The Finish Line project, an initiative of the David and Lucile Packard Foundation, works in and across states to build upon efforts toward the goal of providing health coverage to all children. An evaluation component, led by Mathematica Policy Research, aims to inform decision makers in states and at the national level about promising coverage strategies and programs.
The brief summarizes key findings from site visits made to six (of eight) states where the Packard Foundation has made its most substantial investment in advocacy through multiyear “Finish Line” grants. Findings from these site visits affirm the critical importance of persistence, flexibility, and commitment to conducting effective state-based advocacy; the added value of building meaningful coalitions that encompass both grassroots and state-level stakeholders; and the importance of maintaining a unified voice among a sometimes crowded community of advocates working to improve children’s well-being. Although work remains to attain health coverage for all children, a number of important gains in children’s coverage have been achieved despite a severe and ongoing economic downturn.
Site visits conducted to seven states found that the establishment of strong relationships between advocacy organizations and policymakers is central not only to moving children’s health care coverage agendas forward, but also to preserving previous coverage gains. Understanding states’ unique political environments is an important first step for advocates in developing effective strategies to engage policymakers and gain their support. Common strategies include identifying, nurturing, and supporting political champions; creating strategic linkages between grassroots organizations and policy advocacy groups; using effective messaging that appeals to policymakers; establishing advocacy organizations as the “go-to” resource for reliable data and information; and sharing ownership of agendas and successes. How advocates in the seven states have used these strategies provides useful lessons for other advocates pursuing expansions in health insurance coverage.