Joel Ferber, director of advocacy for Legal Services of Eastern Missouri, has been with that program since 1985. He specializes in public-benefits issues, particularly Medicaid and, recently, state implementation of the Patient Protection and Affordable Care Act’s Medicaid provisions. He has litigated health and benefits issues in federal district and appellate courts. Joel wrote most recently for Clearinghouse Review in the March–April 2012 issue; see Affirmative Litigation Ensures Coverage of Medically Necessary Adult Diapers. He also serves as faculty for the Sargent Shriver National Center on Poverty Law’s Affirmative Litigation Training. When not buried in inscrutable health and benefits data and policy, he plays guitar, banjo, and mandolin; that’s Joel (center in photo) on mandolin with his group, Missouri Breaks.
What’s a case or client or piece of advocacy that comes to mind as giving you particular personal satisfaction? Why?
Narrowing it down to one is hard. I’m really proud of a recent case covered in Clearinghouse Review. The case required the state Medicaid program to cover medically necessary adult diapers for individuals 21 and over, based on federal Medicaid requirements and the Supreme Court’s Olmstead decision. Beyond that I’d probably have to pick two others. In one case we successfully challenged Missouri’s failure to implement nonemergency medical transportation in its Medicaid program. Missouri was one of only two states that didn’t have such a program, and the legislature refused to fund it. To this day, thousands of Missourians are transported to their medical appointments daily because of that litigation. The other was a lengthy and multipronged advocacy effort (including litigation) on behalf of Missouri consumer groups. We challenged the conversion of Blue Cross and Blue Shield of Missouri to a for-profit company. The litigation resulted in a settlement that created the Missouri Foundation for Health, which not only funds critical health programs but also directly funds advocacy and health policy work.
With regard to the Medicaid expansion, I think that the economic and budgetary impact is going to have to carry the day—the positive impact of substantial additional federal funds and the severe adverse impact on hospitals and other providers if the state doesn’t accept those funds.
What’s a case or client or piece of advocacy that comes to mind as causing you particular anxiety? Why?
Probably my greatest disappointment was the inability to stop severe, harmful Missouri Medicaid cuts in 2005. Over 90,000 low-income parents lost coverage, and “optional” services were eliminated for thousands more. Our organization and others pursued advocacy in multiple forums, but most of the proposed cuts were implemented. For the most part, they haven’t been restored. Of course, my own disappointment paled in comparison to the severe hardship for our clients. The Affordable Care Act presents an opportunity to remedy this problem.
If you were in charge, what’s one way (other than having more funding!) that public interest legal work would be different?
Low-income clients in every state would have access to the full range of legal advocacy, including affirmative litigation, legislative, administrative and policy advocacy, and all of the legal tools that are available to corporations and other private-paying clients.
You’ve worked on implementation of the Affordable Care Act’s Medicaid provisions in your state, Missouri, which hasn’t wholeheartedly embraced the Act. What have you found are the most effective arguments in winning over skeptics of “Obamacare”?
This is a tough one because there’s been such resistance to the ACA here and it’s become so politicized. With regard to the Medicaid expansion, I think that the economic and budgetary impact is going to have to carry the day—the positive impact of substantial additional federal funds and the severe adverse impact on hospitals and other providers if the state doesn’t accept those funds.
What’s one of your guilty pleasures?
I’d have to say New York Giants’ football. I’ve lived in St. Louis for nearly thirty years, but I grew up on the New York Football Giants and I’m still a hardcore fan—something I acquired from my dad. When I was a kid, I cried when they lost (which was quite often), and now I go to a sports bar most Sundays with other transplanted New Yorkers and New Jerseyians, where I watch my beloved Giants frustrate me with more heartbreaking losses, or excite me with compelling fourth-quarter comebacks. It’s great to yell and scream at the television screen surrounded by people who feel the same way. One year we chartered a bus to Kansas City to see them play the Chiefs, complete with a caterer and videos of previous Super Bowl and playoff victories.
You can contact Joel Ferber at email@example.com.