So, You Are a NAHU Legislative ChairNow What

1
So, You Are a NAHU Legislative ChairNow What?

• National Association of Health Underwriters
• Government Relations Department
• August/September 2005

2
Overview of Responsibilities

• Congratulations! Youve been appointed (or maybe
  you have been begged to serve) as your chapters
  legislative chairperson for NAHUNow, what are
  you supposed to do?
• Basically, NAHU Legislative Chairs have two
  distinct responsibilities
• Managing the legislative and regulatory
  activities of your chapter, and
• Serving as the link between your chapter members
  and the national office staff, legislative
  council and the BoT on legislative and regulatory
  issues of interest to the association.

3
Managing Your Chapters Government Relations
Activities

• Insurance is primarily regulated at the state
  level of government. Keeping track of everything
  going on is a lot of work!
• The first thing you will need to do is establish
  a team of people to help you.
• Having a legislative team in place will
• Ensure a line of succession (no one should be
  legislative chair for life!)
• Ensure that important policy decisions are made
  by a representative group of members.
• Ensure that all of the work gets done in a timely
  manner, with no one volunteer shouldering too
  much of the load.

4
Building a State Legislative Committee

• Who should be on the team?
• State legislative chair, vice-chair,
  representatives from each of the local chapters,
  state president, state president-elect, HUPAC
  chair, state PAC chair, media chair, and the
  chapter lobbyist (if applicable).
• How often should you meet?
• It depends on your state legislative session.
  All state legislative committees should meet at
  least monthly, even when the state is not in
  session, because regulatory and media activity
  can happen at any time, and lots of behind the
  scenes activity occurs even when the legislature
  is not officially in session. States that have a
  very brief legislative session may need to meet
  as frequently as every week during the session to
  keep on top of all developments.

5
State Legislative Management Team

• What if a key development comes up too suddenly
  for a meeting?
• Each state should develop a subcommittee that is
  authorized to make key decisions on an instant
  basis. It could include for example, the state
  President, the SLC, the Vice Chair and the
  lobbyist. Its important that their be several
  people on this committee, including someone with
  executive authority, so that decisions are not
  made in a vacuum. We do this on a national level
  and cal it the Legislative Management Team (LMT).

6
Building a State Legislative Committee

• What are the roles of the members of the State
  Legislative Committee?
• Theres a ton to cover on the state level, so
  its good to assign every member of your
  committee a specific job. Examples include
  monitoring the DOI and other state regulatory
  bodies, grassroots, coalition building,
  developing a state PAC, coordinating with the
  media relations committee, working with the state
  lobbyist, and/or election activity. These all
  might be good jobs for the local legislative
  chairs that help comprise your committee.
• Its critical to have at least one other state
  board member on the committee other than the
  state legislative chair. This ensures that the
  state board is in touch with whats going on
  legislatively, and it also provides legitimacy to
  the committee, and gives the committee an
  objective member that can make sure that all
  sides are represented should a conflict arise.

7
Building a State Legislative Committee

• What do you do if the committee cant agree on
  how to handle an issue?
• This is one of the most common problems our
  states face, and its natural because so one is
  ever going to agree 100 on political issues.
• First of all, develop a PP on how policy
  positions by the state association are developed
  an approved, and then follow that structure.
• Disagree in private, but speak with one voice in
  public. Encourage a healthy debate, but once a
  position is approved, dont revote and dont fail
  to support that position in front of others.
• Review the NAHU guidelines for chapters on
  speaking with one voice.
• Talk to national. Other states may have
  experienced the same problem, and we might have
  an idea that could work for you. Also, the issue
  might not be as black and white as it seems. We
  might be able to find a middle ground that you
  didnt already notice.

8
Local Legislative Chairs

• For local legislative chairs, your chapters
  legislative committee structure will probably not
  need to be as formal as what is required on the
  state level.
• Also, the development of a legislative management
  team will probably not be necessary.
• However, developing a committee structure and
  meeting regularly will ensure that local
  legislative tasks get done.

9
Local Legislative Chairs

• Some examples of roles individuals on a local
  legislative committee could play include
• Organizing grassroots activity
• Organizing chapter key contacts and an
  adopt-a-legislator program
• Organizing chapter representation at state and
  national chapter legislative events (i.e.
  Capital Conference, state Day On The Hill)
• Local political campaigns
• Local chair for the state PAC and the
• Local HUPAC chair.

10
Serving as the Link Between Your Chapter and
National

• In addition to coordinating all of the
  legislative and regulatory activities of the
  chapter, a legislative chair also serves as the
  primary link between NAHUs national government
  relations staff, the NAHU Legislative Council,
  and the NAHU Board of Trustees.
• Its legislative chairs job to disseminate
  legislative information provided by national back
  down to the state board, the state legislative
  committee, local chapters and the rank and file
  membership.
• The other part of this job, which is just as
  important, is communicating the feelings of your
  state membership about policy issues back to
  national and keeping us informed and involved in
  legislative and regulatory activities going on in
  your state.

11
How Should You Communicate with National?

• State Legislative Chairs need to faithfully
  attend monthly regional legislative
  teleconferences.
• Your participation in these teleconferences gives
  your RLC and the NAHU legislative staff a clearer
  picture as to whats going on in your state and
  how they can help.
• It allows you to share information and resources
  with other states in your region.
• It allows national to share important information
  about whats going on both in the organization
  and in DC.
• Teleconferences will include time for issue
  discussions, so that you can communicate the
  feelings of your membership about specific policy
  issues to your representative on the legislative
  council.

12
How Should You Communicate with National?

• By keeping in regular contact with the NAHU
  Government Affairs staff person assigned to your
  state, as well your regional legislative chair.
• This communication allows national to develop
  materials (i.e., comparisons of all state laws
  relative to a particular issue) that might of
  assistance to you, direct you to resources, help
  build coalitions, and also follow-up on your
  issues when we come into contact with state
  officials, coalition partners and other
  interested parties at national meetings and other
  events.
• An easy way to do this is to add your national
  staff person and your regional legislative chair
  to your legislative committees email
  distribution list.

13
How Should You Communicate with National?

• By utilizing the resources of Operation Shout!
• Operation Shout! can be used at the state level
  too.
• Its an easy way for you to leverage the
  grassroots resources of your chapter, and it also
  helps national stay on top of the issues in your
  state.
• You can use state-level operation shout to track
  grassroots participation by your chapter. It
  helps you know who is responding to your requests
  and is also great for awards.
• To start a state-level operation shout, the state
  President, Legislative Chair or Lobbyist needs to
  contact national and provide us with a brief
  overview of the issue. Well take it from there
  and do the work for you!

14
How NAHU Communicates with You

• NAHU regularly runs legislative articles in HIU,
  including a monthly column on federal issues.
• NAHU produces two government relations
  publications for NAHU members.
• The Washington Update, gives members up-to-date
  information about health insurance issues pending
  on Capitol Hill.
• Through the Grapevine provides members with
  anecdotal reports about state-level legislative
  activities occurring in each of the associations
  six regions.
• The most widely used source of information for
  legislative chairs, policymakers and other
  interested parties in the NAHU websitewww.nahu.or
  g.
•     

15
Resources on the NAHU Website

• The Health Care Coverage Option Database
• An on-line tool to help make American health care
  consumers aware of all of the coverage options
  available to them. The Database contains
  information about private health insurance
  coverage, as well as the many public and private
  programs available to Americans to help them
  obtain the medical care they need. Policymakers,
  the media and other interested parties can also
  use the Database as a means of comparing health
  care coverage options for Americans on a
  state-by-state basis.

16
Resources on the NAHU Website

• IssuesAn in-depth review of all policy issues
  that are a priority to the association.
  Information includes an overview of each issue,
  NAHUs position, opposing views and resource
  materials related to each topic.
• Charts and AnalysesCopies of charts and analyses
  prepared by NAHU staff that compare different
  federal bills, state-level requirements, etc.
• Position StatementsNAHUs official position
  statements on issues, as approved by the NAHU
  BOT.
• NewslettersBack issues of all of NAHUs
  government relations publications for members.

17
Resources on the NAHU Website

• Chapter ResourcesInformation for legislative
  chairs, such as training Power Points, chapter
  management guidelines, awards materials, this
  manual and more.
• HUPACInformation about NAHUs political action
  committee. Includes the HUPAC bylaws and answers
  to frequently asked questions.
• Meetings InformationIn-depth information about
  upcoming regional meetings, Capital Conference
  and Annual Convention.

18
How You Can Communicate With the Members in Your
State

• Give brief but regular legislative updates at
  each chapter meeting.
• Contact national to get copies and training on
  our federal issues PPT presentation. Its always
  up-to-date, and this one-hour presentation makes
  an ideal CE presentation. We can help you make
  the presentation fit your time needs.
• Poll your membership as to their opinions about
  the NAHU issue (s) of the month, which will be
  communicated to you by your RLC and the NAHU
  staff member responsible for your state.
• Encourage every state member to adopt a
  legislator.
• Find out what grasstop contacts your members
  have, and keep national informed as to what you
  find out. Youll be surprised to learn who some
  of our members know and what contacts they have.
• Plan legislative events like Days on the Hill,
  candidate briefings, Healthcare 101 sessions for
  legislators, etc.
• Encourage all new members to get involved with
  the legislative committee, and then put them to
  work.

19
How NAHU Can Help You

• NAHU routinely produces legislative research
  products for members, state- and federal-level
  policymakers and other interested parties.
• These products include comparisons of state and
  federal legislation, detailed analyses of pending
  and enacted measures, overviews of state and
  federal healthcare reform laws, analyses of
  program implementation across states and charts
  illustrating the cost and availability of health
  insurance in the different states.

20
How NAHU Delivers Our Message to OthersCapitol
Hill

• NAHU regularly briefs Capitol Hill staffers and
  committees on underwriting and the health
  insurance market.
• NAHU also is frequently asked to consult on the
  structure and language of pending and proposed
  legislation.
• NAHU monitors all relevant hearings and other
  meetings and provides written testimony for
  relevant congressional and administrative agency
  hearings, as well as oral testimony when invited.
•      

21
How NAHU Delivers Our Message to OthersExecutive
Branch

• NAHU comments on every relevant federal
  regulation, and is often involved with the
  regulation before it is officially issued.
  Recent comment letters have addressed the issues
  of HSAs, Medicare, medical privacy, claims
  administration, the state Childrens Health
  Insurance Program (CHIP), and high-risk pool
  grants.
• NAHU serves on the National Medicare Education
  Program board, a position we were appointed to by
  the Center for Medicaid/Medicare Services (CMS).

22
Our Federal Coalition Involvement

• Coalition for Affordable Health CoverageBoard
  Member
• Health Benefits CoalitionLobbying Committee,
  Grassroots Committee, Policy Committee
• Americans for Long-Term Care SecurityBoard
  Member
• Alliance to Improve MedicareSteering Committee
  Member
• Medigap Coalition - Founding member

• RX Education Network
• Association Health Plan Coalition
• HSA Coalitions
• RX Coalition
• HCLA/Health Care Liability Alliance
• HC Five CoalitionReinsurance, and Chronic and
  Catastrophic Costs
• Medicare Today

23
Federal Grassroots Activity

• NAHU frequently arranges in-district meetings
  with members of Congress in conjunction with
  other coalition members. Our members have been
  called the best-educated and articulate among
  those participating.
• NAHU members also participate in town hall
  meetings sponsored by their congressional
  representatives during each recess. 

24
Operation Shout!

• NAHUs Operation Shout! is available at
  www.nahu.org, and can be utilized to send letters
  via electronic mail to both state and federal
  legislators.
• Operation Shout! contains valuable political
  background information and links to federal and
  state-level government websites.
• Members can access media information, voting
  records, issue summaries, PAC details, and
  election information.
• Members can also register to vote and receive
  weekly e-mails on how their representatives
  voted.

25
What We Do in the States

• NAHU routinely monitors the meetings of the
  National Association of Insurance Commissioners
  (NAIC), the National Conference of Insurance
  Legislators (NCOIL), the American Legislative
  Exchange Council (ALEC), and the National
  Conference of State Legislators (NCSL).
• NAHU serves as a member of the NAICs Industry
  Liaison Committee.
• NAHU serves as a voting member of the NAIC
  Medicare Statutory Working Group.
• We also are active members of the Industry
  Education Committee to NCOIL.

26
What We Do In the States

• We serve on the Health and Human Services Task
  Force at ALEC, where we have chaired several
  subcommittees.
• NAHU provides written comments and oral testimony
  to all of these groups whenever issues of
  relevance to health insurance producers are
  raised.

27
What We Do In the States

• NAHU regularly assists our chapters with
  legislative language and strategy for pending
  state-level legislation and regulations.
• We often develop charts, testimony, position
  statements, articles, analyses, and other policy
  documents at the request of our state chapters.
• We work with state legislators, regulators, and
  other officials on implementation of legislation
  and particularly on state/federal cooperation on
  federally passed legislation.   

28
The NAHU Government Relations Staff

• Janet Trautwein, Executive Vice President and CEO
  
• Tom Bruderle, VP of Congressional Affairs
• Jessica Waltman, Legislative Director of Public
  Policy Research
• Janice Kupiec, Legislative Director of State
  Affairs
• John Greene, Legislative Director of Federal
  Affairs
• Jennifer Hillert, Manager of Grassroots
  Initiatives
• Megan Mamarella, Manager of State Affairs
• Victoria Campbell Carter, Administrative
  Assistant
• Legislative Interns

29
The Legislative Management Team

• Tom Harte, Legislative Council Chair
• Paula Wilson, Legislative Vice-Chair
• John Nelson, NAHU President
• David Fear, NAHU President-elect
• Janet Trautwein, NAHU Executive Vice-President
  and CEO
• Tom Bruderle, NAHU Vice-President of
  Congressional Affairs

30
The Legislative Council

• Tom Harte, Legislative Council Chair
• Paula Wilson, Legislative Council Vice-Chair
• Jamie Scholl, Associate Chair for Employee
  Benefits and the Uninsured
• Darlene Kazmarek, Associate Chair for Medicare
• Jim Summers, Associate Chair for Long Term Care
• Region 1 Legislative Chair Jack Kalosy
• Region 2 Legislative Chair Claudia Dodge
• Region 3 Legislative Chair Dave Cluley
• Region 4 Legislative Chair Bob Grundman
• Region 5 Legislative Chair Bob Shupe
• Region 6 Legislative Chair Ken Schmidt
• Region 7 Legislative Chair Ann Sperling
• Region 8 Legislative Chair Larry Hurst

31
Legislative Council Working Groups

• The NAHU Legislative Management Team presently
  has authorized the following internal working
  groups
• Healthcare Cost Containment Working Group
• Uninsured Working Group
• Consumer Directed Products Working Group
• Long Term Care Working Group
• Medicare Working Group
• Each group works on specific projects to assist
  in development of policy or education projects
  for NAHU.
• Working groups may make recommendations on policy
  to the NAHU Legislative Council if appropriate
  for their assigned project.
• The NAHU Board of Trustees makes final policy
  decisions.       

32
Important Things You Can Do

• Set up a good legislative team
• Have procedures for deciding legislative policy
  and strategy
• Trust your team
• Speak with one voice
• Respond to Operation Shout requests
• Respond to other requests for legislative action
  in your local area
• Hire a lobbyist or make sure the lobbyist you
  have is right for you

33
Important Things You Can Do

• The most important thing you can do is to think
  big.
• Envision yourself and your chapter where you want
  it to be.
• Devise a plan for getting to that place.
• Stick with the plan and work it frequently.
• Involve the whole team and bring in new talent.