Progressive group MoveOn.org was a vocal proponent of health care reform and the passage of the Patient Protection and Affordable Care Act of 2010, also known as Obamacare. The group spent more than a year working to pass what Civic Action Executive Director Anna Galland calls "the most progressive version of health [care] reform possible," meeting with members of Congress and countering initiatives to derail the bill’s passage into law.
However, as the implementation phase began, MoveOn.org’s leadership began to speak out about another health care reform issue that led it through the federal court system.
A core component of Obamacare was the expansion of Medicaid, moving the income eligibility level to 138% of the poverty level for adults. The government’s Obamacare portal, Healthcare.gov, states that individuals in Medicaid expansion states will likely qualify with income levels of $16,105 annually or $32,913 for a family of four.
The expansion was intended to make Medicaid available to more low-income adults, including the approximately 70% of poor non-elderly adults who were not previously eligible. After the law was passed in 2010, a June 2012 Supreme Court ruling made Medicaid expansion optional for states. As of March 2014, 24 states had no plans to implement the expansion, according to the Kaiser Family Foundation, a Menlo Park, California, nonprofit foundation focusing on global health policy.
Enter what Galland calls the "Medicaid blockade"—states that refuse to use the appropriated funds to expand their Medicaid programs. MoveOn.org estimates that full expansion would offer coverage to approximately 5 million Americans. In an effort to persuade governors and legislatures of some of those states to change their positions, they organized rallies, gathered signatures on petitions, and purchased billboard space to spread the word. In nine states, they posted boards that satirized state tourism themes to draw attention to the Medicaid issue.
In Louisiana, that theme was "Pick Your Passion." The MoveOn.org billboard read, "LOU!SIANA Pick your passion! But hope you don't love your health. Gov. Jindal's denying Medicaid to 242,000 people." Shortly after the billboard was posted in January 2014, the organization was served with a cease and desist letter demanding that the billboard be taken down as it violated the state’s tourism trademark. MoveOn.org wasn’t budging, though, and in mid-March, Lieutenant Governor Jay Dardenne filed a federal lawsuit over the claimed infringement.
Galland and her team faced a decision: Stay the course to fight for their beliefs or travel the path of least resistance and remove the billboard. A lawsuit in federal court could cost hundreds of thousands in legal fees, which is a significant risk for any organization—even one like MoveOn.org, which has 8 million members. Would members think that was a good use of the organization’s funds?
MoveOn.org’s leadership and legal teams huddled, evaluated the risks, and decided to come back with a strong, public refusal. The day that the lawsuit was served, Louisiana Governor Bobby Jindal made an appearance in New Hampshire. MoveOn.org organized protesters at the event and sent a plane with a banner that read, "Stop denying 242,000 Louisianans health care."
Galland’s concern was that if the organization backed down, even in the face of such financial risk, the move would embolden political leaders to use the tactic to stifle messages they didn’t like. Her team believed the billboard met the criteria for satire and was protected speech.
"I found myself thinking about the local activist groups of all political stripes who want to exercise their right to free speech. If there was a lawsuit that forced MoveOn to back down you could imagine that would have a chilling effect on free speech," she says.
Bottom Line: On April 7, 2014, a federal judge sided with MoveOn.org, and the billboard could stand, ending the first time MoveOn.org had faced down this kind of challenge. Galland says it definitely had an impact on the organization, making the team review and recommit to their values and stand up to an action that threatened their ability to speak out about their beliefs.
"The lesson I took from all of this was that the moment of making a significant decision for your organization in the face of a significant threat or challenge can be scary, but if you stay close to your core principles, you will emerge stronger," Galland says.