One year after the Tea Party insurgency disrupted Democratic Congressional town hall meetings, it’s worth asking how healthcare reform survived. By the beginning of 2010, Scott Brown had taken Ted Kennedy’s Senate seat, reform proponents had lost the national narrative and voters in swing states around the country had soured on reform.
Still, health reform became law, an achievement that for all its flaws, finally establishes a government obligation to make health coverage affordable. How, despite all the odds, did it happen?
The victory was no accident. The progressive campaign to win healthcare reform was several years in the making and was based on a well-developed and resourced plan, from which we can take key lessons for other progressive campaigns. Here is what we did to win.
Early in-depth public opinion research: A coalition of groups joined in a two-year project to identify public attitudes towards healthcare reform. We found that: we needed to reassure people that they would not lose the coverage they liked but would instead gain more choices, affordability and security; it’s futile to compare ourselves to other countries, in a nation that firmly believes that we’re number one; and we need to animate anger and hope as the antidote to the opposition’s main weapon, fear. We also found evidence—not surprisingly—that the popular target for anger was the insurance industry.
A unifying policy proposal: It’s difficult to understate the importance of the public option in creating unity among most of the organized left. The public option bridged the gap between the deep desire for single-payer among healthcare activists and the reality that neither the American public or political system could tolerate having everyone enroll in a government health insurance plan. Without the public option, we would never have been able to put together the coalition that formed a strong, well-resourced campaign to win reform.
A broad, progressive coalition: We built a coalition, Health Care for America Now (HCAN), from among the biggest multi-issue, progressive organizations, particularly those able to mobilize people outside the Beltway. The twenty groups that eventually made up HCAN’s leadership included major unions, community-organizing networks, netroots groups and organizations representing women and communities of color and think-tanks. The coalition agreed to ten specific principles for reform and the leadership organizations each made a major commitment to the campaign of money, staff and membership mobilization. The combination of unity around policy and mission and significant investment in the actual campaign meant that the coalition would do what most people thought impossible: stick together to the end.
A detailed campaign plan: The HCAN Organizing Committee wrote an 865-page campaign plan incorporating: grassroots and netroots organizing; communications through traditional, paid and new media; coalition building including creating a new organization of small businesses; fundraising; and a new round of public opinion research focused on generating anger at the health insurance industry.