In the scramble to carve out a role in the health-care debate, Atlantic Philanthropies has stepped forward with perhaps the most aggressive bet among nonprofit players.
Since last year, it has awarded $25-million to push President Obama and members of Congress to support a health plan that covers all Americans, includes a government-run insurance program, and makes medical services more accessible to minorities and poor people.
Atlantic gave the money to Health Care for America Now, or HCAN, a coalition of more than 1,000 liberal advocacy groups and labor unions that was created last year to wage a nationwide campaign — and one that pulls no political punches.
While conservatives deride HCAN, saying its ideas would hurt companies and fail to lower health-care costs, Atlantic says it is simply leveling the playing field.
“In 1993 and ’94, the forces that opposed health-care reform had many more resources than those that supported it,” says Stuart Schear, Atlantic’s communications and policy executive. “We wanted to make sure that the progressive end of this discussion held up.”
For Atlantic, the support for HCAN is a mark of its relatively new leader, Gara LaMarche, who joined the foundation in 2007. Mr. LaMarche, who previously ran U.S. operations for George Soros’s Open Society Institute, has branded Atlantic a supporter of “social justice.”
While he has not altered the causes Atlantic focuses on — the elderly, disadvantaged youngsters, health, and human rights — the new approach does mean more money for advocacy.
Regarding HCAN, Mr. LaMarche says, “We made the decision that we could do few things that would have more lasting impact than play some catalytical role in achieving health care in the United States.”
Quick Payout
Atlantic made its first grant — $10-million — to HCAN last year to make sure that health policy was a top-of-mind issue in the presidential campaigns. For example, HCAN persuaded almost 200 members of Congress, including Barack Obama while he was a senator, to sign its “core principles” about how to revamp health services.
With a new president who has made an overhaul of the country’s health system one of his top priorities, the foundation added to its wager, giving HCAN an additional $15-million. And unlike most big grants by foundations, which are paid out over several years, Atlantic will give HCAN all of the funds by the end of this year.
Atlantic’s money will pay for half of the group’s planned spending this year, says Richard Kirsch, the national campaign manager.
“There was a new president who was committed to health care, who ran on it, whose basic approach was similar to HCAN’s,” says Mr. Schear, a former Robert Wood Johnson Foundation employee. “It gave us a lot of reason to reinvest in HCAN in 2009.”
Mr. Schear says that Atlantic chose HCAN because of its robust advocacy activities. The coalition has held protests, used social-networking tools like Twitter, and organized volunteers to go door-to-door to express its views.
Recently, the coalition, which includes the Association of Community Organizations for Reform Now and the AFL-CIO, has received news-media attention for spending $500,000 on a television ad campaign that criticizes Republican lawmakers and for organizing people to counter conservative protestors at town hall meetings.
Bermuda Based
Due to the foundation’s unusual setup and how HCAN was established, the health-care group is able to use Atlantic’s money for partisan activities that federal rules prohibit other foundations from supporting, like promoting or criticizing specific legislation.
HCAN is registered as a political-advocacy group — classified under Section 501(c)(4) of the federal tax code — which allows it to use an unlimited amount of money to influence lawmakers. The difference is significant because charities and other groups that fall under Section 501(c)(3) are limited in how much of their budget they can devote to lobbying.
Foundations can make grants to an organization like HCAN, but must require that the money support only charitable or educational activities. But Atlantic is incorporated in Bermuda, which allows it to skirt the American legal restrictions.
In addition, unlike most foundations, Atlantic plans to exhaust its $2.9-billion endowment and close its doors before 2020, making big grants more feasible since it does not want to exist indefinitely.
Despite its special circumstances, Mr. LaMarche is encouraging other foundations to follow Atlantic’s lead and support HCAN or other advocacy groups.
“I’m hoping more foundations will spend money on this type of thing,” he says. “We want to be evangelistic about that.”
While Atlantic is HCAN’s largest supporter, a few grant makers have awarded grants for educational purposes. The California Endowment, for example, has given $4-million to HCAN’s sister charity, the Health Care for America Now Education Fund.
With the legislative negotiations on health care far from finished, it’s unclear whether HCAN’s lobbying efforts will bear fruit.
For its part, Atlantic argues that regardless of what health-care policies may be enacted, its $25-million grant has helped influence the process.
What’s more, as Atlantic explores its new role as a social-justice foundation, the network of grass-roots activists HCAN is building can be used for other policy battles, like immigration and voting rights, he says.
For Mr. LaMarche, the $25-million to HCAN is certainly no sure bet.
“It’s a very big gamble because for 60 some years presidents have tried and failed” to overhaul the health system, he says.
But he adds: “We exist to take risks.”
Suzanne Perry contributed to this article.
FOUNDATIONS AND HEALTH: A SAMPLING OF NEW EFFORTS
Foundations have stepped up their work to educate politicians, health experts, and the public about national and local health-care issues. Here’s a sampling of their efforts.
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Henry J. Kaiser Family Foundation. The Menlo Park, Calif., foundation manages a robust communications network to discuss health issues, including side-by-side comparisons of current health-care proposals, a history of efforts to change the health system, and an independent news service focused on health.
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Robert Wood Johnson Foundation. The grant maker is working with the Urban Institute, a think tank in Washington, to quickly publish health data relevant to the debate on Capitol Hill. It is working with the Associated Press to poll Americans about their views on the health services they receive. The organization, in Princeton, N.J., has also created a new blog that features opinion articles about potential changes in health care from leading experts.
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Commonwealth Fund. The New York foundation last year started “Talking Health,” a Web video series it produces with the City University of New York Graduate School of Journalism and the Association of Health Care Journalists.
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Colorado Health Foundation. The Denver foundation gave a three-year, $280,000 grant in 2007 to the state public radio station to hire a full-time reporter to cover health. It is among several grant makers focused on improving health at the state level that are helping residents learn more about the issues.