Once again, psychology's membership-based grassroots advocacy network showed itself to be a powerful force when mobilized. With literally tens of thousands of psychologists letting their senators know what they thought of the Health Insurance Marketplace Modernization and Affordability Act, or HIMMA, the ill-conceived health insurance deregulation bill was stopped in Congress this spring.
On its face, HIMMA proposed to enable small businesses to band together for the purpose of offering health insurance coverage to employees who have not otherwise been able to get coverage from their employers. Although a laudable goal, the legislation proposed to accomplish this end by preempting or eliminating a generation's worth of state-level protections for mental health and other health-care services. As many as 68 million people in state regulated health plans-and millions more with individual insurance coverage-were faced with the potential loss of mental health coverage if the bill became law. Thirty-nine state mental health parity laws and 32 state-mandated minimum mental health benefit laws would be preempted. So, too, would 43 "freedom of choice" laws, which guarantee a consumer's right to choose a psychologist's services when their health plan covers a psychiatrist's services.
One of the APA Practice Organization's top legislative priorities for 2006 has been to stop HIMMA, designated as S.1955. The 600-plus attendees at this year's State Leadership Conference were thoroughly briefed on the legislation, including the most important arguments to make when they visited their members of Congress at the close of the conference. Psychology delegates visited 86 Senate offices to express their opposition to HIMMA. And numerous additional face-to-face conversations between psychologists and Senate staffers occurred between the conference and the eventual demise of S.1955.
But more than just constituent visits are necessary to successfully oppose legislation that was supported by the insurance industry and the business community. With the use of the Legislative Action Center at www.APApractice.org throughout the spring, psychologists sent more than 18,000 e-mail messages concerning HIMMA to elected officials. Reports of Senate offices being "inundated" with anti-HIMMA calls in the days just before the Senate vote were also not uncommon.
To buttress psychology's grassroots response, APA Practice Organization government relations staff sought support from state attorneys general and state insurance commissioners, two groups assumed to have concerns about eliminating state insurance regulations. By the time S.1955 came to the Senate floor for a vote, 41 state attorneys general had a signed letter from the National Association of Attorneys General to the Senate objecting to HIMMA. Twenty insurance commissioners also wrote in opposition to the legislation.
Other groups besides psychology were concerned about the detrimental effects of HIMMA were it to become law, and Practice Organization staff co-chaired the Stop HIMMA Coalition to convene the largest possible community to work the agenda. The coalition included the AARP, Families USA, AFL-CIO, American Academy of Pediatrics, American Nurses Association, American Podiatric Medical Association, American Cancer Society and American Diabetes Association. Even with all of these groups coming together to oppose HIMMA, the opposition was still considered by many to be a "David" pitted against the "Goliath" of the National Association of Manufacturers, the National Association of Realtors, the U.S. Chamber of Commerce and the National Federation of Independent Business. Rarely has this set of special interests been stopped in the current Congress.
When the Stop HIMMA Coalition hosted two national "call-in days," more than 21,000 individuals used the toll-free phone number provided to express their opposition to HIMMA to their members of Congress. In addition, one coalition member, the American Chiropractic Association, reported that its members in Wisconsin alone made 45,000 contacts with Senators' offices. The coalition's members also worked to take its messages about HIMMA "public" through orchestrated media coverage. Among other efforts, APA, the American Diabetes Association and the National Partnership for Women and Families created an audio news release (ANR) distributed to radio stations. Over 4,000 radio stations aired the ANR, reaching close to 6 million listeners nationwide.
Psychology's grassroots capability has been building for close to 20 years. While it is not realistic to expect that we can win every legislative battle we fight, it is clear that our members, through grassroots activity, are a force to be reckoned with.
It also is clear that winning the battle isn't the same as winning the war. HIMMA continues to have strong support on Capitol Hill, and the bill's proponents may try to resurrect it or similar legislation in the coming months. If that happens, we know we can marshal our grassroots psychologists yet again to help protect the interests of tens of millions of Americans and the health benefits they need.
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