Richard Kirsch

USAction

But Kirsch was soon bored in government, so he went to Albany, N.Y., to open an office for New York Citizen Action, another USAction affiliate.  He stayed there for more than two decades, as legislative director from 1985 until 1987, and then as co-executive director with Karen Scharff.

Beginning in 1986, Kirsch’s main priority was reforming health care at the state level.  He helped New York pass Child Health Plus, one of the first programs to provide public health coverage to children, in 1991. That program, plus a similar one in Rhode Island, served as models for national State Children’s Health Insurance Program legislation.

In 1992, Kirsch and his team helped push a plan for a full-financed single-payer health insurance bill through one house of the New York state legislature.  Though it never passed both houses, the bill was the first of its kind in the nation to make it that far.

Clinton Health Reform Effort

When Bill Clinton was elected in 1992, Kirsch’s job became even more prominent. “I was based in New York, but I was very much involved in working with our national organization,” he said of the early ‘90s health-care reform effort. “We wanted to get legislation passed that would guarantee quality affordable health care for everyone—same goal we have this year,” he said in a 2009 interview with WhoRunsGov.com.WhoRunsGov.com Interview with Richard Kirsch, March 30, 2009

“We were looking to take what the Clintons proposed and generally support it with improvements,” he said. “A lot of our energy was going after those people who just wanted to trash reform at any cost and find any excuse for it to fail.”

Among other things, Kirsch had supporters of reform send a million post cards to the White House advocating  single-payer health insurance coverage.

1993 and Beyond

After the failure of the Clinton reform plan, Kirsch focused on passing legislation to regulate managed care companies. He joined Cathy Hurwit, who is now chief of staff to Rep. Jan Schakowsky, to write a book entitled The managed Care Consumers’ Bill of Rights.Finkelstein R, Hurwit C, Kirsch R. “The Managed Care Consumers' Bill of Rights,” New York, 1995, Public Policy and Education Fund of New York   “The book became like the template that state legislatures used around the country to write managed care bills,” Kirsch said.WhoRunsGov.com Interview with Richard Kirsch, March 30, 2009

At the same time, Kirsch fought to expand the number of people covered by the government Medicaid and SCHIP programs.

In the run-up to the 2008 elections, a coalition of interest groups that included USAction asked Kirsch to lead the drafting of an 895-page campaign plan for passing meaningful health-care reform under the next president.  The group called themselves Health Care for American Now. In the spring of 2008, they asked Kirsch to move to Washington to lead the campaign.

Grassroots Organizing

“The heart and soul of this campaign is outside the Beltway,” said Kirsch, whose group has 120 organizers in 41 states already planning meetings and building local coalitions in support of health-care reform. “The demand for reform outside the Beltway will overcome the resistance inside the Beltway.”WhoRunsGov.com Interview with Richard Kirsch, March 30, 2009

In the battle to fix health care, Kirsch sees his group as the voice of working-class Americans at war with elite Washington special interests. “Most of the well-financed groups inside the Beltway are trying to kill meaningful reform, or trying to have reform that protects their profits,” he said.WhoRunsGov.com Interview with Richard Kirsch, March 30, 2009

Kirsch believes gaining support from regular Americans for HCAN’s proposals will be easy. “Even when the other side attacks it, the public won’t believe them, the public wants this proposal and supports this proposal, it makes sense to them,” he said. “It’s what they need.”WhoRunsGov.com Interview with Richard Kirsch, March 30, 2009

If Obama proceeds with a landmark effort to overhaul health care, Kirsch and HCAN will be key to mobilizing grassroots support for the effort.

Public Insurance Option

Kirsch advocates one of the most controversial aspects of health-care reform proposals: offering a government-funded insurance plan as an alternative to private insurance.

Kirsch’s proposed plan would look something like the benefit plan received by federal employees, and people would be able to choose between that plan and private insurance plans.  While he believes Americans should have the option of keeping their current private insurance plan (a key component of Obama’s reform proposal), Kirsch argues that the government’s mass purchasing power will enable it to dramatically slash costs for such things as prescription drugs, creating a more efficient system.

“The health insurance industry’s first priority is always going to be a healthy bottom line, not the health of their clients. That’s why they’re in business,” Kirsch said.  “A public health insurance plan’s first priority is going to be to provide health care to people, that’s why it’s in business.”

Opponents of HCAN’s proposal argue that the government will prove a goliath in the insurance market and become an unfair competitor in an established industry. An independent study by the Lewin Group suggested about 100 million people would migrate to a public insurance plan if given the option.  The insurance industry says it would put them out of business.

“Studies that say people will abandon private health insurance for public health insurance are reflecting the fact that Americans think that private health insurance has failed them,” Kirsch said. “If that turns out to be true, it’s because private health insurers aren’t able to compete with a public health insurance plan.”

If a public option is created, Kirsch and HCAN want it to be affordable, and to include a generous standard benefits package, including coverage for things like dental visits and prescription drugs, rather than offering limited coverage with a high deductible.

But Kirsch has not gone so far as to say his coalition would oppose a plan that did not include a public option.  "For anyone other than, say, the president to say what's a deal-breaker would be presumptuous," Kirsch told the National Journal.Harder, Amy, “Left-leaning Groups Slam Insurance Lobbyists,” Under the Influence blog, The National Journal, March 5, 2009  

The Coalition

Coalition-building is a necessary skill for Kirsch as head of  Health Care for America Now. It’s a coalition of influential progressive interest groups, from consumer groups to think tanks to unions, joined together to promote health care reform.

HCAN’s steering committee alone comprises 17 liberal groups, including six unions, the Children’s Defense Fund Action Council, MoveOn.org, the NAACP, the National Women’s Law Center, and many others.  The entire coalition has about 850 member groups.See the full member list here

“Understanding how to involve and balance the needs and strength of all those organizations is a lot of what the job entails,” Kirsch said.