The Legal Aid Society is the nation’s largest public defense and civil legal services provider. The largest law firm in New York City is home to over 2000 attorneys, paralegals, social workers, investigators, and more. Each brings their unique perspective to the fight for justice in every borough.

What inspired you to work at Legal Aid?
I am a public health practitioner at heart, which is the work I did prior to becoming an attorney. I strive to do work that in the end has the effect of improving the larger public’s health. Health is a right that many of us often taken for granted until we realize how vulnerable it is, and how fundamentally it can impact our lives. Health is also a way in which inequity, racism, and discrimination can be imprinted upon the lives of marginalized and vulnerable communities. Life opportunities from early on can be reduced when healthcare infrastructure and other social factors receive disinvestment; and this compounds as other social structures are not designed or equipped to support those struggling. The Legal Aid Society has provided an avenue for me to use the law to protect my individual clients’ health, but also to work to provide systemic access to care, and to reduce systemic discrimination that impacts population health.

What’s a recent project or piece of work you’re proud of, and why?
In early 2024, The Legal Aid Society, and Pro Bono law firms Willkie Farr & Gallagher LLP, and Freshfields Bruckhaus Deringer LLP, reached a robust settlement in Ciaramella v. Zucker that greatly increased access to Medicaid-covered dental services. While I did not work on that litigation, the Health Law Unit soon began witnessing how the change in the Medicaid dental policy was being implemented on the ground. HLU practitioners have been able to track trends and provide critical information to report back to the State as to how the change in policy needs to be better implemented by health insurance plans, and providers. Policy change happens in many different ways and phases; it’s been rewarding to be a part of reporting back on settlement implementation. More so, as a Unit we have helped countless clients obtain critical dental care. Dentition is tied to both physical and emotional health, as well as the ability to be confidently employed. It has been an honor to see my clients get the services they deserve, and move forward with their lives.

What’s the most challenging part of your job?
Healthcare law is an immense and dynamic field. On my best day, it is hard to keep up with the pace of new rules and regulations. Suffice it to say, today is not our best day. The Federal Administration is implementing policy that seeks to decimate many parts of the Medicaid program. It is challenging to stay on top of these impending changes, working to slow or stop them when we can, still rely on the laws that continue to be in place, and keep up with the never-ending onslaught of new attacks on healthcare in this country.

What’s something about your work that most people misunderstand?
Well, most people understand that accessing healthcare is frustrating and unfairly difficult. There are insurance barriers to care where automated systems issue denials well before any human looks at an individual patient’s need. This system is designed to set up limits on care to save cost. What I would say though, is that most of our appeals are successful. Consumers need to be vigilant and painfully patient, but once they appeal and a human actually evaluates their need for care, I’d say 95% of the time they will get approved. This doesn’t make the current system acceptable, but care is not out of reach.

What is the impact of your work on the lives of New Yorkers?
My clients often get a very tangible win – they get health insurance, or health care services. These wins are not always sexy or creating systemic change, but they do have a very real impact on the day to day lives of our clients, and I would hope their overall long-term health.

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Heidi Bramson is an attorney with The Legal Aid Society’s Health Law Unit.