Democracy Talk 

Massachusetts made national headlines this month with its groundbreaking law to assure near-universal health care coverage. When other states are cutting public investment in health care, what emboldened Massachusetts to take this dramatic step forward?

The law didn’t come about because of charismatic politicians or brilliant academics and think-tanks, but rather because the citizens of Massachusetts demanded it.

Among them were members of Greater Boston Interfaith Organization, a coalition of 70 religious congregations and community organizations founded in 1998, whose combined members include roughly 50,000 people. (GBIO is part of the Industrial Areas Foundation national citizen network featured in Chapter Seven of Democracy’s Edge.)

This story begins in December 2004 in a church hall in Dorchester, at the heart of Boston’s Haitian community. GBIO had just celebrated a victory protecting the civil rights and dignity of immigrant health care workers. Sweet as this victory seemed, the Haitian nursing assistants shared with other GBIO members that their biggest worry was their lack of health insurance; at $25,000 per year, they earned “too much” to qualify for the state Medicaid program but too little to afford employer-sponsored insurance.

Their story resonated with other members, from working poor without insurance to moderate-income families struggling to make premiums to affluent families whose adult children were among Massachusetts’ 550,000 uninsured.

Sensing a political opportunity to influence a major public policy debate about an urgent concern of their members, the clergy and lay leadership of GBIO voted to join a state-wide coalition pushing for comprehensive health care reform. When the law filed by this coalition failed to gain traction among Massachusetts’ political elite – the Speaker of the House, the Senate President, and the Governor – GBIO and the coalition embarked upon an ambitious strategy for direct democratic accountability: put the reform law in front of the voters as a ballot initiative in November 2006.

Thanks to the people-power of churches, synagogues, and unions, the coalition quickly gathered over 110,000 signatures, enough to qualify their law for ballot.

The political and business establishment sat up and took notice. House Speaker Salvatore DiMasi recognized the tremendous political organization behind this effort and the clear will of Massachusetts voters to participate in their own Living Democracy. In his own health care legislation, he embraced key proposals of the ballot initiative. The Senate President also adopted some of the key principles in his own, more modest proposal.

DiMasi credited GBIO with convincing him of the urgency and political reality of comprehensive reform and used the ballot initiative as leverage with the Senate President and the business community. He was able to negotiate a compromise which promises to expand access to quality, affordable health insurance to the 550,000 Massachusetts residents currently without.

This legislation, signed into law by the Massachusetts Governor on April 12, 2006, makes the following promises to Massachusetts:

• Expand Medicaid access to 27,000 children and 58,000 adults
• Provide fully subsidized private insurance to 65,000 adults below the federal poverty line.
• Provide sliding-scale subsidies to purchase quality insurance to 150,000 adults between 100-300% of the federal poverty line.
• Make it easier and cheaper for individuals and small businesses to purchase insurance plans at pre-tax dollars.
• Pay for these expansions with assessments on businesses that do not provide health insurance and through existing state revenues.

“There are still important questions about affordability and long-term sustainability that are of critical importance to the people of Massachusetts, but there is no question that a spirit of generosity and respect for the dignity of the person is written throughout this bill,” says Rev. Hurmon Hamilton of Roxbury Presbyterian Church, the president of GBIO.

“We will be tireless in working with the legislature and the next governor of Massachusetts,” said Rev. Hamilton, “to make sure that this bill is implemented fairly and equitably, and gets us to the goal of providing quality, affordable health insurance for everyone in Massachusetts.”

Visit www.gbio.org!

May, 2006

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