The role of prescription medicines in healthcare has changed significantly since Medicare was first created in the 1960s.  Despite a dramatic increase in the demand for these medicines, a benefit for them has never been added to Medicare.  In the summer of 1999, President Clinton introduced a proposal that would create a government-administered prescription drug benefit.  The President’s proposal, however, drew criticism from a number of seniors’ groups, patient advocates, pharmaceutical research companies, and businesses.  These groups feared that the plan would be bureaucratic and inefficient, cut off necessary research and development into new medicines, and force many seniors and patients out of their current coverage plans and into a potentially lower quality government program.  

In an attempt to coordinate their efforts and impact the national debate on the issue, Citizens for Better Medicare (CBM) was formed. While the President’s proposal made headlines in many prominent national newspapers, most Americans were unaware of what was at stake in the debate over a prescription drug benefit for Medicare.  A unique opportunity to shape this debate at the grassroots level was presented to APCO by CBM.  We were asked by CBM to develop and launch the coalition and to help run a national issue campaign. During 2000, APCO successfully expanded last year’s efforts to recruit and educate coalition supporters, to educate the media on the impact of plans in Congress to reform Medicare, and to encourage supporters to send key messages to their members of Congress.


APCO’s main challenge was to battle negative press from governmental agencies whose operations would be negatively affected by citizens standing up for themselves against unfair Medicare proposals as well as motivating constituents to action.


APCO, working in partnership with National Media and Public Opinion Strategies, crafted key messages for the campaign based on national survey research.

Media lists were created based on a comprehensive assessment of key media markets and corresponding outlets that reached targeted demographics as well as national opinion leaders.


The plan focused on developing a grassroots and media outreach campaign that would recruit coalition supporters, educate supporters and media on the impact of plans in Congress to reform Medicare and move supporters to deliver key messages to their members of Congress.    


Create an environment for a real policy debate rather than a politically charged “sound bite” campaign.  

Build a grassroots movement for comprehensive Medicare reform that includes a prescription drug benefit for seniors and the disabled.

Generate earned media coverage of a private sector approach to providing prescription drug coverage benefits to seniors under Medicare.

Mobilize constituents to pressure Congress for comprehensive, bipartisan Medicare reform that includes prescription drug coverage.


Use media and key opinion leaders as vehicles for injecting Coalition messages into the debate about Medicare reform.

Unite key constituencies to fight for Medicare reform that protects seniors’ choices in coverage. 

Organize earned media activity at the local level such as reporter briefings, editorial board meetings, op-ed placement and media events.

Mobilize grassroots supporters to urge members of Congress to support responsible Medicare reform legislation rather than engaging in election-year political tactics.

Target Audiences:  Congress, media, seniors, business leaders, health care providers, patient advocates and patients.


National coalition development 

Built a national coalition of nearly 50 senior, business and patient advocacy organizations whose membership numbers well into the millions.  

Engaged an impressive breadth and diversity of coalition members ranging from the National Association of Manufacturers to the Alliance for Aging Research and the Association of Black Cardiologists. 

State coalition development 

Worked with local representatives of APCO’s national coalition partners and other local activists, to help CBM build state chapters across the country.  

Compiled all the necessary tools and materials for these state chapters, including our “Activist Resource Kit.” 

Earned media 

Advised CBM on an earned media strategy and worked with them to tell its story to the media.  

Developed a comprehensive media strategy including hosting events, issuing press releases, briefing reporters, garnering third-party support for media, op-ed placement, and editorial board outreach

Direct contact 

Put in place a state-of-the-art direct contact program that utilizes Internet recruitment (working with Mindshare), direct mail, person-to-person recruitment and telephone outreach. 

Recruited over 300,000 citizen supporters


Objective #1:  Create an environment for a real policy debate 

Media coverage since the launch of the campaign is threaded with our messages.

Members of Congress have developed policy positions that mirror our policy position.

Legislation has been introduced that supports our principles for reform.

Objective #2:  Build a grassroots movement for comprehensive Medicare reform 

To date, we have recruited over 300,000 individual supporters.

Our national coalition includes nearly 50 organizations.

We have built state coalitions that mirror our national organization.

Objective #3:  Generate earned media coverage of a private sector approach to providing prescription drug coverage benefits under Medicare.

Print stories about the coalition have appeared in The New York Times, Wall Street Journal, USA Today, The Washington Post, and The Washington Times and in major dailies in targeted media markets across the country.

Televised coverage of media events has appeared in targeted media markets.

Talk radio interviews have aired in key media markets.

Opinion Editorials have been placed in major dailies and newspapers in over 25 states.

Objective #4:  Mobilize constituents to pressure Congress for comprehensive, bipartisan Medicare reform that includes prescription drug coverage.

In the short time since our launch we have already recruited more than 200,000 individual supporters to the cause and generated nearly twice that many individual contacts to Congress.  

25,000 handwritten communications have been sent to Congress.

15,000 calls have been made to members of Congress.
60,000 telegrams have been sent to Congress.