The next president had made repeal of the Affordable Care Act a leading priority of his campaign. Republican legislators who controlled both the House and Senate were eager to make it happen. Plans to drastically cut Medicaid funding were in the works.
None of this was lost on health care advocates who had campaigned for passage of the ACA and later worked to help implement the law now enabling health insurance coverage for millions of Americans with financial support from Medicaid.
“Everything we had been doing for the past seven or eight years was threatened,” said Robert Restuccia, executive director of Community Catalyst, at an Oct. 30 meeting of the Gerontology Speaker Series at UMass Boston’s McCormack Graduate School.
“Not only did they want to repeal the ACA, they wanted to decimate Medicaid,” he said. “We had to turn our attention away from implementation and toward survival.”
Community Catalyst is a national non-profit organization based in Boston dedicated to making affordable health care available to everyone. It became an important force in the ensuing political battle, helping block efforts to repeal the ACA and resist steep cuts in Medicaid. Along the way, its efforts also brought attention to the critical role Medicaid plays financing long-term supports and services to millions of older Americans.
Restuccia provided a detailed look at the strategy behind the health care campaign to the UMass Boston audience.
Shortly after the election, Community Catalyst joined forces with other advocacy groups to form Protect Our Care. It provided a kind of campaign infrastructure that helped develop plans and organize resources. A Washington strategy soon focused on the Senate and targeted six Republican senators, urging them to vote against plans advanced by their party leadership.
But health care advocates believed they needed to build broader support around the country for the ACA and Medicaid. “We needed a grass roots response,” said Restuccia. “A key element was developing a ground game in the states.”
Community Catalyst raised more than $3 million, in turn distributing grants to 70 organizations in 25 states. It provided resources and technical assistance to state advocates across the country. Those advocates were organizing protests, leading “Save My Care” bus tours and promoting local stories of people depending on care made possible by the ACA and Medicaid.
Community Catalyst also went to work developing state-by-state data that would show exactly who and what was at risk from potential Medicaid cuts.
Marc Cohen, co-director of the LeadingAge LTSS Center @UMass Boston, also serves as research director at Community Catalyst. He prepared a detailed analysis of which states would likely be hurt most by proposed per-capita caps on Medicaid spending. His report also estimated how many home and community based health care workers might lose their jobs in each state.
Other research backed by Community Catalyst explored additional areas of health care that could be impacted if the ACA was repealed and Medicaid funding slashed. In each case, it became a priority to provide data on a state-by-state basis to make a local impact across the country.
Healthcare advocacy organizations prevailed in Congress, for now, but Restuccia said Community Catalyst remained on “war-room status.” More recently, it has been supporting a ballot initiative to expand Medicaid coverage in Maine and working on possible Medicaid expansion in Kansas.
Responding to questions, Restuccia did not rule out support for some kind of program that would directly address access to funding for long-term supports and services as a future campaign issue.
“Is there a long-term care plan we could propose? The Democrats need to have something pro-active in 2020. I think Medicare for all is a stretch and it doesn’t deal with long-term care.”