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Packard Releases New Report on Impact of Children’s Health Care Advocacy


This blog is cross-posted from Say Ahhh! A Children’s Health Policy Blog.

By, Gene Lewit and Lian Wong, The David and Lucile Packard Foundation
Posted May 15, 2012

Those of you who are regular Say Ahhh! readers know that more children have health insurance coverage today than at any point in the nation’s history. The steady growth in children’s health coverage did not happen in a vacuum. State and federal leaders and program directors, policy and grassroots advocates, and concerned citizens – not to mention key pieces of federal legislation – all contributed to this success. In particular, state efforts, to grow and improve their children’s coverage programs, supported and urged onward by policy and grassroots advocates, played a crucial role in the growth in children’s coverage.

Today, the David and Lucile Packard Foundation and Mathematica Policy Research released new findings on the impact of children’s health care coverage advocacy in the states. This brief, Applying Advocacy Skills in Tumultuous Times: Adaptive Capacity of Insuring America’s Children Grantees, is the latest from the evaluation of the Packard Foundation’s multi-year, multi-state, Insuring America’s Children (IAC): States Leading the Way grantmaking strategy launched in 2007. One of IAC’s goals was to broaden and strengthen the state-based children’s health advocacy ecosystem to support the expansion of children’s coverage at the state and federal levels en route to our goal of covering all of America’s children. As the nation engages in the implementation of health care reform and attempts to address a number of other pressing problems, we believe the findings in the just released brief hold lessons not only for children’s coverage advocates and funders but for broader advocacy efforts as well.

What ultimately transpired between 2007 and 2010 was a tumultuous period characterized by a severe economic downturn, an intense political battle around the reauthorization of the Children’s Health Insurance Program, and widespread erosion of employer sponsored health insurance, capped by an intense debate on national health reform.

So, how did state-based advocacy groups navigate these rapidly shifting state and federal environments? By analyzing four years of comprehensive data, the evaluation team at Mathematica found that support of capacity and network building among state-based advocacy groups of different sizes strengthened their communications and policy capacity to make children’s coverage a priority both within their own states, in other states, and at the national level. The groups’ work strengthened popular support for the broad goal of insuring all children and supported many targeted policy goals, such as expansion of CHIP eligibility, program improvements, and simplified, more efficient enrollment and retention practices.

Findings from the study highlight the key strategies that advocacy groups pursued aggressively to prepare for and respond effectively in a dynamic environment, including:

  • Building and adapting strategic partnerships as the economic and political contexts in their states were shifting. Advocacy groups assumed new and expanded leadership roles within state-based coalitions;
  • Serving as critical sources of information and analysis to state policymakers and other key stakeholders. Advocacy groups strengthened their reach and influence;
  • Employing consistent and positive messaging. Advocacy groups successfully broke through the mire of a gloomy economic forecast and sometimes combative political atmosphere;
  • Leveraging technical assistance and external support by the Packard Foundation, such as peer-to-peer learning.

Advocacy groups were able to maximize their individual and collective efforts. As the goal of ensuring that all children have health care coverage becomes increasingly attainable, understanding how advocates have carried out this work in different and dynamic environments can provide lessons for future advocacy efforts on a variety of issues. The full details of these findings can be found on the Packard and Mathematica websites. To learn more about Insuring America’s Children: States Leading the Way, visit our website.