Who speaks for the uninsured? Assessing the current state of the social movement for universal health insurance

Despite widespread knowledge of the causes and consequences of the large uninsured population in the U.S., significant national action to address the problem will also require: 1) a major shift in the priorities of elected officials; and 2) mobilization of a strong, grassroots social movement to counter opposing interest groups. This project focuses on the second of these conditions, neglected despite recognition that the Clinton health care reform initiative failed in part because groups representing consumers and the uninsured were not well-organized or were only lukewarm supporters of the approach taken by the Clinton administration. While grassroots organizing and mobilization appears to be a vital element in the long-term campaign for universal health insurance, there has been little systematic understanding of the scope, capacity and cohesion of advocacy groups pursuing that goal.

Employing a variety of methods, we identified national, state, and local groups with the stated goal of advocating for or educating about universal coverage. After reviewing websites and foundation databases for information on group affiliations, activities, staffing, funding, and other organizational characteristics, we conducted in-depth interviews with a purposive sample of leaders of advocacy organizations, leaders of opposing and affiliate groups, and other stakeholders, including foundation staff and policy makers.

The findings of this research will be significant for the advocacy organizations and coalitions themselves; current and potential funders of those organizations; researchers and policy analysts focused on health insurance coverage issues; and journalists who cover health care issues, among others.