« November 2017 Issue

Message from Executive Director Rob Restuccia

Legislation to repeal much of the Affordable Care Act, radically cut Medicaid and defund Planned Parenthood died on September 30 when Senate leadership was unable to get the requisite 51 votes to pass the Graham-Cassidy-Heller-Johnson bill. Passage of the bill would have resulted in millions of people losing coverage, state budgets going into free fall, women losing access to reproductive services and dramatic cuts to safety-net hospitals and providers.

Despite these disastrous potential impacts, it took a concerted campaign to stop the Republican legislative effort. Community Catalyst fought non-stop as the Frankenstein legislation kept rising from the dead. Health care advocates across the country played a critical role in each iteration of the campaign to defeat repeal. They flooded congressional offices with phone calls and visits, organized town halls and rallies, and lifted up stories in news articles, broadcast segments, op-eds, letters to the editor and social media to illustrate the potential devastating impact on consumers.

Community Catalyst and the Community Catalyst Action Fund supported these state-by-state efforts in multiple ways. We funded grassroots organizing efforts, worked with organizations on the ground to develop campaign strategies, provided intelligence about what was happening in Congress and within the administration, developed policy analyses of the impact of repeal bills on specific populations such as individuals with substance use disorders and those who rely on long-term services and supports, and produced TV and radio ads that illustrated the dangers of repeal on people.  (See our photo montage for some highlights from the campaign.)

We won this round, in part, because it was a team effort. Community Catalyst was part of the national coordination campaign, Protect Our Care, which included dozens of national health advocacy groups. Joining in the fight were a wide range of grassroots organizations, including some who were new to the health care fight and fighting battles on other fronts. Diverse groups such as the National Council on Independent Living, ADAPT, ACT UP, National Congress of American Indians and Little Lobbyists organized sit-ins and mobilized massive demonstrations in Washington, D.C. and around the country. At a state level, these and other grassroots and state advocacy organizations worked together to defeat the Republican agenda. Many hospitals, doctors and other health providers, and insurers took a stand against the Republican repeal plans and in many places worked together with advocates.

Now that this latest round is over, we cannot lull ourselves into thinking we have won. Despite the recent defeat in Congress, the Trump administration continues to undermine the ACA and Medicaid through regulation, executive order, budget cuts and neglect. (Read our story about how we are working to promote the ACA’s fifth enrollment period in the face of the Trump administration’s efforts to dampen enrollment.) Next, the leadership in Congress is turning to taxes, but with an eye toward renewed attacks on the ACA, Medicaid and Medicare. 

Yet as the health care sabotage campaign continues in Washington, much of the action on health care is shifting to state and local decision makers. A number of governors are seeking workarounds to ACA regulations—such as waivers to impose work requirements on Medicaid recipients—while others are on the front lines trying to improve the ACA and strengthen the insurance marketplace.

While we remain largely on defense, we also need to take advantage of the opportunities to go on offense. One such opportunity is Community Catalyst’s work with advocates in Maine on a ballot initiative to expand Medicaid in the state.

However, to succeed in balancing both offensive and defensive work, now more than ever we need smart, savvy, nimble state and local advocacy. Strong state-level networks of organizations representing the interests of all consumers will be critical. They will need to work on local, state and federal issues and hold elected officials accountable. This won’t be easy. In most states, advocates will face strong opposition. The Koch brothers also recognized the importance of state-based and local organizing, and they have been effective at building a well-resourced, deep infrastructure across the country that opposes progressive health reforms. Advocates are going to need to continue to take on these organizations, and support and resources will be critical to success.

Moreover, Community Catalyst and our allies in the health justice movement cannot defeat the war on health care just by working on the health care fight alone. The attacks on health care will stop only when we have public officials who support consumers and universal coverage. We need health care voters. Public education and promotion of civic engagement especially among low-income communities is critical to shifting health policy in the future.

As long as the immediate threat to Medicaid and the ACA remain, it is important for our health justice community to be on guard for attacks and to continue work together. At the same time, as we look to the future, there is a real opportunity to bring the progress we made over the past six months to the next level. A more permanent, diverse and robust infrastructure of organized consumers on the local, state and federal level would hold elected officials accountable and help to reshape our politics over the long term.