A Marketplace Odyssey: Countdown to October 1 (77 Days)

This is the second post in a new ACHP blog series that will track health policy updates in anticipation of the start of open enrollment on Oct. 1.

77 days until open enrollment:

In April, Kaiser reported that only six in ten Americans are aware that the Affordable Care Act (ACA) is still in effect. A recent Gallup poll found 56 percent of the uninsured population is unaware  of the individual mandate. Among those who are in the know, only 35 percent favor the law according to Kaiser’s June report. But barring any more major delays, enrollment is set to open Oct. 1. And the evidence will soon be on park benches and sunscreen bottles.

Supporters of the ACA are recruiting ambassadors to reach the populations they need most – notably, 2.7 million young adults to offset the costs of older and more expensive patients. Getting the population to pay a monthly premium will be a hard sell, even when most Americans who do not sign up for insurance will face a fine in 2014. The 18-35 age group is relatively healthy, short on extra funds and can now stay on parents’ health plan until age 26.

Fifteen states and Washington, D.C., are set to launch their own online marketplaces and will spend the rest of the summer pitching enrollment. Kantar Media estimates that $1 billion will be spent on ACA ads by 2015. In Texas, Florida and several other states where officials are resistant to the law, private and nonprofit firms are likely to lead outreach. Some organizations are trying to block advertising efforts or launching their own campaigns in response. State officials in charge of ad blitzes say the effort is about clarifying the details of the law – not advocating the ideological grounds.

Supporters and opponents of the ACA are communicating through a variety of channels:

Moms: From consumer advocacy groups to professional athletes to President Obama himself, everyone agrees that young people listen to their mothers. Research shows that mothers tend to make health appointments and primary health decisions in a family. ACA promoters are focusing on moms to help get young people enrolled. The White House has partnered with parent advocacy groups like Moms Rising to empower mothers as mouthpieces by sending out informational packets and social media ideas. Americans for Prosperity has a commercial out this week featuring Julie, a mom who is concerned about the effect of the ACA on her family.

Pro athletes: The new health care system shares a clutch audience with ESPN: young, healthy men. HHS has publicly requested help from athletes to help sell the public on health care. Timing-wise, the law’s initial sign-up period parallels the NFL season, from October through March. HHS has not gained much yardage with professional sports. Top Senate Republicans wrote a letter urging the commissioner to reject the deal and the NFL declined. Historically, American athletes have hesitated before getting engaged in politics.  Michael Jordan once refused to endorse a Democratic senator, saying, “Republicans buy sneakers too.”

HHS may have a shot with Major League Baseball. Colorado has begun running sports-themed ads during Rockies baseball games. The Boston Red Sox promoted the 2007 Massachusetts health reform law. The Massachusetts Health Connector hosted informational booths at Fenway Park, aired radio spot during games and featured Red Sox players in their print ads.

Libraries: Enrolling in the online marketplaces is easy enough for anyone with access to a computer and the Internet. For others, the local public library is a crucial resource. The Centers for Medicare and Medicaid Services (CMS) and the Institute of Museum and Library Services are partnering to enlist libraries’ help. Across the country, libraries will link their websites to the Healthcare.gov web portal, keep public computers reserved for health insurance research and train librarians to answer questions about the law. But it will be up to individual local libraries to decide how much effort to put in. Strapped for resources, some libraries may not make the ACA a priority.

Wild cards: States are using their grant money in creative ways. California has allocated some of its outreach funds to the Los Angeles public school district. High school students will be trained as ACA ambassadors to their families, a move that angers many conservatives in the state. Other states are avoiding controversial partnerships by strategically avoiding the language of the federal law. Oregon TV and radio ads feature native folk and hip hop artists singing “Long Live Oregonians.” Last week, the state began plastering its marketplace’s name on bus shelters and coffee cups. Connecticut’s promoters are headed to the beach, where they will distribute sunscreen with custom labels reminding beachgoers to “get covered.” Experts and bloggers predict celebrity endorsements to surface in the next 77 days – and expect plenty of eye-rolling in response. Obama has no shortage of friends on the red carpet; rap artist Jay-Z has indicated it would only take a text.

-Sophie Schwadron
ACHP Intern