By Gene Lewit and Liane Wong, The David and Lucile Packard Foundation
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.