« December 2018 Issue

20 Years of Building Consumer-Based Power for Health Justice

By: Kate Villers, President, Community Catalyst

When I established Community Catalyst in 1998, it was to help build in other states the advocacy capacities and infrastructure that had enabled Massachusetts health care consumers to drive progressive reforms since the 1980s. Those reforms had already made the state a national leader in meeting the health needs of key vulnerable constituencies.

A Massachusetts Model of Consumer Advocacy

As director of a small Massachusetts philanthropy program during the 1980s, I began channeling financial resources to several community-based organizing groups working with low-income seniors, people with disabilities and uninsured home care workers to identify their health access problems and establish relationships with policymakers to press for solutions. I also funded staff for the “health care for all” coalition formed by these groups, which persuaded then-Governor Michael Dukakis to add a coalition representative to the multi-stakeholder commission he had created to recommend major health reforms to the state legislature. For the first time, Massachusetts health care consumers were “at the table” with providers, insurers and legislative leaders. The result was the Massachusetts Health Security Act of 1988, which greatly expanded coverage and care for tens of thousands of residents. Another result was the incorporation of Health Care For All (HCFA) in 1989 as a non-profit organization that continues today to be the leading voice for Massachusetts consumers, as well as a steadfast Community Catalyst partner.

Taking the Massachusetts Model National

With the founding of Community Catalyst in 1998, my goal was to take the model of building consumer advocacy capacity and policy impact to national scale. In the ensuing 20 years, Community Catalyst has enhanced and applied this model to a variety of issues, and is credited with being a leader in growing state-based health justice advocacy infrastructure and capacity across the country. Today, health consumers, including the most vulnerable, impact health care policy and politics nationally, as well as in state after state.

Beginning under the visionary leadership of former executive director, Rob Restuccia, Community Catalyst has continually worked with partners on a variety of critical health issues that affect consumers, among them: requiring pharmaceutical, device and biotech industries to be transparent about their financial relationships with medical providers; creating new, innovative models of care for older adults and people with disabilities; and unwaveringly fighting for passage of the Affordable Care Act, and against all efforts to repeal or weaken it.

Rob built strong ongoing partnerships with the philanthropic community, other national organizations and aligned stakeholders, and leveraged Community Catalyst’s leadership and technical assistance roles to deliver more than $40 million in resources for on-the-ground capacity-building and strategic campaigns. In 2019, some $7 million in subgrants from its Health Justice Fund will support policy and organizing in Medicaid expansion campaigns, for oral health care access, and the prevention and treatment of substance use disorders.  

Community Catalyst won a $15 million legacy grant from The Atlantic Philanthropies that launched the Center for Consumer Engagement in Health Innovation in January of 2016. The Center is working to make health systems more responsive to historically underserved individuals, including low-income older adults and younger adults with disabilities, by advancing use of best practices shown to reduce inequities and improve community health. Community Catalyst’s Children’s Health Initiative is working to reduce barriers to care affecting children and their families, and the Women’s Health Program is lifting up the voices of women who are rarely represented in health policy discussions, such as young women, women of color, immigrant women, older women, low-income women and members of the LGBTQ community.

Community Catalyst today has nearly 70 staff and a $17 million budget, offices in Washington, D.C., Atlanta, Pittsburgh and St. Louis, strategic partnerships with many other national organizations, and relationships with consumer advocacy groups and local community organizations in more than 40 states. 

Further Enhancing the Model to More Deliberately Address Health Equity

Our vision of health equity is one where everyone has the opportunity to achieve the best health outcomes possible.

While the health advocacy infrastructure is strong, it is not as effective as it could be because it is not fully reflective of all the various populations it serves. The past 20 years have seen much progress, yet the current political environment poses severe challenges for diverse populations, especially those without financial or other means to obtain needed health care and who experience inequitable treatment.

Community Catalyst’s work over the years has elevated opportunities to expand and diversify the health advocacy movement. Internally, our efforts led us to diversify our senior leadership team, appoint a Director of Diversity, Equity and Inclusion, and shift our organizational work with the implementation of a health equity and racial justice framework that’s applied to all programs. Externally, we are engaging and funding new partners, building leadership capacity within communities of color, and directing funds in support of these efforts at the local level.

Because health justice is necessary to achieve other social gains in an unequal society, Community Catalyst also is building bridges between leaders of health justice organizations and other justice movements, to strengthen both.

I am proud to see Community Catalyst’s foundational ideas serving both the mission of health justice and the organization well over these past two decades. Our dedicated staff have never stopped looking for the most effective ways to level the playing field for vulnerable consumers, to make health care better for all, and to defend the progress we have fought so hard for. I have every confidence that we will continue to be both visionary and practical in the ways we realize these goals in the years ahead.