America's Agenda Health Care for All

What it reported doing in 2024

During the course of 2024, america's agenda ("aahca") continued our ongoing work to build and strengthen broad citizen coalitions that unite businesses, labor unions, and other stakeholders in effective advocacy to achieve reforms that will assure that every american has affordable access to high-quality healthcare. As the cost of prescription drugs has emerged as the fastest-growing component of overall health costs, aaha has adopted reduction of prescription drug costs as a high priority concern and focus of aahca activity. Aahca-organized advocacy campaigns have resulted in enactment of america's agenda-designed strategies to reduce prescription drug costs and capture substantial savings for patients, taxpayers, state government, and public employees in several states across the country. Each of our aahca state campaigns has built on the success of our policy initiative in New Jersey, where implementation of the america's agenda-designed public policy strategy for creating a dynamically competitive marketplace for pharmacy benefit managers captured $2.52 billion in prescription drug savings over 5 years for state taxpayers and the New Jersey state employees health plan. Aahca's federal medicare reform advocacy initiative aims to eliminate perverse prescription benefit manager (pbm) incentives to provide medicare participants higher, rather than lower, priced drugs and prevent pbm conflicts of interest that drive costs higher for america's seniors.the following examples highlight accomplishments of continuing aahca advocacy initiatives over the course of 2024: - in Colorado, during 2024, aahca expanded our advocacy coalition of Colorado citizen organizations that had built the momentum leading to the 2022 enactment of Colorado's competitive pharmacy benefits manager marketplace act. The expanded coalition united around core principles for a broader public and private sector prescription drug market reform with the goal of substantially reducing cost of prescription drugs for patients in all of Colorado's public and private sector insurance programs by eliminating the price-increasing prescription drug manager ("pbm") practice of prescription drug arbitrage and by creating a new, competitive marketplace for pbm services with transparent, competitive dollar-value pricing. Colorado aahca coalition organizations advocated for the urgency of prioritizing enactment of effective prescription drug affordability reforms in the next legislative session, commencing in 2025, and as a result of these efforts over the course of 2024, a bipartisan group of legislative leaders stepped forward as advocates and prospective sponsors in the Colorado legislature.- in Minnesota, aahca remobilized our advocacy campaign partner organizations who had won enactment of Minnesota's 2021 pbm reverse auction statute for the purpose of defending against a 2024 pbm industry-backed initiative to rexcind the reforms after they had redirected tens of millions of dollars per year of pbm gross revenues back to savings for Minnesota tax-payers and public employee families. During the extended session of the 2024 session of the Minnesota legislature, the advocacy and educational work of aahca and our campaign coalition partners ultimately succeeded in thwarting the attempt to rescind thr Minnesota's pbm reverse auction reform. - in Iowa, aahc, in coordination with our state coalition partners, provided technical support and advisement to officers of the state administration - aligned in goals with state legislators to whom aahca has provided advisement earlier in 2024 - with a common objective of implementing a competitive, technology-enabled pbm reverse aution process modeled on aahca principles that have captured billions of taxpayer dollars in prescription drug savings for state governments and public employee families in New Jersey, Colorado, and Minnesota. - the aahca coalition for medicare part d prescription drug market reforms has aimed its focus over the

Financial Efficiency

• Mission deployment rate: 96.6%; rating input score 97
• Program expense ratio: 98.4%; rating input score 98
• Fundraising efficiency: $0 raised per $1 spent on fundraising; rating input score 0; 0th percentile among comparable filings

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 62nd percentile among comparable filings
• Pay-setting controls: 2 of 6 controls in place; rating input score 33
  • Compensation committee: Pass
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: 100%; rating input score 100; 41st percentile among comparable filings
• Major donor itemization: Limited
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 95.7%; rating input score 96; 29th percentile among comparable filings
• Governance controls: 5 of 8 controls in place; rating input score 62
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Fail
  • Other executive compensation review process: NotApplicable
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Missing
  • Independent financial-statement audit: Fail

Sustainability

• Operating margin: 1.7%; rating input score 41; 41st percentile among comparable filings
• Total-asset coverage ratio: 0.33; rating input score 9; 9th percentile among comparable filings
• Liabilities to assets ratio: 0.01; rating input score 92; 92nd percentile among comparable filings
• Officer compensation ratio: 3.9%; rating input score 61; 61st percentile among comparable filings

Growth

• Program expense growth: 33.9% per year; rating input score 100; 96th percentile among comparable filings
• Revenue growth: 27% per year; rating input score 100; 95th percentile among comparable filings
• Asset growth: 19.5% per year; rating input score 100; 89th percentile among comparable filings