Tessa Hammer ’13

Attorney, California Health Benefit Exchange

 
 
 
 
 
 
 
 
 


Do you consider yourself to be a health lawyer? And what does it mean to you to be a “health lawyer”?

I do. What we do at my agency is connect people with healthcare, and so everything that I do here has an impact on that, and is geared towards improving people’s access to care, and quality of care. I do a lot of responding to public records access requests, and although they don’t always have to do with health law, in particular, my work contributes to the organization’s goal to get people insured, and to make sure that people ultimately have the access to the care that they need. I am one of twelve attorneys here.

I think a health lawyer works towards improving a community or individual’s health.. That’s the goal here: improving access to care, and in a broader sense helping to change the healthcare delivery system. There are so many different ways of doing that: through litigation, legislation, or policy work.

 

What was your impression of healthcare law back when you were a student at UC Hastings?

Health law was very new, and people in the community were still not really sure what it was. That was intriguing to me. I took two health law courses while I was at UC Hastings. The first one was focused on long standing laws like ERISA and HIPAA. The second one was focused on hospital structures, as well as The Affordable Care Act, which had just passed. This marked a whole new set of opportunities for attorneys that weren’t there before, and it changed the concept of what health law was. It was especially helpful for me, since now I work directly with the Affordable Care Act.

 

What most excites you about your work?

Everything is so new. It is a state agency, so we do a lot of things that all state agencies have to do, but we are doing these things for the first time. I started here at the end of our first open enrollment period ever, and a lot has changed since then. I get to see my fingerprints all over things that we use every day. Things like contract templates, and contract processes.

Also, I am one of only a handful reading the new regulations for the Affordable Care Act, analyzing them, and advising the organization on how they are going to affect us. Being one of a small group of people who read those regulations is pretty exciting.

"I think a health lawyer works towards improving a community or individual’s health. That’s the goal here: improving access to care, and in a broader sense helping to change the healthcare delivery system"

 

What is the biggest challenge in your work?

The biggest challenge for me is sticking to a strictly legal role. Every day people all across the organization are making decisions. A lot of them are policy and business decisions. It’s hard for me to not weigh in on these decisions. My role is supposed to be to evaluate the risk to the organization, to analyze the law, and provide legal opinions and options for the organization. So I try to not weigh in from a non-legal perspective, but that has been hard for me because I really enjoy policy work, and so sometimes I will share my thoughts if somebody asks for my opinion. It’s a challenge because I really believe in this organization and I always want to be more and more a part of it. In terms of changing the whole healthcare system, we have been a model for the nation, as far as the implementation. I would like to have my hands in everything, if I could.

 

What aspects of your training or background most inform the work you do now?

One of the things I really appreciated, when I was at UC Hastings, was the focus on practical, real-life applications of the law. Although we looked at theories too, there was an emphasis on the fact that you were here to learn the law, and that ultimately there is a service component to being a lawyer, where you have to think about who your clients are, and how what you do is going to affect them. So, at my job, I try and keep in mind what kind of impact my decisions will have on all applicants. Everybody in California is in some way impacted by what we do. I try to think more globally about big changes, and how they fit into the broader picture, instead of just thinking about things in the abstract.

I remember a lot of times professors would stop, after reading a case, and say, “okay what’s really going on here? I know these people are litigating about something, but what’s the underlying issue here?” We had a case in Contracts and somebody was suing their aunt and everybody was saying “that’s crazy, why would you sue your own aunt? That’s such a terrible thing to do!” And the professor said, “well think about it in real life. Of course, they are just trying to go after their insurance money. You would probably sue your own brother to collect insurance money and your brother would probably be okay with it.” This put things in a real life perspective, instead of just thinking about what is going on in the law. This helped lay the foundation for how I think about things now.

I worked in healthcare before law school, assisting people who were on Medicaid and Medicare. And then in law school, I had an internship doing mental health law, and then another one in healthcare law. After I graduated I had a Bridge Scholarship working with a Medical-Legal Partnership at Bay Area Legal Aid. I worked with the Medical-Legal Partnership Clinic at UC Hastings my 3L year, which was the first iteration of that clinic. That was a great experience. I loved the clinic, and it also ties back to thinking about real people. In my work now, I do not have any regular contact with applicants or enrollees, but thinking back on these experiences makes the work that I am doing now more meaningful, because I remember the importance of access to care.

 

Tell me about a day in the life of you.

I always start by checking my email, since a lot of people ask me legal questions over email. Also people drop by my office all day long, to ask random questions, or to ask if I know anything about a certain contract that’s going through, for example. I really like that, because I get to meet people from all over the organization, and I get to see what’s going on, and I am a very social person and just enjoy that kind of interaction.

In terms of the content of my work, I always have a few contracts to approve, and those can vary from simple contracts to complicated ones. They are contracts between us and outside vendors that we need if we can’t accomplish something in-house. There are state contracting rules about when you have to use state employees, so I keep these in mind when I am evaluating contracts and advising people on whether it’s appropriate to contract something out or whether they need to use an employee.

You never know what kind of contractual issues will arise. I was researching one this morning, and I think I will definitely go and talk to the other attorneys about it. We each have our own subject matter expertise. There are attorneys who focus on insurance and others who focus on privacy. And so if something comes up where I need support, I will drop in on one of the other attorneys and just pick their brains. The rest of the time I am researching different issues, writing things up, sending emails, and going to meetings.

I had a meeting this morning with a number of directors, just to be the one legal person in the meeting. That way,  if there are any legal issues that come up I can bring them back to the appropriate attorney and ask, “hey did you know about this? What do you think about this?” Or I can identify other sorts of legal issues that people might not have known about.

In terms of workplace culture, a lot of people eat together. We have a cafeteria downstairs. It’s a big organization with a few hundred employees. Three or four years ago there were only seven employees, or something like that. It is amazing how much it has grown! Sometimes I will eat with people in the office, or at my desk, it really varies.

 

Can you say a little bit about your work/life balance and how it might compare to some of your colleagues who work in other areas of the law?

Sure. I keep in pretty good touch with my friends from UC Hastings, which has been great, so I do hear about their lives in private firms. My job is a state government job, so it’s pretty different from some of my friends and peers who work in private firms. The expectations are different. I don’t think that anybody here expects us to work past five, and of course I certainly do from time to time, but if I do, it’s because I want to finish something, and it’s my own decision. Also I don’t feel guilty taking vacation time. I feel like I am in control of my own schedule. It can be challenging for some people to get things done when they don’t have somebody knocking on their door, but it’s mostly kind of freeing. I don’t think there are many people here on the weekends, and the attorneys are required to be in a union. I’m sure that my pay is commensurate with the kinds of hours that I work, but I do feel like I have a lot of flexibility. The great work/life balance is a big draw.

 

Now, more than ever, there is pressure on lawyers entering the workforce. Do you have any advice you would like to give the next generation of law students interested in healthcare law?

I think it’s really important to be flexible. I know the job market is not ideal, but it’s better than it was when I graduated in 2013. I also think it’s really important not to compromise completely. So, if there is something that you really want to do, I think it’s important to hold out for it. There is a lot of pressure on students to choose something right away, to have a job right away when they leave school, or after they finish the bar, even if it’s not as meaningful to them.

If somebody knows they really want to do health law, I wouldn’t recommend working for a criminal defense firm, for example. I know that some people don’t have the means to hold out for a job because the loans are looming. I got a Bridge scholarship from UC Hastings which was really helpful and luckily I have family in the area, so I was working three days a week for Bay Area Legal Aid while searching. Not having a full time job really allowed me to find this job, apply for it, and when they offered it to me, I was able to accept it right away. I also had the flexibility to drop everything and move to Sacramento. I’m sure not everyone has been in that kind of position, but it worked really well for me. I knew that I wanted to do some sort of public service and that I wanted it to be connected to health law. I’m glad that’s what I held out for.

 


Interview by: 

Rachel Goodman, MFT

Senior Academic Program Coordinator with the UC Hastings Center for State and Local Government Law. She is also a psychotherapist in private practice in Berkeley, CA.