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Richard Kirsch

National Campaign Director, Health Care for America Now (since 2008)

(HCAN)

Why He Matters

In the war for comprehensive health-care reform, Kirsch led the broad coalition of liberal groups who demanded a progressive overhaul of America's private insurance system.

Kirsch's background working on health policy for community action groups has given him deep knowledge of the politics and policy of health care, as well as a knack for campaign-managing and coalition-building.

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His group, Health Care for America Now (HCAN), united unions, progressive think tanks and grassroots organizers for a single purpose: passing legislation that will guarantee all Americans access to affordable health care. HCAN's steering committee alone comprised 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.

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

But Kirsch and progressive reform advocates were sorely tested during the first year of the Obama administration, as the fight for a public government-run insurance option-their core cause-played out. Even though the House approved a plan with a public option, it was stripped out of the Senate bill and excluded from the final package.

But Kirsch was victorious in the end. After more than a year of legislative wrangling, the House passed the Senate version of health-care reform on March 21, 2010, clearing the way for the Senate to approve a package of amendments insisted on by the lower chamber with a simple majority (using a process known as reconciliation).

The $940 billion bill requires most Americans to carry health insurance and requires that insurance companies cover them, regardless of pre-existing conditions. It establishes a national insurance exchange allowing Americans to compare and purchase insurance plans. The bill will be paid for by increasing taxes on well-off Medicare recipients and by taxing premium insurance plans. By the end of the bill's 10-year roll-out, 32 million uninsured Americans will have health coverage and the deficit will be $138 billion lower, the Congressional Budget Office estimated.

In His Own Words

"The demand for reform outside the Beltway will overcome the resistance inside the Beltway."

More on: Richard Kirsch

At a Glance
Path to Power
The Issues
The Network
Additional Resources

Background

At a Glance

Career History: Co-executive director, New York Citizen Action (1987 to 2008); Legislative director New York Citizen Action (1985 to 1987); founder, New Jersey Citizen Action (1982 to 1985)
Birthday: January 20, 1953
Hometown: New York City, N.Y.
Alma Mater: Brown University, B.A. (psychology) 1974; University of Chicago, M.B.A, 1980

Spouse: Claudia Ricci
Religion: Jewish
Office: Health Care for America Now, 1825 K St., Suite 400, Washington, D.C. 20006, (202) 454-6200
Web site

Path to Power

Kirsch grew up in New York City and nearby Chappaqua, N.Y., and attended Brown University. During a semester off in 1972, Kirsch was traveling on the West Coast when he decided to volunteer for George McGovern's (D) presidential campaign in Seattle.

He returned to Brown, graduating with a B.A. in psychology in 1974, and then heading back out West.

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Kirsch joined the 1974 campaign of Sen. Warren Magnusson (D-Wash.), who was known for his championing consumers. From 1975 until 1977, Kirsch helped Magnusson's ally, Ralph Nader, organize public-interest research groups in California and Washington.

In 1977, Kirsch went to business school at the University of Chicago; he graduated in 1980.

Kirsch wanted to use his M.B.A. for the public good, so he took a job as financial director of the Illinois Public Action Council from 1980 to 1982. He worked with two young Illinois Democrats named Rahm Emanuel and Jan Schakowsky. Both would go on to represent Illinois as Democrats in Congress, and Emanuel is now Obama's White House chief of staff.

Illinois Public Action is affiliated with the national progressive group USAction, and in 1982, Kirsch returned to the East Coast to found another USAction affiliate, New Jersey Citizen Action. Kirsch's primary areas of focus were progressive tax and housing policy, and he worked on elections and community organizing related to both.

When he left in 1985, Kirsch briefly worked for New Jersey's Essex County, running a tenant resource center.

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. In 1991, he helped New York pass Child Health Plus, one of the first programs to provide public health coverage to children. 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.

"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 (D-Ill.), to write a book entitled "The Managed Care Consumers' Bill of Rights." "The book became like the template that state legislatures used around the country to write managed care bills," Kirsch said.

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.

The Issues

"The policy and politics of health care are intrinsically intertwined," Kirsch said. "They're inseparable."

Luckily, Kirsch's background has given him an expertise in both, as well as a background in running major campaign and building coalitions.

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He leads Health Care for America Now (HCAN) in its goal to make sure all U.S. citizens have access to "affordable, quality health care from a provider of our choice, at the time we need it, at a cost we can afford."

The group's 10-point "Statement of Common Purpose" includes: universal coverage with a generous package of benefits, letting patients choose their own doctor, offering subsidies to those who can't afford to buy insurance, regulating insurance companies and using technology to reduce administrative error and costs.

Some of the group's ideas are more controversial. HCAN proposes basing the cost of treatment on a patient's ability to pay, expanding insurance pools to distribute risk and offering a publicly-funded insurance plan in addition to the private plans already offered.

As of March 2009, nearly 200 lawmakers, mostly Democrats, had signed on to HCAN's proposals. "Members of Congress know we're out there and we're just beginning," Kirsch said.

Grassroots Organizing

"The heart and soul of this campaign is outside the Beltway," said Kirsch, whose group has 120 organizers in 41 states who planned meetings and built local coalitions in support of health-care reform in 2009. "The demand for reform outside the Beltway will overcome the resistance inside the Beltway."

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.

In 2009, Kirsch believed gaining support from regular Americans for HCAN's proposals would 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."

Public Insurance Option

Kirsch advocated one of the most controversial aspects of health-care reform proposals: offering a government-funded insurance plan as an alternative to private insurance. After a long fight, the measure was excluded from the compromise reform bill passed by the Senate in December 2009, and was not included in the final legislation.

Kirsch wanted a public option that looked something like the benefit plan received by federal employees. While he believes Americans should have the option to keep their current private insurance plan (a key component of Obama's reform proposal), Kirsch argues that the government's mass purchasing power would 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 a public option argued that the government would 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 a public option 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."

But Kirsch never said 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.

In the end, the health-care reform bill passed without a public option, and Kirsch was applauding from the House Speaker's gallery as it did.

The Network

Kirsch worked at the Illinois Public Action Council from 1980 until 1982 with future Rep. Jan Schakowsky (D-Ill.) and future White House Chief of Staff Rahm Emanuel.

Kirsch knew Schakowsky's chief of staff, Cathy Hurwit, from her work on National Citizen Action. The two co-authored the "Managed Care Consumers' Bill of Rights in 1995."

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Additional Resources