Medicaid 101 Policy Academy: What I Wish I Had Known

What I Wish I Had Known Representative Susan Lontine, Colorado Representative Chad Caldwell, Oklahoma Senator Bryan Townsend, Delaware

What is the first thing that new members of health committees should do?

How do you work with members across the aisle?

What is your greatest accomplishment as a health committee chair?

What is the best piece of advice you have received as a health committee member?

What is the first thing that new members of health committees should do?

“Hopefully new members will have a baseline of understanding the needs of their districts. From there, getting to know the State Departments that play a role in access to healthcare. In Colorado, that’s our State Departments of Public Health; and Human Services (2 different departments) as well as Health Care Policy and Financing-who directs Medicaid. I would also suggest familiarizing yourself with the budget process as much as possible. There are also the relationships with partners like the state Hospital Association, the state association of the AMA as well as the other provider organizations.”

- Representative Lontine “Establish relationships. Find a fellow committee member you trust and has experience with the subject matter. Seek out the heads of the health agencies and their legislative liaisons. Get to know them and express why you’re interested in health care and what your concerns are.”

- Representative Caldwell “Engage in detailed conversation with Health Chair regarding recent efforts, ongoing projects, Chair's future aims, and new members' own goals/projects. It is important to understand how it all fits together, in order to be as impactful as possible. Also let Chair know that new members will be speaking with other stakeholders, particularly the executive branch (e.g., Health Secretary; Medicaid Director), to come up to speed fully.”

- Senator Townsend

How do you work with members across the aisle?

“Find commonality in how you approach a situation. Be honest about what you hope to achieve. Be honest, transparent, and willing to compromise on ideas, not ideals.”

- Representative Caldwell “You can’t understand where others are coming from unless you develop a relationship so I would suggest at least reaching out, having coffee or lunch and just getting to know the members of your committee. Try to visit and get to know districts outside your district. For example, I’m a Metro Denver legislator and last week we had a committee tour of rural Southeast Colorado. A very different place then my own. We have members who have offered to host folks in their districts and I plan to offer something in my own district before session starts this year.”

- Representative Lontine “At least in Delaware, there are many opportunities to work across the aisle on initiatives that clearly will benefit Delawareans' health, and that we clearly need to engage on. From substance abuse to primary care supports, to many other items, there is not an overt--or even particularly implicit--politicalization of health issues in Delaware. The biggest challenge comes via way of fiscal considerations; anything that would cost money (even if it would save money over the longer term) is subject to more cross-aisle tension.”

– Senator Townsend

What is your greatest accomplishment as a health committee chair?

“Sometimes, just passing a bill that you feel is important isn’t the greatest accomplishment.

Sometimes it’s just about making sure that all voices are heard on divisive issues. I was so happy to have someone on the other side of an issue reach out to me after a very contentious hearing to tell me that they felt I ran a very fair hearing. And that hearing took some preparation, so be prepared for things!”

- Representative Lontine “Brokering compromise between competing factions.”

- Representative Caldwell “In 2019 (effective April 2020), establishing a robust system of dental coverage for adult Medicaid patients. Delaware had long been one of the least supportive states for this group; we've just made a huge leap in progress.”

- Senator Townsend

What is the best piece of advice you have received as a health committee member?

“Don’t get overwhelmed. Health policy is complex. Approach it like eating an elephant. One bite at a time.”

- Representative Caldwell “I don’t remember any specific advice before I became Chair but I have always felt very supported. I will say that before I was Chair, I didn’t realize how much work went into supporting other members and their bills. Making sure policy was properly vetted, that all stakeholders had the opportunity for input, helping members with possible amendments... So, to pass on advice I would say that Chairs should be prepared to play a support role for other members.”

- Representative Lontine “Buckle up; health issues are the intersection of essentially every policy driver (moral, fiscal, racial, environmental, etc.), and as one of the largest portions of government budgets, it's imperative that we find solutions to the highly-pressing health challenges facing our states and country.”

-Senator Townsend

Questions?

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