Consumer advocacy works!

That may seem like a no-brainer for those of us in the business, but important new research affirms it. Mathematica Policy Research found in its evaluation of the Consumer Voices for Coverage (CVC) program that 62 percent of policymakers said consumer groups increased their influence during the course of the program, demonstrating the significant impact targeted foundation investment can have on consumer advocacy. You can read the entire paper here.

As part of its long-standing mission to develop policies and programs to expand health coverage in the U.S., the Robert Wood Johnson Foundation (RWJF) established CVC with Community Catalyst as the national program office. RWJF initially funded 12 state-based advocacy organizations to strengthen the consumer voice to promote innovative and comprehensive health reform efforts. Each grantee worked to build a state leadership team and establish common objectives, policy priorities and coordinated advocacy campaigns in their states.

Mathematica evaluated the program across what we call the “six capacities.” This framework, created by Community Catalyst, includes: 1) building coalitions; 2) generating grassroots support; 3) analyzing health policy research; 4) designing and implementing health policy campaigns; 5) crafting media and communications strategy; and 6) fundraising.

As a field coordinator for CVC, I worked directly with several of the CVC states and saw the impact that this support had on their efforts in their states and also on the federal level.

Before CVC, some of the organizations had not worked together in a formal coalition. As a result of the program, all 18 CVC grantee states (RWJF added six states to the program in 2008) now have strong systems of advocacy that enable them to bring the consumer voice to state and federal policy discussions and to be important leaders in these discussions.

For instance, in New York – where there are numerous savvy advocates – a single statewide consumer health care reform coalition made up of diverse constituencies did not exist prior to the CVC program. With the support of the program, the New York consumer advocates came together to create the Health Care for All New York (HCFANY) coalition. The coalition now boasts close to 120 organizational members.

As a result of their work they have made significant gains for New York health care consumers, such as:

• -- requiring the State Department of Insurance to pre-approve health insurance premium hikes on individual and small group policies
• -- creating a buy-in program for the state’s Family Health Plus Program
• -- extending COBRA from 18 to 36 months for laid-off workers
• -- expanding dependent coverage to age 29
• -- expanding New York’s Child Health Plus program to include families up to 400 percent of the federal poverty level

These policy changes only tell half the story. In order for HCFANY to achieve these wins, they also grew their capacity significantly. Guiding their work all along were 10 Standards for quality, affordable health care for all. These principles helped keep the coalition together, build relationships with new organizations and activate grassroots networks throughout the state.

For instance:

• -- HCFANY held the “People’s Public Hearing on Health Reform” and other regional meetings in all areas of the state to engage and build their grassroots networks.
• -- The HCFANY coalition was able to stay together due to the support of the program, enlist new local and statewide partners, and engage in work with small businesses.
• -- HCFANY members built relationships with federal and state policymakers and served as a resource to people on both sides of the political aisle.
• -- HCFANY set up a blog and website and established themselves as the “go to” resource for health policy information.

The successes in New York are not the only story. There are numerous victories and lessons learned from state advocates across the country. And the advocates shared those lessons through what we call the “learning community.” The learning community allows advocates to share strategies, struggles and victories while helping one another replicate best practices and avoid pitfalls. This community continues to thrive and grow beyond the 18 CVC states to include state health advocates across the United States.

The Mathematica evaluation shows that investing in health advocacy works to amplify the voice of consumers in health policy. Now, more than ever, there are more opportunities and more need for national, state and local foundations to support consumer advocates as they work to implement and defend the Affordable Care Act to ensure people can get the health care they need, when they need it.

-- Reena Singh, Associate Director of State Consumer Health Advocacy