| The latest news from and for state health care advocates |
October 2010 |
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In each edition, we'll feature an action, victory, campaign, or interesting tactic shared by a state advocate. Send us your updates. |
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In This Issue:
Buzz around the States
UHCAN Ohio’s Cathy Levine is honored with the Public Health Community Leader of the Year Award.
North Carolina Justice Center uses video technologies to get out consumer stories.
Colorado groups urge residents to vote no on ballot measure 63.
Forward Montana hosts Speed Candi-Dating to get residents the facts about candidates for the November 2nd elections.
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States in Focus
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To ensure the consumer voice is considered during implementation, it’s vital to capitalize on old relationships, as well as develop new relationships with key players. If you have not developed these relationships yet, it is not too late. As new governors and state legislators take office, begin to create mutually beneficial relationships with those key opinion makers. By providing legislators with knowledge and resources, you solidify yourself as an authority on health reform implementation.
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Wisconsin Advocates Gain Access through Relationship Building
In the midst of an intense election season, health care advocates across the country are moving forward to ensure that the implementation of the new law is both effective and consumer-friendly. Wisconsin has shown great leadership in this area with Governor Doyle’s creation of the Office of Health Reform and the state legislature’s establishment of a special implementation task force. With Governor Doyle leaving office, Robert Kraig, executive director of Citizen Action of Wisconsin, asserts that advocates will continue to push the agenda for health reform implementation in his state and build upon the relationships that were developed under Governor Doyle’s administration. Robert and three other members from his coalition serve on an implementation study group created by the state legislature, which is currently focusing on creating a model insurance exchange.
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Robert Kraig, Executive Director, Citizen Action of Wisconsin
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Robert understands that Wisconsin is a model for consumer involvement in the state implementation process, but he notes that high-level consumer advocate participation is not by chance; it is strategic. According to Robert, it is important to develop relationships with the various chairs of relevant committees within the state legislature early. Robert believes that relationships with key leaders and legislators must be mutually beneficial. During the legislative process to pass the Affordable Care Act, Robert developed strong relationships with legislators by serving as a vital health care resource. He regularly briefed legislators on the progress of national health reform, developing a reputation as the go-to source for health care information. Citizen Action of Wisconsin also served as a hub for consumer health stories for legislators. Now, as the state is required to make important decisions and pass legislation regarding implementation of the law, Robert plays an active role in making proposals and in the writing of that legislation.
If you have not developed these types of relationships with key legislators already, Robert says, “It is not too late!” With this election cycle, there will be turnover of governors and administrations in many states. Hence, the issue will be unfamiliar not only for the new governors, but also for new legislative leaders. Robert emphasizes that state exchange plans are not due until January 1, 2013, which means that many decisions relating to health reform will be made next session. Thus, he urges health advocates to start developing relationships with the new legislative leaders now. He encourages advocates to focus on major goals that they have established and not become overwhelmed with technical details. Lastly, he believes it is useful to learn from other states and national groups to help craft the best strategies for implementation success in your state.
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Although efforts to repeal the health care law may not seem conducive to a rigorous implementation plan on the state level, advocates in Virginia have shown that they can actually be a useful organizing tool. These attack efforts can serve as just the oppositional force you need to motivate activists to action and get them actively engaged in implementation work.
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Virginia: Combine Strategies to Push Back on Attacks and Engage Consumers in Implementation
In Virginia, health care advocates face a very challenging landscape for implementation, but they have been able to use challenges to the health care law as effective organizing tools to engage consumers in implementation. Virginia Organizing, a statewide grassroots organization dedicated to empowering people to fight injustice, has played a central role in this effort. Together with their coalition partners, they have combined their defensive efforts against attacks and their offensive efforts to ensure the effective implementation of the legislation in a singular effort to push reform forward in Virginia.
On October 18, the Virginia Federal District Court in Richmond heard the case against the Affordable Care Act brought on by Virginia Attorney General, Ken Cuccinelli. Although the judge did not issue a ruling, the event attracted much press coverage due to Cuccinelli’s extreme attacks against the entire law. At a press conference held after the hearing, Virginia Organizing inserted their message into the day’s coverage. With an impressive line-up of health care consumers, the Virginia Poverty Law Center, and members of Virginia Organizing’s Health Care Committee, the group pointed out that in spite of the frivolous lawsuit by the Attorney General and supported by the Governor, implementation is happening in Virginia.
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Julie Blust, Communications Director for Virginia Organizing puts up signs that lined the streets outside of the Courthouse.
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“Governor McDonnell clearly understands that the Patient Protection and Affordable Care Act is now the law of the land. Two weeks ago the Governor was celebrating the 2 million dollars in increased health care funding for older adults and those with disabilities due entirely to the new health care law,” said Jim Lindsay of the Virginia Organizing Health Care Committee. “Yet he and the Attorney General continue this court case so that insurance companies can go back to denying coverage due to pre-existing conditions and dropping people when they get sick. Now is the time to roll up our sleeves and work on implementing the health care law so that we do not return to the status quo where insurance companies hold all of the cards.”
Their strategy—to use the attacks against reform to help galvanize Virginians to take part in state implementation—has paid off. Active citizen engagement is an especially important component to the process in Virginia because the formal implementation structure created by the Governor, known as the Health Care Reform Initiative, does not include a role for a consumer representative. The Health Care Reform Initiative has six working groups on various issue areas, and Virginia Organizing has been hard at work organizing consumers to participate in the public comment periods of the meetings. They have met with members of the Health Care Reform Initiative to express their concerns in individual meetings. They are also urging their members to contact the director of the Initiative with a simple message: Make quality, affordable health care accessible to all and work to include everyone’s voice in the process. Urging this process to be transparent and open is essential to ensure that the consumer voice is heard when important implementation decisions are being made over the next several years.
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Implementation is overwhelming—there are a lot of decisions to be made in every state. In states where there is not yet a formal structure to address those decisions, convening stakeholders on a regular basis can help to keep important players engaged. In states like South Carolina, maintaining neutrality while sticking to principles can help you position yourself as a “go-to” resource for information on implementation.
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In South Carolina, Taking Initiative Pays Off
Since the Affordable Care Act became law, many states have convened implementation task forces. However, in states like South Carolina, a formal group has not yet been assembled to begin grappling with key state implementation choices.
Sue Berkowitz, executive director of South Carolina Appleseed, said that the health advocacy community saw this as an opportunity to help set the agenda for the state. Consumer health advocate groups (including SC Fair Share, SC Small Business Chamber of Commerce, and AARP-SC) in partnership with the SC Public Health Institute at the University of South Carolina (SCPHI), convened 40 stakeholders in August, including the South Carolina Hospital Association, the March of Dimes, and several agency officials, to discuss how to best implement the new law in South Carolina.
To date, the partnership has proven to be very successful—the state has applied for the three largest grants—rate review, exchange planning, and consumer assistance. The group organized policy “boot camps” in September to immerse advocates in the various policy issues that will be important for implementation in the coming year. Nine working groups emerged from the sessions to tackle different areas and monitor their progress during implementation.
As the committee expands and tackles more important decisions, Sue added that in order to be credible, there needs to be a neutral partner involved in the process. Berkowitz emphasized their partnership with the University as an important component to implementation work, allowing the committee to maintain a high level of credibility with state and government officials. For example, before the next legislative session the group is planning to organize a briefing for state legislators in which SCPHI will act as the convener. By organizing the session this way, all partners hope to attract stronger participation among state legislators and foster a rich dialogue about their implementation recommendations.
Beat of the Month
Taking the lead from Virginia Organizing, the Beat of the Month is all about standing your ground: I Won’t Back Down by Tom Petty and the Heartbreakers.
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Is your state involved in the litigation led by the Florida Attorney General? A total of 20 states plus the National Federation of Independent Business are moving forward with a lawsuit attacking the Affordable Care Act. Families USA’s Stand Up for Health Care has an action to speak out against this suit. You can ask your members to call their state officials and/or write letters to the editor speaking out against the suit. Feel free to use this action or use it as a template for your own action. Find the action here: http://www.standupforhealthcare.org/get-involved/take-action/stateofficials
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New Resources from Families USA and Stand Up for Health Care
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