The Consumer Voice in States Promotes Change

Washington, D.C., October 3, 2006. Recent passage of major healthcare coverage expansions in Massachusetts, Colorado, and Illinois suggests that momentum for significant policy change will increasingly take place in states rather than in the federal government.  The active involvement of consumer advocates is a critical ingredient of successful state health reform.  These are key findings of a new benchmark study released today by   Community Catalyst, a Boston-based non-profit organization.  The report, “Consumer Health Advocacy:  A View from 16 States,” examines consumer health advocacy in a cross section of states across the country and found that while political environments vary widely state by state, an organized consumer voice makes a difference in all states.  “In some states like Colorado, Illinois and Massachusetts, consumer advocates were the drivers of health policy reform expanding care for hundreds of thousands,” said Community Catalyst executive director Rob Restuccia, “while in other states like Mississippi and Ohio, they were the linchpins in campaigns to protect thousands of people from losing access to health coverage.” 

The findings of the study, funded by the W.K. Kellogg Foundation, are derived from over two-hundred interviews with local and state-level leaders and in-depth surveys of more than seventy key health advocacy and grassroots organizations in sixteen states.

The report points to three key factors to determine the scope and success of consumer advocacy efforts:

  • The political and economic environment of the state;
  • The ability of advocates to organize grassroots people and build broad-based coalitions that can bring the voice of consumers to the policymakers making the decisions that affect people’s lives; and
  • Funding support and resources for consumer health advocacy initiatives.

“Where consumer organizations are organized and well-supported, they have the most positive policy impacts on real people’s lives,” explains Susan Sherry, deputy director of Community Catalyst.  In Illinois and Massachusetts, two states with particularly sophisticated advocacy capacity, advocates have achieved “breakthroughs” that have expanded health coverage for hundreds of thousands of people.  In Illinois, consumer health advocacy is credited for enabling 280,000 uninsured adults to obtain Medicaid coverage by raising eligibility limits so that parents in a family of four, earning $37,000 or less, now have health security.  In Massachusetts, a three year campaign by consumer health advocates won new affordable health coverage plans for 350,000 low- to middle-income individuals. 

The study finds that more people in Southeastern states suffer disproportionately with health care access problems.  These problems are largely the result of depressed economies, low rates of employer-sponsored health insurance, and strong political opposition to health policies that benefit the uninsured and underinsured.  Yet even in these states, advocates have had an impact on policy. “It was very eye opening to find that consumer advocates in states like Mississippi have been effective in the face of an environment that is challenging on every level,” said Sherry.

In Mississippi, advocates mounted a successful campaign to stop an effort that would have terminated the Medicaid coverage of 65,000 low income seniors and disabled individuals.  The public pressure generated by advocates across the state led to a delay in the termination until most of the recipients were eligible for Medicare prescription drug coverage. 

The report pinpoints the specific capacities that result in effective advocacy and a more powerful consumer voice in each state. To develop strong and organized systems of consumer advocacy in all fifty states and to ultimately influence national health care debates, the report makes four key recommendations:  

  • Strengthen and build systems of advocacy within each state based on assessment of local needs;
  • Develop a national program to coordinate state efforts and deliver strategic support;
  • Organize issue campaigns within and across states to build momentum for reform; and
  • Develop a stronger resource base to support consumer health advocacy.

“With more Americans losing or at risk of losing health security every day, creating strong consumer organizations on the ground-level in each state would change the whole tenor and outcome of the health care debate,” stated Restuccia.  “It is the missing ingredient to providing all Americans with quality health care and this report serves as blueprint for how to make it happen.” 

About Community Catalyst:
Community Catalyst, Inc., located in Boston, Massachusetts, is a national nonprofit advocacy organization that builds consumer and community participation in the shaping of the U.S. health care system to ensure quality, affordable health care for all.  It works in numerous states with consumer groups, policymakers, and foundations as well as with other national organizations.  For more information or to download a copy of the report, please visit