Case Study: Covering Uninsured Children

Since 2006, Spitfire has led the development and full implementation of the Narrative model – an innovative messaging initiative that gives state-based advocates the communications support to promote health care for all children. The goal of the project is to establish a common set of messages on the issue of children’s health coverage and use those messages to shift the state and national policy discussions to a more positive, proactive framework.

The narrative approach offers a coordinated way to move the debate along a “storyline.” It starts by moving away from a frame that questions whether we can cover children to one that asserts the fundamental importance of covering children – then culminates with a discussion about covering all children. The narrative is intentionally flexible and responsive to different state policy environments, allowing each organization to begin the communications process at the point most appropriate for the state’s policymaking environment.

The Narrative has successfully changed the conversation about covering kids. The messaging has achieved traction in hundreds of media outlets across the country, including The Los Angeles Times, The Washington Post, The New York Times, and The Wall Street Journal. More importantly, the Narrative has set the stage for progress on covering uninsured kids. States like Washington were able to cross the finish line with policies to cover almost every child. States like Texas that were fighting tough climates changed the conversation to reform eligibility rules and enroll more than 170,000 additional uninsured children.


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