Giving Compass' Take:

• Susan Fitzgibbon Shumaker and Sandra Welch Boren explain how the Cone Health Foundation engaged in public policy advocacy to improve the Affordable Care Act. 

• How can other funders learn from and emulate this model? 

• Learn about another foundation shaping health policy. 

How does a local funder use all the powers of philanthropy–our assets, our voice, our convening power–on national health care policy as complex as the ACA? We were working without a net in those early days of the ACA. There was no playbook about how to wade-in on such a politically-charged issue. Having a board willing to take risks and understand we were on the precipice of great change in the health care landscape meant we needed to lean-in to all the possibility the ACA held.

However, we also understood that the success of the ACA reforms was not guaranteed and would depend largely on strong outreach and education efforts.

Our participation with the NC Get Covered coalition gave our staff and board deeper insight into all of the complexity and challenges with health care reform–from technical difficulties with healthcare.gov, to economic factors affecting individual insurance market plan premiums, to the state legislature’s decision not to expand Medicaid–and a greater appreciation for the far-reaching impact that policy decisions can have, particularly for people who are already marginalized.

From a public health perspective, the implications of the decision not to close the health insurance coverage gap through a Medicaid expansion, are enormous. Research tells us that the uninsured experience sicker lives and poorer health than others and that participation in Medicaid helps the previously uninsured avoid the strain of catastrophic medical expenses.

These troubling public health trends prompted Cone Health Foundation, in concert with the Kate B. Reynolds Charitable Trust, to commission a nonpartisan, first-of-its-kind, study by prominent researchers at George Washington University that assessed the impact of not expanding Medicaid in all 100 North Carolina counties. The study clearly demonstrates that the cost to the state of expanding Medicaid is low, compared to the economic boom it brings.

Read the full article about public policy advaocay by Susan Fitzgibbon Shumaker and Sandra Welch Boren at Grantmakers In Health.