From: / Spitfire Strategies
Date: / April, 2010
Re: / Draft messaging recommendations
The enactment of national health reform legislation offers state-based children’s advocates a significant opportunity to strengthen children’s health and their families’ economic security. To support state-based children’s health coverage advocates in making the most of this opportunity, the Georgetown Center for Children and Families (CCF) asked Spitfire Strategies to develop an updated messaging recommendation.
This memo opens with a quick review of background and context. It then presents recommendations for proactive messaging on health reform. It then recommends responses to likely opposition critiques or efforts to distract from proactive messages. The memo concludes with notes on feedback and next steps.
Background and Context
The March, 2010, enactment of health reform is a game-changing event that will not only transform the public policy climate in states but will also occupy a central place in the public debate around health and economic issues in states and at the national level. This focus on health reform will be particularly intense prior to the November, 2010, general election. Though not without potential pitfalls, this conversation also presents real opportunities for children’s advocates. Messaging consistency can help advocates make the most of those opportunities.
The strategic approach underlying this effort is as follows:
- Encourage consistent communications across state lines on the value and effectiveness of health reform for children and families;
- Provide counter-pressure against efforts by opponents of reform to paint it as a failure or a boondoggle
- Make the most of reform’s public and media focus on health coverage to cover eligible-but-unenrolled children through CHIP and Medicaid; and
- Enlist the partnership of state-based advocates in identifying the most effective messages on health reform.
We encourage recipients of this memo to regard it as confidential. The value of delivering consistent messages across state lines can be undermined if coordination among advocates becomes the focus for policymakers and news media, rather than the more pressing budget and policy issues important to kids.
We also encourage recipients to treat these recommendations as a draft. They are intended as a starting point for discussion at CCF’s regional meetings, and we hope to update them based on feedback from regional meeting participants. They will be “finalized” after the regional meetings are completed and shared with all partners, but even that final version will be updated based on guidance from advocacy partners as to the real-world effectiveness of the recommended messages.
Recommended Proactive Messages
Context, Objectives, and Structure
Opponents of health reform have and will continue to pursue a messaging strategy that conservative activists have found effective for decades: launching a myriad of attacks against reform, and amplifying any that appear to be sticking. This strategy has proven effective because it is well-designed to attract the attention of news media, which are by nature always seeking new angles on an old story. Opponents’ strategy will be more effective to the degree that the conversation in states focuses on the critiques and distractions they raise, rather than on the value of reform to kids and families.
We recommend that reform proponents deny them that advantage, by adopting a simple messaging strategy that reminds lawmakers, partners, and the media of the value of reform to children and families. Specifically, we recommend a strategy based on two simple, clear messages (in the box below) that advocates can consistently repeat to increase the impact of the message.
As you can see, these topline messages are supported by a nested array of “supporting points that prove the point,” which advocates can use modularly, as time permits. Thus, in practice, the recommended messages can be used flexibly as follows:
- If the situation offers very little time, as in a press release quote or an opening statement on a television news interview, advocates can at least deliver the topline messages.
- If circumstances allow more time, as in a panel discussion or an op-ed, advocates can deliver the topline messages plus the second-level supporting points, or even the entire array of supporting points.
Recommended Messages
The First Thing to Say / If You Can Say Nothing Else
Health reform is a major victory for children and families. It delivers what families need: affordable, reliable health coverage that won’t disappear if they lose a job or get sick.
Thanks to PROGRAMNAME and Medicaid, we can start to cover uninsured children right now.
Now is the time to roll up our sleeves and start working to make sure that reform works for the millions of American families who will be expecting results.
The Complete Message Set With Supporting Points
Health reform is a major victory for children and families. It delivers what families need: affordable, reliable health coverage that won’t disappear if they lose a job or get sick.
- Reform delivers quality coverage for the whole family ….
- Requires insurance companies to provide pediatrician-recommended care for children so they can grow and thrive
- Continues PROGRAMNAME, which has successfully worked in partnership with Medicaid to cover X kids in STATE
- Allows parents to keep their college-age children (up to age 26) on their family health plans.
- That they can rely on when they need it most ...
- Ends insurance companies’ discrimination based on pre-existing conditions. Starting right away, children who have insurance can’t be denied coverage for a pre-existing condition.
- Ensures that losing a job no longer means families also have to worry about becoming uninsured
- At a cost families can afford …
- Makes coverage more affordable for middle class families by boosting their bargaining power and providing tax credits to those who need extra help through health insurance exchanges.
- Provides Medicaid coverage to low-income families, allowing children and parents to be covered together.
- Through family-friendly systems with less red tape.
- Protects families from insurance bureaucracies that today deny coverage and care to millions of kids.
- Encourages elimination of red tape, so taxpayers’ scarce resources are used covering kids and families, not pushing paper.
Thanks to PROGRAMNAME and Medicaid, we can start to cover uninsured children right now.
Now is the time to roll up our sleeves and start working to make sure that reform works for the millions of American families who will be expecting results.
- Kids can be the first winners in health reform, if we help the NUMBER uninsured children in STATE who already qualify for PROGRAM NAME or MEDICAID to enroll
- Families can apply for coverage today by going to WEBSITE/PHONE.
- Our leaders in CAPITOLCITY can help, by OUTREACH/SIMPLIFICATION AGENDA.
Practical Example
Appendix A offers an example of the recommended message strategy applied to a practical need: a letter-to-the-editor. This illustrates how advocates can apply the messages in the course of their routine communications.
Recommended Responses to Opposition Messages
Proponents are likely asking themselves how opponents will attack reform. As noted above, the answer is any way and every way they can. During just the first week after reform’s enactment, opponents argued publicly that health reform will:
- Cost Democrats in November
- Be struck down by the U.S. Supreme Court
- Not work as advertised
- Undermine state budgets
- Cost businesses money
- Slow economic recovery
- Cost families jobs
- Undermine personal freedom
- Generate a storm of litigation
- Embolden the Tea Party movement
Opponents are well-organized and well-financed by business interests, and going toe-to-toe with them on every issue will put proponents at a disadvantage. Instead, we recommend that advocates focus on their own proactive talking points, by using simple messages to redirect away from the opposition’s conversational turf and back to reform’s value for kids and families.
To that end, we have prepared recommended responses to a few of the opposition’s favored attacks. It is important to note that these responses are intended to make a point and then provide an opportunity for advocates to pivot back to what we must emphasize – the value of reform to kids and families.
Obamacare is the Problem. Exemption Lawsand Lawsuits are the Solution.
They Say:Obamacare imposes an unconstitutional mandate, requiring that STATE families buy insurance, even if they don’t want it or can’t afford it. And Obamacare puts Washington bureaucrats in charge of STATE’s budget, imposing a giant budget deficit that forces our legislature to cut other important services or raise taxes. That’s why we’re suing and passing legislation to exempt our state from Obamacare.
We Say:Some would rather talk about partisan ideology and legal maneuvering than the real issues facing kids and families. Thankfully, the U.S. Constitution protects families from these misguided efforts and ensures that we’ll be able to get on with the serious business of meeting their health care needs.
Obamacare is the Cause for State Budget Woes
They Say:Obamacare will increase our already over-strained state budget deficit by AMOUNT. They want to force our legislature to cut other important services or raise taxes. But we’re standing up to the Washington liberals, by suing or passing legislation to exempt our state from Obamacare.
We Say:The federal government is a strong partner that will cover 95% of the costs.State and local governments will actually save money, as STATE families will no longer be forced to rely on expensive emergency room care, and we can start using health dollars smarter, on prevention. And by increasing families’ economic stability, health reform strengthens the state’s economy.
Obamacare is Costing Businesses Money
They Say:America’s largest employers, including 3M, Caterpillar, John Deereand Valero Energy, have already reported billions in new costs from Obamacare. This boondoggle is already undermining our economic recovery and putting jobs at risk.
We Say:Giant corporate lobbyists have opposed reform for decades, so this isn’t much of a surprise. What corporate lobbyists aren’t telling you is that these “costs” are actually coming from repealing a multibillion-dollar federal subsidy that – before reform – was being paid by your family and mine. What reform did was close this corporate tax loophole, so that money can provide care for kids and families.
Reform is a big win for small businesses:
- It gives small businesses a bigger voice, with insurance exchanges that let small businesses pool their buying power to get better deals from insurers.
- It provides $40 billion in tax credits specifically focused on making insurance more affordable for small businesses.
- And it will drive down costs, by cutting burdensome paperwork, refocusing payments to reward quality care not the quantity if care, and accelerating efficiency through technology.
Obamacare Puts Washington Bureaucrats In Charge of Your Health Care
They Say:This law was a giant federal power-grab by the Democrats in Washington. It puts federal bureaucrats in charge of deciding what your health care costs, and even whether you’ll get care at all. You know better than the government does what your family needs – and so does your doctor. We need to repeal this law, so we can put American families back in control of their own health care.
We Say:Let’s be clear. Before, it was the insurance companies that had all of the power and control. Families didn’t have real control when insurance companies raised premiums nearly 40% in a year. They didn’t have real control when insurance company bureaucrats denied necessary care to save a few bucks. They didn’t have control when the only insurance “choices” available are too expensive to afford. And they didn’t have control when insurance companies completely denied coverage, and their only options are the emergency room and unpaid medical debt.
Health reform gives you more control. You get real choices of insurance, through a state-run exchange that will includes trusted insurers and the same doctors and hospitals that are serving STATE families today – and help to make those choices affordable. You get real dependability, because losing your job or getting sick won’t give insurance company bureaucrats an opening to cut you loose. And you get a real chance to drive down costs, by pooling your purchasing power with other families and small businesses in the exchange.
Doesn’t Reform Still Leave Insurance Companies in Charge?
They Say:The insurance companies just ignored the reform law and said they’d continue to use pre-existing conditions to deny coverage to kids. If they’re willing to do that, has anything really changed?
We Say:It’s no surprise that the insurance industry has unleashed its army of corporate lawyers and lobbyists, looking for a loophole in the law. But they backed down when the Obama Administration announced that its regulations would protect kids and families.
We can expect that insurance companies will keep looking for any way to maintain their advantage. We also expect that the Administration will continue to both watchdog the insurance industry and defend kids and families when the industry steps over the line.
Feedback and Next Steps
As noted above, both the proactive messages and the responses to opposition critiques are recommended as drafts. As the debate evolves, the recommended messaging strategy – especially the recommended responses to opposition attacks – will evolve as well. Our efforts to support state advocates will be more effective if informed by feedback on the effectiveness of recommended messages, as well as emergent messaging needs.
Appendix A – Letter to the Editor Featuring Proactive Messages
Much of the health reform news (see HEADLINE, DATE) has focused on political winners and losers. But parents are more concerned with their own families than political box scores. And let me be clear, the reform plan passed by Congress is a major victory for STATE children and families.
Health reform puts doctors in charge, by requiring insurance companies to provide pediatrician-recommended care that helps kids grow and thrive. It continues PROGRAMNAME, which works with Medicaid to cover NUMBER STATE kids, and it strengthens Medicaid so kids and parents can be covered together. It gives middle-class families real bargaining power through new health insurance exchanges and offers tax credits to those needing extra help. And – starting right away for children who have insurance – it finally ends insurance companies’ discrimination based on pre-existing conditions.
The recession costs more STATE children their health insurance every day. Rep. NAME1, Rep. NAME2, and other real leaders in Congress deserve our thanks for putting politics aside and delivering what families need: affordable, reliable health coverage that won’t disappear if they lose a job or get sick.
And thanks to PROGRAMNAME and Medicaid, most of STATE’s uninsured children can be insured right now, if we can find them and help them enroll. Interested readers can contact ADVOCACYORGANIZATION at CONTACTINFO for more information. If we work together, we can make STATE kids the first winners in the health reform debate.
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