This week, Montana becomes the 29th state (plus the District of Columbia) to close the coverage gap, and the first state to get legislative approval to expand Medicaid in over a year. As a result, 70,000 low-income Montanans will soon gain health coverage, many for the first time.
This was not an easy fight. The bipartisan compromise passed through both Republican-controlled chambers this month despite the best efforts of well-funded conservative political organizations like Americans for Prosperity (AFP) and the state’s Tea Party-affiliated House leadership.
How did people prevail over politics? There are a lot of reasons, but top among them is smart, sustained, authentic community organizing.
Under the leadership of Montana Women Vote and the Montana Human Rights Network among others, a coalition of advocates had been conducting public education events and canvassing in key districts on this issue since 2013. Over the years, they built a list of thousands of volunteers who were educated and actively engaged, they trained dozens of Montanans who were trapped in the coverage gap to lift up their voices, and they engaged countless hospitals, businesses, and even city council-members in target areas.
Because of this solid groundwork, the campaign was able to generate a firestorm of support for closing the coverage gap in the weeks leading up to the final votes, including over 11,000 calls to legislators and an average of 8-10 earned media pieces a week.
By contrast, AFP did not invest time building relationships in affected communities on this issue. Instead, they invested hundreds of thousands of dollars, and assumed that would buy them the influence they needed. But they were wrong.
AFP and other conservative political organizations relied on expensive paid ads, push-polls and mailers in the weeks leading up to the vote to generate opposition to closing the coverage gap. But without pre-existing relationships on the ground, these efforts generated only 755 calls to legislators during the week of the key votes; during that same week, supporters generated nearly 6,000. And when AFP organized “town hall” events to target three Republican legislators who were considering supporting the bill, Montana citizens who supported closing the coverage gap turned out in such high numbers that AFP was forced to apologize for its tactics.
The recent success in Montana is a win for low-income Montanans, and it’s a refreshing reminder that sustained, strategic and organized consumer advocacy can triumph over moneyed interests.