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November 2009 U.S. Poverty Action

Mobilizing to Meet the Health Needs of Low-Income Americans

Take Action! Build a Community Action Network and Get Ready to Make a Final Push for Health Care Reform. Designate a person in your group to be the contact person for getting call-in messages to your group and local networks. Identify the grassroots and “grasstops” (local VIPs) in your community who share a desire to improve health care for all Americans, particularly low-income individuals, children, and families who need it most. Reach out to these groups to see if they would be willing to make calls to Congress during the floor debate on health care legislation in Washington. Ask if they would be willing to share call-in requests with other networks as well. In particular, calls should state the following: For representatives: I am pleased the House health reform bill will expand Medicaid to all individuals at or below 150 percent of the federal poverty line while strengthening the program. This is a vital component in providing health care for all Americans. I urge Representative _________ to vote YES to the House health bill, HR 3962, the Affordable Health Care for America Act. For senators: I urge Senator ____________ to follow the House’s lead and expand the Medicaid to all persons at or below 150 FPL. In addition, I urge him to support amendments to the Senate bill that ensure that newly eligible persons receive the same benefits as current enrollees, doctors are reimbursed at the same rate or better than Medicare (like in the House bill), and the federal government should provide 100 percent of the financing for the expansion. Urge everyone in your network to end their calls with a clear message: investing in Medicaid will help ensure that the expansion will work as intended — to provide safe, quality, affordable health care to America’s most vulnerable persons. Note: To find contact information, including telephone numbers and addresses for congressional offices and the names of the health staffer, visit the Take Action Now page of this RESULTS website. For directory assistance, you can contact the U.S. Capitol Switchboard at (202) 224-3121.

House and Senate Will Begin Debate on Health Care Legislation in November

The movement to enact health reform in the U.S. is steadily moving forward. The House is expected to vote on the bill sometime the week of November 2. House Speaker Nancy Pelosi (D-CA-2) wants their bill passed by November 11. The Senate will likely begin debate sometime the week of November 9. Debate in the Senate is likely to take several weeks. Both the House and Senate are planning to enact significant expansions of Medicaid. This is due in part to RESULTS volunteers working for months to see that health care for low-income individuals and families are included in any final reform bill. See the grid below on how each chamber’s bill would expand Medicaid (Last Updated: November 2, 2009):

RESULTS Position	Senate America’s Healthy Future Act	House Affordable Health Care for America Act (H.R.3962)
Expand Medicaid to include everyone at or below 150% of the federal poverty line (FPL).	Medicaid eligibility expanded to include everyone at or below 133 percent FPL (beginning in 2014). Persons between 100 and 133 percent FPL would have the option to opt out of Medicaid and enroll in a private plan.	Expands Medicaid coverage to everyone at or below 150 percent FPL. No provisions for counter cyclical funding during hard economic times.
Expand Medicaid with 100 percent federal financing and help states through "counter-cyclical financing": automatic increases in federal funding during economic downturns	States would bear some of the financial responsibility for the cost of the expansion. No provisions for counter-cyclical funding.	Provides 100 percent federal funding for the expansion, until 2015. At that point, states will be required to contribute 91 percent of the funding.
Increase access by bringing reimbursement rates at least up to those in Medicare.	Amendment to increase Medicaid reimbursement rates failed during committee consideration.	Medicaid reimbursement rates for primary care will increase to Medicare within three years.
Preserve existing Medicaid benefits for current and new enrollees.	The Finance Committee proposal provides coverage at the “bronze” level; new Medicaid enrollees will not have access to the traditional benefit package that includes assistance with transportation costs and critical mental health services.	Preserves existing Medicaid benefits for current and new enrollees.

As the debate moves forward, it is imperative we make our voices heard. Despite the gains made above, they can still be undone. There are also additional provisions that should be included to ensure that the Medicaid expansion is successful. To see the latest information on RESULTS’ priorities as compared to the House and Senate bills, see our updated health reform chart on our Recent Developments on Health Reform page.

During the floor debates, phone calls to congressional offices will be necessary. Because votes can come up any time and circumstances can change quickly, phone calls are the only reliable means to let your voice be heard at the right time. You can use the talking points listed above to make calls to congressional aides or even to office receptionists, but every person in your group should plan to call if at all possible. The more calls that are made, the better. Furthermore, please designate one person in your group as your health reform floor debate coordinator. The RESULTS office will contact this person about key times for call and in turn, this person will send out requests to the group for calls and messaging. Because this debate is historic and the process could take weeks (in the Senate), numerous calls on various amendments, procedural votes, and final votes will be needed. RESULTS will do all we can to keep you up-to-date on what is happening and which messages will work best.

Build a Community Action Network to Make Calls During the Health Care Floor Debate

We all well know that the more people talking to their members of Congress, the more influence they have. This could not be more important than in the coming weeks during the health reform floor debates in the House and Senate. Quite simply, we need as many people as possible calling members of Congress in support of health care for all. In your RESULTS work in your local communities, you may have come in contact with other persons or groups who share the same or similar ideals about health reform and caring for the poor. Now is the time to enlist their help in seeing meaningful health reform passed this year. In doing so, you start to create a Community Action Network that you can call upon in certain situations to take action, even if they are not part of your local RESULTS group. A Community Action Network is a local collection of connected individuals who have an interest in a common issue or goal, and through their established relationships with each other, are prepared to mobilize when an opportunity arises to move their work forward.

Community Action Networks are exciting because they are filled with both grasstops and grassroots activists. Grassroots are all of us. They are the heart of any community, the ordinary people who make up the fabric of a neighborhood, a town, city, state, or nation. Grasstops are leaders and organizers in your community who are connected to or with difference constituencies in the community. They have lots of resources at their disposal, are in a position to make a pivotal change happen through their positions in the community, and/or can organize large groups around a common cause.

How do I Create a Community Action Network? In some cases, you may already have a Community Action Network in your area. In that case, simply contact them now and tell them to get ready to take action health care reform. You want to “prime the pump” so people will be ready to act at a moment’s notice. When specific requests do come, be sure to include the following:

• Who the calls should go to, i.e. representatives and/or senators
• Phone numbers for members of Congress Washington DC offices and their local office in your area (Toll-free numbers to call Washington will likely be available, which RESULTS will send to you)
• The message to be delivered. It should be short and to the point. When contacting your group point person, RESULTS will provide this messaging if at all possible.
• Thank them for their help in this important effort.

However, you may not have a Community Action Network built up at this time. This is the perfect opportunity to start one. RESULTS has a step-by-step guide to help Create, Manage and Activate a Community Action Network and how to Build a Coalition of Community Allies.

Because time is pressing in this situation, you may have to be more straightforward in creating your network for the health reform debate. However, it is very easy. Simply start with the people you know — your family, friends, work colleagues, faith community members, Facebook friends, and others who might be willing to make some calls. Ask them if they would be willing to make calls to their members of Congress about health reform. Don’t be shy about asking; you never know who will say yes. Let them know that you will provide phone numbers and statements they can use to make it as easy as possible,

Once you have your list of persons who will call, create an e-mail and phone list that you have easy access to and can send out quick requests and updates, Have it ready to go at any time. Also, be sure to contact the RESULTS office (202) 783-7100 ext.116 to let us know who your group point person is. Generally, the RESULTS office will contact a person directly when there is a specific message going to a specific legislator. Otherwise, use our weekly updates and action alerts for guidance. Forward the relevant portions of our updates and alerts to your Community Action Network as needed, and please do not hesitate to contact the RESULTS office if you have any questions. This is an historic time for us. We have come a long way on enacting health care for all and we are on the cusp of making some important improvements to our health care system. However, we all need to stay actively engaged until the job is finished. With your and your network’s help, we can help enact quality, affordable health care for all in 2009.

We will discuss our Health Care for All campaign on the November National Conference Call — Saturday, November 14, at 12:30 pm ET. To participate, call (888) 409-6709 with your group by 12:28 pm ET.