After years of silence within the Idaho Legislature on closing the coverage gap, and no visible intention of addressing it in the 2016 legislative session, advocates refused to leave 78,000 Idahoans in the gap and successfully shifted the conversation on the issue from a nonstarter to the center of legislative debate. The Republican-controlled Legislature ended up printing multiple bills and holding several hearings on the issue. Legislation that would have begun the waiver process to close the gap passed the state Senate by a vote of 28-7, and the Republican Speaker of the House promised to pull together a task force to develop a proposal to close the coverage gap for consideration in 2017. Idaho health consumer advocates of Close the Gap Idaho have a lot to be proud of. This success was a result of their excellent preparation, solid coordination, flexible approach to organizing and opportunistic response to an unexpected catalyzing event.
When Governor C.L. “Butch” Otter proposed a plan to increase primary care – but not offer complete coverage – for some people in the gap, Close the Gap Idaho jumped on the opportunity to draw attention to the issue and the need for a broader solution to address it.
They held a press conference at the beginning of the legislative session on the need for a complete solution to the coverage gap problem instead of a partial program that would provide limited primary care services to uninsured Idahoans. They created infographics and other materials to help the press understand why funding primary care services with state dollars would inadequately meet the health care needs of working Idahoans and be an ineffective use of funds. This effectively helped to shape coverage of the governor’s primary care proposal by redirecting the media’s attention to the real solution: accepting federal funds to close the coverage gap.
For maximum impact, advocates employed social media, postcards, emails and public events to focus attention to the issue and encourage rapid response involvement. With simple factsheets, short videos and photos, the coalition was able to transform the conversation from politics to people. Advocates successfully elevated the widespread impacts of closing the gap on the economy of the state and the lives of its residents, including veterans. The Close the Gap Idaho Facebook page was used as the main vehicle for raising awareness and spurring actions and within three months of the 2016 legislative session beginning, their posts reached over 39,000 people.
During the final weeks of the session, the campaign intensified. Advocates connected the media and legislators to key spokespeople for Idahoans in the gap like physicians, faith leaders and law enforcement officials. With the support of approximately 120 organizations (including but not limited to academics, health care providers, law enforcement agencies, faith groups, disability rights advocates and social workers), the coalition collected dozens of consumer stories and generated hundreds of news articles about Idahoans in the coverage gap who were in need of health care. Physicians in white coats testified at the Statehouse asking legislators to “set aside ideology and politics and try to see the gap population the way we do: as working Idahoans who just need a little help.” Religious leaders delivered their interfaith sign-on letter to legislative leadership with over 80 signatures of faith leaders backing action to close the coverage gap to “save hundreds of lives, and most importantly alleviate suffering and enhance the quality of life in our state.” Hundreds of people turned out for hearings pressuring legislators to do the right thing. In total, their efforts generated 5,320 emails, 4,380 postcards and 2,908 calls to legislators in support of closing the gap.
Ultimately, legislators responded to this pressure. While no legislation was passed during this session to close the coverage gap, a majority of the state Senate is now on record voting in support of closing the gap and the Speaker of the House is committed to developing a solution.
Close the Gap Idaho will build on these successes next year and continue to keep the conversation relevant while holding lawmakers accountable for their failure to close the gap.