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Domestic Weekly Update January 19, 2010

This is no time to engage in the luxury of cooling off or to take the tranquilizing drug of gradualism. Now is the time to make real the promises of democracy.

- Dr. Martin Luther King, Jr., from the "I Have a Dream" speech, delivered August 28, 1963 

New and Urgent in This Week's Update

  • Reach Out to Haiti with PIH and Fonkoze
  • Final Health Care Bill Must Increase Access to Health Care
  • Health Care Negotiators Appear Close to Agreement

Latest from Washington, DC, and Beyond

  • Start Preparing for Group Planning
  • Fundraising Update: Thank You!
  • Quick News

Organizational Reminders and Updates

  • Announcements
  • Upcoming Events
  • RESULTS Contact Information

Reach Out to Haiti with PIH and Fonkoze (from RESULTS Executive Director, Joanne Carter)

You have almost certainly seen and heard the reports of the devastation in Haiti, with loss of tens of thousands of lives, injury and displacement of massive numbers of people, and destruction of already overburdened and under-resourced services and infrastructure. The need for an immediate and sustained response is enormous. For those who want to make direct contributions to the relief and rebuilding efforts, two partner organizations in Haiti that we trust and respect immensely are on the front lines of the response and need your support now: Partners in Health, the medical organization founded by Paul Farmer, is on the front line of recovery efforts and will be critical to addressing the health crises in the aftermath of this disaster. Fonkoze, a full-service microfinance organization in Haiti, has been doing remarkable work to reach the very poor and has successfully helped families recover from prior natural disasters in Haiti. Please consider sending a donation for Haiti via either or both of these great organizations. Let's help our brothers and sisters who are in need in Haiti.

We are also working with allied advocacy organizations to quickly assess ways RESULTS can proactively support a smart policy response to the situation in Haiti - including helping ensure that aid to Haiti is sufficient, does not come with harmful policy conditions, aid is in the form of grants and not loans, and Haiti's debt is cancelled. [On Friday, a Washington Post editorial on Haiti included a call for the IMF and other creditors to cancel Haiti's debt]. We'll be back to you soon on this. Please stay tuned.

Final Health Care Bill Must Increase Access to Health Care (January Action)

House and Senate leaders are still negotiating a final health care bill in the hopes of having something on President Obama's desk as soon as possible.

One of the key final sticking points - how to finance reform - seems to have come to a tentative resolution last week. Both the House and Senate bills rely on changes to public health programs and government streamlining to cover much of the cost of reform (about two-thirds). However, they differ on how to pay for the final one-third of the cost (President Obama has refused to sign a bill that is not fully paid for). The House bill imposes a surcharge on individuals earning over $500,000 per year; the Senate bill imposes a 40 percent excise tax on expensive health plans and raises the Medicare payroll tax on incomes above $200,000 for individuals ($250,000 for couples). The House surcharge has little support in the Senate and the excise tax has little support in the House.

The concern on the excise tax is that it may tax plans that are expensive not because they have generous benefits but because they cover a sicker group of people or were negotiated as part of collective bargaining in exchange for little or no pay increases for employees. Last week, it appears a compromise may have been reached. While exact details have not be released, it seems that the final bill will retain the Senate's excise tax, but the threshold for imposing the tax would be raised and collectively bargained plans would be exempt until 2017 (to give employees and employers time to renegotiate existing contracts). Whether this agreement will satisfy House progressives is unknown, but reports were cautiously optimistic.

Completion of a compromise bill is likely to take several more weeks, although the dynamics could significantly change after the Senate race in Massachusetts today (see next section below). While there are still other issues to resolve, a large part of the delay stems from the fact that the Congressional Budget Office must "score" the compromise bill (assess its cost) before final votes are taken, which could taken several weeks.

Because negotiations are ongoing, RESULTS message remains the same: pass the broadest possible expansion of Medicaid and community health centers (CHC). Specifically:

  • Medicaid should cover everyone up to 150 percent of the federal poverty line.
  • The Medicaid expansion should start as early as possible and the federal government should cover 100 percent of the cost for as long as possible.
  • Medicaid reimbursement rates for primary care providers should equal Medicare reimbursement rates.
  • Existing Medicaid benefits should be maintained for all current and new enrollees.
  • Funding for community health centers should be set at the House level of $14 billion over five years.

Don't forget to remind congressional offices that Medicaid doctors are only paid 66 percent of what Medicare doctors are paid for primary care and in 2008 only 40 percent of physicians accept all new Medicaid patients. RESULTS has signed onto a letter to congressional leaders that asks them to adopt "the House provision to adjust Medicaid payments for primary care to at least 100 percent of Medicare rates."

TAKE ACTION: Take the January Action. This is the final push for real reform! Contact senators and representatives, or their staff, directly and ask them to push for the strongest provisions for Medicaid and community health centers. Urge your members of Congress to weigh in with Senate Majority Leader Harry Reid (D-NV) and House Speaker Nancy Pelosi (D-CA-8) on the points listed above (see our House and Senate bills summary chart for more details). Don't be afraid to ask staffers for follow-up to ensure that your messages are getting through to members of Congress (MoC). End your call with:

Thank you for your time and consideration. Would you please get back with me as soon as you speak to Sen./Rep. _____________ to let me know what they said?

If you don't hear back within a few days, call the staffer back and ask what the MoC said.

Be sure to contact all the House and Senate offices in your state, not just your specific members of Congress. In addition, contact the networks you cultivated in November and December and urge them to call as well. If you cannot get through to your members of Congress DC offices, try their local offices in your state. If you don't get through the first time, try again later. Also, you can supplement your calls by sending an e-mail to them. You can find contact info on our Elected Officials page of the RESULTS website.

Finally, please sent any feedback you or your networks get from House and Senate offices to Meredith Dodson at dodson@results.org. To make it easy, use our online call-in alert when calling and you can enter your feedback right on the alert form; your feedback will then be automatically sent to RESULTS' Domestic staff.

Massachusetts: Health Care State of Play

Many of you already know that all eyes of the health care debate are focused on Massachusetts today. Today is the special election in that state to fill the Senate seat of the late Edward Kennedy (D-MA). Back in September, Gov. Deval Patrick (D-MA) appointed Paul Kirk to temporarily fill Kennedy's seat until today's election. The seat will be filled by either Democrat Martha Coakley or Republican Scott Brown.

The reason this race matters so much to health care is that the winner will determine if a final health bill compromise passes the Senate. Senate rules only require 51 votes to pass a bill, however 60 votes are needed to overcome a filibuster to get to that final vote. Republicans in the Senate have vowed to filibuster any health bill, and to date have followed through on that promise. Brown has vowed to oppose the health reform bill if elected; Coakley has said she would support it. Recent polls indicate that Brown is the front-runner to win.

Because of the above dynamic, the politics of health reform could change very quickly depending on the outcome of this election. Here are some possible scenarios:

  • Coakley wins: Nothing changes; the House and Senate finish negotiating a final bill and vote in the next several weeks.
  • Brown wins (scenario 1): Brown is sworn in as the next senator from Massachusetts, upholds the filibuster against the compromise bill in the Senate and the health reform bill stalls.
  • Brown wins (scenario 2): House and Senate negotiators frantically finish the final reform bill and use Sen. Paul Kirk's vote to pass it in the Senate before Brown is sworn in (because of election certification requirements in MA, it could take 10-15 days before Brown is sworn in as senator).
  • Brown wins (scenario 3): The House passes the Senate bill as is. Because the Senate has already passed its version of health reform, the Patient Protection and Affordable Care Act, the House could simply vote to pass that bill with no amendments. It would then go to President Obama for signature. However, because many progressive House members have serious problems with the Senate bill, it is unknown if Democrats have 218 votes to pass the Senate bill with no changes.
  • Brown wins (scenario 4): The House passes the Senate bill as is and the House and Senate use the budget reconciliation process to implement changes. In this scenario, the House would pass the Senate bill verbatim and either have a companion bill with agreed upon changes ready to go using the budget reconciliation process or use reconciliation to pass changes sometime this spring. Budget reconciliation is sometimes used to pass certain types of legislation, namely those that impact the budget. For example, the Bush Administration used it to pass tax cuts in 2001 and 2003 and the Deficit Reduction Act in 2005. It is appealing because it allows for a simple majority vote in the Senate (51 votes). Because reform supporters would still have 59 votes in the Senate, using reconciliation to pass changes to the Senate health bill would render Brown's NO vote moot. However, because reconciliation can only be used for matters that impact the budget, not all areas of health reform are eligible. For example, while increasing Medicaid reimbursement rates (which is in the House bill but not the Senate's) clearly impacts the budget and could be dealt with in reconciliation, repealing the anti-trust exemption for insurance companies (that many in Congress support) likely would not. In addition, using reconciliation would further inflame the already partisan rhetoric around health reform.

As of right now, RESULTS message remains the same - pass a strong health reform bill that helps those most in need. Regardless of the outcome tonight, members of Congress need to hear from us about expanding Medicaid and community health centers. With that said, our message could change after tonight. Most prognosticators think that if Scott Brown wins tonight, scenario 3 or 4 would happen, but no one knows for sure. RESULTS will certainly let you know of any changes in our message and/or strategy that may arise from tonight's election. In the meantime, keep up those calls to House and Senate staffers in support of Medicaid and CHCs.

Join Our First Media Training Call of 2010 This Thursday

RESULTS staff schedules optional training calls each month to provide you support in your work to create the political will to end poverty. This Thursday, January 21 we will have our first training call of 2010 - Media Training: A Step by Step Approach to Engaging Your Editorial Writer. RESULTS staff persons Ken Patterson, Jos Linn, and Blair Hinderliter will lead this call in helping develop relationships with editorial writers in your area. If you don't know where to start with your editorial writer, this is the call for you.

TAKE ACTION: Join us for the Media Training call on Thursday, January 21 at 9:00 pm ET, (712) 432-3100, passcode 887871.

Quick News

New Head Start Impact Study Released. The U.S. Department of Health and Human Services released a report this month that confirms a positive impact on children's preschool experience. The 35-page Executive Summary (PDF) is at http://www.acf.hhs.gov/programs/opre/hs/impact_study/reports/impact_study/executive_summary_final.pdf

RESULTS Signs on to Child Nutrition Letter. RESULTS joined other organizations in signing a letter to Congress in support of the Access to Nutritious Meals for Young Children Act of 2009, S. 2749 and H.R. 4402, introduced by Senator Gillibrand (D-NY) Rep. Paul Tonko (D-NY). These bills will increase Child and Adult Care Food Program (CACFP) access and strengthen CACFP's role in supporting good nutrition. These program improvements will help to improve childhood nutrition, reduce childhood overweight and obesity, reduce hunger, and enhance child development and school readiness. You can take Action by using our Senate alert to request that senators cosponsor the Access to Nutrition bill.

Announcements

Have You Scheduled Your Group Planning Meeting Yet? Because passing health reform is front and center right now, we are moving our domestic planning process to February this year. However, you can start getting ready now. First and foremost, please schedule a specific time in February for your group to do group planning. You can do it in conjunction with the February 13 monthly conference, during your second monthly meeting, or at another time during the month. Also, please go to the RESULTS Group Resources page to find the RESULTS 2010 Group Planning Materials, print off the Individual Planning Form, and complete it before your February group planning meeting. Finally, review the Economic Opportunity PowerPoint Presentation to help you understand the background for our primary 2010 campaign: Low-Income Tax Credits: Creating Economic Opportunity. You can also read more about this campaign on our Economic Opportunity pages.

Completing Fundraising Activities. Now that you have looked at your individual and group totals for our 2009 fundraising  campaign, please let your Regional Coordinators know what your final goals and totals will be. If you have any questions, please contact Cynthia Stancil at cstancil@results.org.

Donations Always Welcome. RESULTS and RESULTS Education Fund always welcome your financial contributions. Your support helps us do the work we do. Use our easy, breezy online donation form to make your contribution. (Please note that REF donations made after December 31, 2009 are not tax deductible until tax year 2010).

Upcoming Events

(Click to see a complete calendar)

January 21: Media Training: A Step by Step Approach to Engaging Your Editorial Writer, 9:00 pm ET, (712) 432-3100, passcode 887871.

February 13: RESULTS Domestic National Conference Call, 12:30 pm ET. Guest Speaker: Monica Mills, Director of Government Relations, Bread for the World.

June 20-22, 2010: RESULTS/RESULTS Educational Fund International Conference, Washington Marriott Hotel, Washington, DC.

RESULTS Contact Information

Main Office: (p) (202) 783-7100, (f) (202) 783-2818, 750 First Street NE, Suite 1040, Washington DC 20002.

Domestic Legislative and Grassroots Support Staff: Meredith Dodson, x116 (dodson@results.org); Alan Gold, x106 (gold@results.org); Jos Linn, (515) 288-3622 (jlinn@results.org).

The RESULTS Domestic Update is sent out every Tuesday over e-mail to RESULTS volunteers and allies all over the country. The purpose of these updates is to inform and activate RESULTS activists to take action on our domestic campaigns.