ropes & Gray team is led by business & securities litigation partner Jeffrey Bushofsky.