Learning to Bird-Dog, HIV Advocates Take Power Into Their Own Hands

Activists speak up at town hall with Louisiana senator Bill Cassidy
Steph Preston

In New Orleans, an afternoon town hall with Louisiana Senator Bill Cassidy was packed. Medical students from Tulane University had arrived at 9 a.m., waiting over six hours to ensure that they could get into the library where the town hall was being held. Hundreds of others, many of whom had waited over an hour, were turned away when the library's 200 seats were filled. Unable to confront their congressman, they staged a rally outside, speaking with press about their concerns about proposed health care cuts.

Cassidy is a co-author of the Patient Freedom Act, one of several potential Republican plans to replace the Affordable Care Act (ACA or Obamacare). Under the proposal, states could choose to keep the ACA, change to a different insurance expansion or provide no coverage expansion at all.

Inside the town hall, attendees quickly scuttled Cassidy's plan to control the Q&A by asking them to write questions on index cards. Instead, people stood up and spoke about what ACA repeal would mean to them, both as patients and providers. "Over half the people I see are low income, homeless or underserved in some other manner," stated Steph Preston, a medical student. "Rolling back Medicaid expansion would throw our systems into chaos."

"No One Ever Says 'Uncle' Over the Internet"

These tactics didn't come out of nowhere. The week before, students, including Preston, had attended trainings on how to publicly push Cassidy -- and any other elected official -- to answer questions about the issues they care about, a practice known as "bird-dogging." Bird-dogging has long been used by advocates to press legislators to answer questions they'd rather avoid and to compel them to act. HIV advocates have used the tactic to push politicians to denounce HIV criminalization statutes and pledge support for expanded access to care, as well as to garner $50 million to fight AIDS from then-President Barack Obama.

This past February, concerned people across the country took advantage of the congressional recess to challenge their legislators to think carefully about their votes on health care.

Paul Davis is the national advocacy coordinator of Housing Works. He's also a seasoned bird-dogger. After the election, he and Housing Works made it a priority to defend against Republican attacks on the ACA. Bird-dogging is a key tactic in that struggle. "No one ever says 'uncle' over the internet," he told TheBody.com. "You have to go to where they are and twist their arms in person."

But, to do this, people needed to know how to bird-dog -- and build the skills and confidence to do so effectively. In December, former congressional staffers put out Indivisible, an on-line guide detailing how to grab the attention of congressional representatives. In February, Davis embarked on a multi-city tour in which he trained people of all ages, professions and concerns. "I've been to 23 cities so far," he said. "We've got another 30 cities to go."

"Bird-dogging is powerful because it puts the power in your hands," Gloria Tavera, the president of the North American Board of Universities Allied for Essential Medicines and an experienced bird-dogger who has worked with Davis in the past, told TheBody.com. "It's a tool that's powerful specifically when public officials don't want to have a meeting with you or you don't see progress on an issue." That's why Davis's trainings are so important.

When Keanan McGonigle, a medical student at Tulane University, heard about Davis's tour, he invited him to New Orleans. The timing was fortuitous. "We didn't know about [Cassidy's] town hall when we were organizing the trainings," McGonigle said to TheBody.com. Then they learned that the event was scheduled for the following week -- and they were ready.

At the trainings, Tulane students identified possible barriers to bird-dogging, including feelings of shyness or intimidation. They worked through them and came up with questions to pose to their senator.

When the American Health Care Act was unveiled, Cassidy stated that he was not taking a position until he had done further research. However, he continues to push his own plan as a replacement for the ACA.

Asking Questions of an Empty Chair

During the February recess, some legislators opted not to hold or attend town halls with their constituents. But organizers found other ways to let their elected officials -- and the larger public -- know about their concerns.

Barb Cardell
HIV activist Barb Cardell
Robert Riester

In Colorado, Barb Cardell, a member of Positive Women's Network - USA and Colorado Organizations Responding to AIDS (CORA), had been looking forward to attending a town hall with Senator Cory Gardner. She wanted to press him about the attacks on the ACA and what repeal would mean for her and the 13,000 other people living with HIV throughout the state.

"My medication costs $4,000 each month," she told TheBody.com. "I've been HIV-positive for a long time. The easier medications aren't able to keep me virally-suppressed."

When she and other advocates learned that Senator Cory Gardner was not planning town halls during the recess, they decided to hold one of their own -- with or without him. Within a week, they organized a town hall in Denver, placing an empty chair with Gardner's name at the front of the room. "We sat down with the chair and asked questions," Cardell recalled. "As you can imagine, we didn't get very many responses."

That Wednesday night, Gardner was in Denver meeting with the Space Science Council about bringing more high tech jobs to the state. "We were just a hop, skip and jump [away]," noted Cardell, adding that she and others were disappointed that they couldn't pose their questions to him in person.

While Gardner may not have been interested in a town hall on health care, hundreds of other people were. While only 23 people attended in person, over 500 people tuned in to follow the livestream.

When it was her turn to pose a question to the absent senator, Cardell asked, "How do I afford my medication [if repeal happens]? If I can't, how am I supposed to survive if I have to go back on the cheaper ones that don't keep me virally suppressed?"

Another participant, a transgender woman, asked about the impact of the ACA's repeal on transgender women and challenged her absent legislator to press for data collection that doesn't lump them into the category of men who have sex with men.

Staging the town hall, even without the senator, "gave us the opportunity to feel like there was something we could do," said Cardell. She noted that, shortly after the Women's March, Coloradoans had encountered busy switchboards in congressional offices. "They felt like their voices were not being heard," she said. "This gave us the chance to have our voices heard."

Social media has also enabled their voices to reach beyond the room -- and that evening -- to both other constituents and to Gardner himself. "It used to be that if elected officials didn't meet with you, or their staffers didn't meet with you, your concerns went unheard. Now, with social media and the skills that people with HIV and their allies have developed, it's possible to bird-dog via social media," noted Cardell. In neighboring Fort Collins, constituents held a similar, senator-less town hall that made headlines.

Though Gardner was a no-show, he still seems to have heard his constituents' concerns. When the American Health Care Act was introduced, Gardner did not endorse it.

In Cleveland, hundreds showed up for a senator-less town hall where they posed questions to a cardboard cutout of Senator Rob Portman. The day before, a group of medical students rallied outside his offices. They gave speeches highlighting stories from not only patients but also family members and medical students who are both patients and medical providers. Then, they headed up to Portman's 30th floor office where they handed his aides one patient's statement about the potentially devastating effects of ACA repeal.

A Dual Strategy

Across the country, whether their Congressional representatives meet with them or not, advocates plan to continue pressing for affordable, accessible health care. For those whose representatives do not schedule town halls or public events where constituents can ask them questions, Tavera recommends a dual strategy. "If they're not going to show their faces in town hall, schedule a legislative visit," she said. "Ask them, 'What would a replacement to the ACA look like?' Bring talking points and literature to hopefully influence them positively."

The other part of that strategy is keeping the issue in the public eye. "Are we demonstrating? Are we doing rallies? Are we getting media coverage?" she asked. "Are we creating a visual narrative that shows what will happen when politics are more important than patients?"

How to Get Bird-Dogging Training

For more information on how to get bird-dog training or to set up a new training, contact p.davis@housingworks.org. Upcoming trainings include:

March 21

March 22

  • Sharon, Pa.
    6:00-8:00 p.m.
    76 Shenango Ave
    Sharon, Pa.

March 29

April 6

April 13

  • Houston, Tex.
    6:30-8:30 p.m.
    University of Houston Optometry School
    Health and Biomedical Sciences Building
    Room 267 W