Archive for July, 2011

Aretha Got It Right: R.E.S.P.E.C.T.

July 26, 2011

By Constance Campanella, President and CEO

At a recent conference of state Attorneys General, a corporate advocate referred to the assembly of almost 30 state AG’s as the “farm team.” It was meant to juxtapose AG’s against Governors and was intended as a compliment.

Unfortunately, as a compliment, the reference fell flat. Actually, it fell right through the floor. AG’s were offended to be referred to as a “farm team” at their own meeting.

I also have occasion to work with someone (NOT a client) who constantly refers to state legislators as Members of Congress or State Congressmen. Despite repeated corrections, the reference persists.

For as long as I have been in state and local government affairs, I’ve dealt with the fact that the federal arena enjoys higher status. It is just the way it is.

And, sometimes, those who toggle between the vaulted chambers of the US Congress and our tiny world of 50 STATES, get confused. That’s understandable. Hey, we all make mistakes.

But, as professionals, it is our responsibility to ensure that the individuals we work with on behalf of our organizations or clients know that they enjoy our respect.

And, it works both ways.

If you Show Respect, you can Gain Respect.

My definition of lobbying has long been the “Delivery of Respected Messages. “

When I teach about lobbying, I talk about each of the main words in that definition: Delivery, Respected and Messages and what they represent.

“Delivery” comprises everything from timeliness, methods of communication, access, relationships and responsiveness.

“Messages” embraces content, values, negotiating stances, political pressures and perspective.

“Respected” is the fiber that holds it all together. Absent a respected messenger or a respected client, nothing works. A well-delivered, well timed message from a disreputable messenger is a waste of time.

Fortunately, having a disreputable client is not usually the problem. More frequently, it is the case that a lobbyist or their client is a stranger and must first acquire credibility and respect in order to be effective.

As consultants, we loan some of our respected status to clients while helping them establish their own positive relationships with government officials. Clients are not “going in cold” because we have laid a foundation.

But, you cannot loan what you do not own!

Obviously, in-house lobbyists or state government relations managers must likewise be respected and given the amazing turnover rate among state officials, all of us are constantly in the process of building new relationships and sustaining old ones.

If you are responsible for 5-10 or more states, that’s really hard work and often taken completely for granted.

Regardless of your role in State Government Relations, here are some suggestions for earning R.E.S.P.E.C.T.

Learn about your advocacy targets. Learn about the culture and the processes of the governing body. Learn the lingo, the culture, the Do’s and Don’ts and the Case Studies. Never go in cold.


Bring something to the table besides a winning smile. Know your company, business, industry. Be valuable because you are more than just a hand-shaker. Always be prepared to explain what other states or cities have done. It is the number one question lawmakers ask when confronted with a new topic.


Beyond being an issue expert, being “in the know” is another way to ensure that people return your phone calls and seek your involvement. Someone who can help government officials understand how an issue is being debated, who are the opponents and proponents and other forces at work is highly valued as long as the “sharing” is substantive and accurate. This is not about gossip.


Lobbyists have power when they can bring sides together, when they direct grassroots resources in an issue campaign, when they have relationships that put their clients “at the table,” when they help keep friends and allies in office and when their knowledge and expertise is sought after. Being powerful should be one of your goals.


Participation in government matters by CEO’s and other high-up executives is essential, especially when dealing with Governors and Mayors. It should be a goal to encourage this participation. Also, when the senior executives get first-hand experience of working with government, they often become more passionate supporters of government relations.


It usually falls to state government relations executives to bring together the disparate parts of an organization (company, association, coalition) to reach a decision about a policy. Being able to do that – repeatedly, reliably and in a timely manner – is a great skill and much appreciated and valued by government players.


Last letter. Most important. You must be trusted and trustworthy. Make promises and keep them. If you make mistakes, correct them. And, do not ever ask a public official to take a position you are not prepared to defend.

R.E.S.P.E.C.T., that is what it means to me.

An Overhaul for the National Governors’ Association

July 19, 2011

By Mark D. Anderson, Esq., Senior Vice President

The National Governors’ Association (NGA) concluded its Annual Meeting July 17 in Salt Lake City, Utah. Marking a dramatic change in their process, the Governors allowed most of their existing policies to sunset and unveiled an entirely new policy process for the organization. This complete revamping is intended to breathe life into the consensus-based policy process that had previously constrained the organization’s ability to lobby effectively.

The new process will consist of three types of policy. Executive Committee Policy will be developed before each session of Congress, and it will set forth the issues on which the Governors would like the NGA to lobby Congress. These priority issues for the NGA will be developed in conjunction with the substantive committee leadership.

The substantive committees will then develop their own Committee Policies that will be aligned with the Executive Committee Policy. This process will occur following the development of the Executive Committee Policy until the next session of Congress. The purpose of the Committee Policies is to offer greater specificity to the broad priority issues identified in the Executive Committee Policy.

Finally, Permanent Policy will be developed to provide overarching principles on issues such as unfunded mandates and states’ rights. This Policy will be developed by the Executive Committee.

Instead of a continuous process of developing policies at the Winter and Annual meetings and either sunsetting or reauthorizing them two years later, the policy process will now be tied to the Congressional calendar. From the Annual Meeting in July until early October, NGA staff will meet with Governors to determine their priorities for the upcoming session of Congress. In early October, the Executive Committee and the leadership of the substantive committees will meet in Washington D.C. to develop the Executive Committee Policy. They will then be able to lobby Congress based on this Executive Committee Policy.

From October until the end of the year, the substantive committees will develop Committee Policies for adoption on an interim basis at the NGA Winter Meeting in February in Washington D.C. In January, the substantive committees will begin developing advocacy campaigns, and no additional policy will be developed. As a result, the focus of the Annual Meeting will be on advocacy instead of policy.

The intention of the organization is clear—to become a more effective advocate for the Governors and avoid wasting time discussing policy positions on issues that the Governors cannot agree upon. What issues do you think the Governors will agree to address, and which otherwise high priority issues do you think will fall by the wayside?

Will States Be Ready and Willing to Implement Health Benefit Exchanges?

July 14, 2011

By Robert A. Holden, Esq., Senior Vice President

The United States Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking July 11, setting out guidelines for the creation of State Health Benefit Exchanges under the Patient Protection and Affordable Care Act (PPACA) as well as a process for federal approval of those exchanges. Comments on the proposed rules will be due in late September 2011, fifteen months prior to the statutory January 1, 2013 deadline for federal approval of state exchanges.

For states that have been waiting on these federal guidelines, this does not leave much time to authorize and establish a new regulatory entity to govern access to individual and small group health insurance. This is, in some sense, anticipated by the new rules. As proposed, HHS could grant conditional approval to states that cannot meet the January 2013 deadline for full approval, but that are proceeding toward the PPACA’s January 2014 operational deadline for exchanges. This is still a tall order for states not already well down the road to full implementation, and the federal rules anticipate granting approval to states for new exchanges after the 2014 deadline, outlining a transitional period from a federally run exchange.

Where Are The States On Implementation?

A number of states did not wait for the federal rules to begin implementation. Prior to the enactment of the PPACA, Utah and Massachusetts were operating health insurance exchanges that have now become the models for subsequent exchanges. Last legislative session, California became the first state to adopt legislation authorizing the creation of a new state health benefit exchange pursuant to the PPACA. This session, eleven other states have passed legislation authorizing the creation of a new entity to govern a state exchange. Because these states understood that federal rules could preempt their legislative directives, these laws have been very broadly conceived with little specificity in areas not clearly outlined in the PPACA. This strategy worked, as the new federal rules do not appear to have preempted any of the exchange authorization policies adopted by these states.

Federal Flexibility and State Exchange Creation

The Notice of Proposed Rulemaking reflects federal flexibility in the options for a state to organize the governance of its exchange, either as an independent public entity, a separate state agency, or as part of an existing state agency. Of the states that have already passed legislation, most have opted to create an independent public entity. California, Colorado, Connecticut, Hawaii, Maryland, Massachusetts, Nevada, Oregon, Vermont and Washington have all placed governance of their exchanges into independent entities. The exceptions are North Dakota and West Virginia, which have authorized governance within the Department of Insurance, and Utah, which has its exchange within the Office of Consumer Health Services.

Beyond governance, the Notice of Proposed Rulemaking recognizes both the “active purchasing” model typified by the Massachusetts as well as the “any-willing plan” model associated with Utah. Both models address how plans would be certified as available through the exchange. In an active purchasing state, the exchange would select a limited number of plans to contract with for provision of services through the exchange. Under the any-willing model, all plans that met federal requirements could be admitted to the exchange. Interestingly, post – PPACA state legislation has been mostly silent on the type of exchange states would develop. While California, Connecticut, Hawaii, Maryland, Oregon and Washington have been proceeding down the active purchasing route, they are not required to by state law. Similarly, North Dakota, Virginia and West Virginia are expected to follow Utah’s example, but did not specify this in their legislation. The only state legislature to direct its exchange was Colorado, which has forbidden its exchange from pursuing an active purchasing model.

The new state exchange entities will fill in the gaps left by the state legislatures, and have been granted room by the federal rules to determine not only the standards for health plans as far as marketing requirements and network adequacy, but will also serve to make decisions as far as premium stability is concerned. The federal guidelines leave to the states whether they will engage in a reinsurance program, or a risk adjustment program to manage the risk to their exchange markets as higher cost enrollees come online in 2014. States will also have the flexibility to create multiple state regional exchanges, but also to quilt together intra-state exchanges covering smaller areas, so long as the entire state is covered.

Federal Exchanges

The question for those states that have not already passed authorizing legislation and are in the process of establishing governance for their exchanges remains: how quickly will they be able to come online? At a minimum two states, Louisiana and Oklahoma, will rely on a federal exchange. There will also be a temporary reliance on federal exchanges for those states that are not ready by the 2014 deadline, which may be a majority of states. Now that the federal rules have been proposed, current state interim discussions and the 2012 legislative session will be the last opportunity for states to begin charting their own way before the imposition of a federal exchange. This poses a number of questions. What will the federal exchange look like? How will it incorporate state Medicaid enrollment information? Will there be regional or a unitary federal exchange?