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Health Reform: What Foundations Are Saying and Funding



April 9th, 2010

With the recent passage of federal health reform, GrantWatch Blog has gathered here a sampling of foundation leaders’ comments on reform, examples of what foundations have funded on this topic, and related resources.

Foundation Leaders’ Statements on the Patient Protection and Affordable Care Act (H.R. 3590)

“The Health Reform You Haven’t Heard About,” Robert K. Ross, president and chief executive officer (CEO) of the California Endowment, Bob’s Blog, 30 March 2010. Ross says, “This reform is the civil rights bill for the sick,” and it “also catalyzes the transformation from sick care to true health care.” Another interesting point he makes is that “the final draft of the bill has more than 200 Republican amendments in it,” so whatever people may say, it is a “product of bipartisanship.”

“A Major Step Forward for Better Health and Health Care,” Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation (RWJF), 23 March 2010, RWJF’s Users’ Guide to the Health Reform Galaxy blog. In this statement, Lavizzo-Mourey says that “the new law meets core principles for coverage set down by the Foundation and offers the country the opportunity to improve the health of our people.” She quotes Tom Kean, board chair of the RWJF and former Republican governor of New Jersey, here: “What’s so important about foundations like ours is that we have the long-term perspective to keep our eye on the horizon and stay above the fray, the partners and knowledge to get the job done, and the resources to stick with issues over the long haul.”

“A New Era in American Health Care,” Karen Davis, president, and Sara R. Collins, vice president, Affordable Health Care, of the Commonwealth Fund, Commonwealth Fund Blog, 22 March 2010. The authors maintain that “the legislation will put the U.S. health system on a path to high performance, by providing for the testing of new ways of paying doctors and hospitals to reward results rather than fees based on the volume of services delivered and for the development of strategies to promote prevention and improve quality.”

“A New Outlook for Achieving Access to Health for All Coloradans,” Irene M. Ibarra, president and CEO of the Colorado Trust, 24 March 2010. She wrote this for the trust’s new CommunityConnections Blog. Ibarra outlines the role of the Colorado Trust now that the federal legislation has been inked.

“What Will Federal Health Reform Mean for California? Reaction from the California HealthCare Foundation,”
22 March 2010. This article mentions some of the positive effects expected from the legislation, such as “dramatically” increasing the number of people with health insurance. However, paraphrasing Mark Smith, president and CEO of this California funder, the article cautions that “things may get worse before they get better.” For one thing, some of the major provisions of the health reform legislation do not kick in until 2014.

“Statement from NYSHealth on the Passage of Federal Health Care Reform,” Jim Knickman, president and CEO of the New York State Health Foundation, 22 March 2010. Knickman says that the legislation has numerous strengths; he cautions, though, that its “ultimate success” will greatly depend “on the work done to implement its reforms.” He acknowledges that improvements can be made to the law, and he hopes that “they emerge on a bipartisan basis.”

Poll on Health Reform

“It Passed. So What’s in It?” Pew Research Center for the People and the Press, released this News Interest Index survey on March 31, 2010. Conducted in late March, it found that 55 percent of members of the public polled “say they understand at least somewhat well how the new health care law will affect them and their families.” This center is a project of the broader Pew Research Center, a nonprofit, nonpartisan subsidiary of the Pew Charitable Trusts—a public charity.

Report on Consumer Advocacy and Reform

Building on the Foundation: Consumer Advocacy’s Role in Successful Health Care Reform
Community Catalyst, a nonprofit consumer group in Boston that “is committed to changing the health care system through consumer empowerment and engagement” issued this report “to highlight the challenges and opportunities” for consumer advocacy groups and their funders in the “post-reform environment.”

Rob Restuccia, Community Catalyst’s executive director, said in an accompanying letter, “We wrote the [January 2010] report from the viewpoint that national health care reform [would] be enacted upon soon.” Among the report’s “key takeaways” is that “states will be a central focus” of health reform activity; “new tools and greater community engagement are required to address health disparities;” and “the advocacy infrastructure at the state and national levels will need to be strengthened to ensure effective consumer participation in the process,” he said.

The report suggests several strategies for advocates: (1) building public support for reform and “working for successful implementation of the [reform] provisions that go into effect immediately;” (2) defending existing programs (such as Medicaid) and their current coverage levels; (3) “developing policy and regulations at the national and state levels;” (4) “enrolling people in new programs and monitoring the impact of reform;” (5) “ensuring the sustainability of reform” through delivery system reform that constrains “overall health care spending in the United States.”

Advocacy groups must collaborate, the report adds. Suggestions on this front include “increased coordination among funders to ensure effective application of limited resources, and between funders and advocates to develop shared agendas and strategies based on local environments and needs.” The Public Welfare Foundation funded this report.

$26.5 Million in Grants to Health Care for America Now

“Advocates Plot Next Steps Even as Ink Dries on Health-Care Overhaul Law,” by Suzanne Perry in the March 23 Chronicle of Philanthropy reports on a $26.5 million grant from Atlantic Philanthropies to Health Care for America Now (HCAN), “a coalition of more than 1,000 liberal advocacy groups and labor unions.”

Also, read “A Big Bet on Advocacy Helps to Make History on Health Care,” a column by Gara LaMarche, president and CEO of Atlantic.

On March 11 I heard LaMarche speak at the Grantmakers In Health meeting in Orlando. In his speech he mentioned Atlantic’s large amount of funding for HCAN, so that its member groups could compete more against the “big lobbyists;” the view was that advocacy for health reform needed strengthening. Because it is a Bermuda-based foundation, Atlantic was able to do this. Other funders of HCAN included the California Endowment, Open Society Institute, and individuals.

LaMarche said that Atlantic had learned from its work in other countries about organizing around an issue and had learned to “put an issue on the agenda and keep it there.” He also noted that Atlantic has decided to spend all of its assets [by 2020], because it wants to do more good now by focusing “concentrated resources” on efforts it supports. The foundation, however, accepts only invited proposals, he noted. LaMarche’s speech will be posted soon on Atlantic’s Web site, a spokesperson told GrantWatch Blog.

Related Resources on Reform

Some recent Health Affairs Blog posts analyzing the reform bill and its passage include:

“Eight Rules from The Heart of Power: How Did Obama Do?” Jeff Goldsmith of Health Futures, Inc. (http://www.healthfutures.net), 29 March 2010.

“The Health Care Reform Reconciliation Bill (Updated),” Tim Jost of Washington and Lee University School of Law, updated as of 20 March 2010.

Other resources of interest:

“New Health Initiatives Put Spotlight on Prevention,” Robert Pear, New York Times, 4 April 2010.

“Summary of Coverage Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010,” Henry J. Kaiser Family Foundation, 5 April 2010.

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