Our History

Over the decade since our inception in 2005, America’s Agenda has maintained an unwavering focus on reducing the overall cost of health care for American workers, employers, and taxpayers, while at the same time, improving care quality and expanding patients’ access to it. Our work has advanced through three distinct stages during this time. And at each stage, our innovative and pragmatic approach has won landmark advances of our mission.

In our early years, America’s Agenda focused on merging sound health policy with creative and successful political strategy to win comprehensive health care reform legislation—first, at the state level, and second, at the federal level. In the current stage of our work, America’s Agenda partners directly with unions, union employers, and health industry innovators to transform the way health care is delivered to working families, achieving better health outcomes, lower costs, improved access, and an unparalleled patient experience.

Stage I — State Health Reform, 2005-2009

In 2005, America’s Agenda launched a strategy of waging campaigns for comprehensive health reform in the states where prospects for winning victories were greater than they were, at that time, in Congress. In addition to winning and protecting health reforms that were important to state governments, businesses, and working families, the objectives of the state campaigns were to: 1) build political momentum toward national health reform, 2) field-test innovative political and communications strategies, and 3) develop state health reform legislation that could provide templates to guide in the crafting of effective federal health reform.

Over the next few years, America’s Agenda achieved an unrivaled record of success in building comprehensive health care reform campaigns and winning groundbreaking health reform legislation in states across the country. Our state-of-the-art issue campaign support—including cutting-edge strategic communications, public organizing, and innovative design of effective health reform policy—led to unprecedented legislative victories in Maine, Vermont, and West Virginia.

Stage II — Federal Health Reform, 2007-2010

America’s Agenda state health care reform campaigns laid the foundation for our entry into arena of federal health reform.

The State Children’s Health Insurance Program (SCHIP)

In 2007, America’s Agenda directed its effort to win reauthorization and strengthening of the State Children’s health Insurance Program, or “SCHIP.” Over the period from August 2008 into early 2009, the America’s Agenda Health Care for Kids initiative aired the largest independent TV issue ad campaign in the country. America’s Agenda’s intensive TV and direct mail outreach to voters in 32 states and 75 congressional districts urged constituents to thank their senators and congressional representatives for standing strong for the health of America’s children. At the conclusion of a two-year effort, the campaign achieved its goal. The first bill enacted by the 111th Congress with broad, bipartisan support was reauthorization of a strengthened SCHIP that extended health coverage to 4 million additional children in need.

President Obama signed the legislation on February 4, 2009, saying, “Providing coverage to 11 million children through CHIP is a down payment on my commitment to cover every single American.” The SCHIP victory was a milestone step forward for America’s Agenda.

The Patient Protection and Affordable Care Act (ACA)

Over the first five months of 2009, America’s Agenda brought together national leaders in business, labor, health care, and government in a series of webcast, focus group-type “Summit Conversations on American Health Care for the 21st Century.” America’s Agenda’s state campaign victories had demonstrated repeatedly that broad state-level consensus on health care reform can be forged by focusing on solving the crisis of runaway health costs that is a top concern for unions, employers, health care providers, and government leaders, alike, regardless of party affiliation or political leaning. The Summit Conversations held in Miami, St. Louis, Madison, Wisconsin, and San Francisco, revealed that a similar consensus had emerged among leaders of diverse sectors at the national level.

In January 2010, when health insurance reform appeared to be stalemated, America’s Agenda co-sponsored a public appeal for a two-step strategy to complete passage by the 111th Congress. The proposed sequencing of a House vote to adopt the Senate reform bill and passage of a supplemental reconciliation bill to resolve the most significant differences between the House and Senate reform bills was ultimately adopted by the President and Congressional leaders as the roadmap for enactment.

On March 23, 2010, President Obama signed the historic Patient Protection and Affordable Care Act into law.

Enactment of federal health insurance reform, providing coverage for 33 million previously excluded Americans, was an important step forward, but it was only the beginning of the comprehensive health care transformation needed to assure that every American had affordable access to high-quality care.

Stage III — Care Delivery Transformation: Plan by Plan, Region by Region, and Industry by Industry, 2011-Present

The ACA lacks a coherent strategy for solving the #1 health care crisis facing most Americans: a relentless growth in health costs that has eroded workers’ living standards, reduced business profits, retarded job creation, and challenged the ability of governments to deliver essential public services.

Following enactment of the ACA, there was little political appetite for another round of health reform legislation. Yet, absent transformative redesign of a fragmented, wasteful, and all-too-often unsafe health care delivery system, the root drivers of health cost hyperinflation remained intact and in operation. America’s Agenda opted not to wait.

In 2011, America’s Agenda pivoted away from our former focus on legislative reform as the primary strategy for advancing our mission. Instead, we formed direct partnerships with unions, union employers, Taft-Hartley trusts, innovative health care providers, and elected leaders to design and implement cost-effective, high-performance health care delivery networks for collectively-bargained and jointly governed health plans.

Currently, we are working with public and private sector partners at various stages in the design and launch of high-performance care delivery networks in New York City and Miami, in New Jersey, across several Midwestern states, and in Northern California.

In all of these projects, America’s Agenda holds an unwavering focus on care delivery transformation that aligns payer, patient, and provider incentives to improve patient health outcomes, reduce overall health care costs, increase care coordination, and deliver an incomparable patient experience. When our partners decide to move forward, results follow quickly. In less than a year since we partnered to launch a food industry-wide initiative to transform care delivery, for example, the doors opened at redesigned union family health care centers in three meat packinghouse communities in two Midwestern states. Shortly thereafter, we received accolades from executives of our first corporate adopter (who praise reductions in wasteful emergency room costs) and local union members (who praise improvements in patient services and total elimination of out-of-pocket costs for primary care).

America’s Agenda’s ultimate objective is to enable entire communities to enjoy the benefits of participating in care delivery systems designed and created in response to our union and employer partners’ demand for a superior experience, lower costs, and better health outcomes. By taking on cost-saving transformation of care delivery plan by plan, region by region, and industry by industry, we are advancing the America’s Agenda mission to assure that every American has affordable access to high-quality health care.

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