PR Shaping Health Care Debate

By Ananda West, Epoch Times
November 5, 2013 Updated: November 6, 2013

WASHINGTON—Now is when Americans start figuring out that President Barack Obama’s health care law goes beyond political talk, and really does affect them and people they know.

With the problem-ridden rollout of the health care website, and millions of people receiving letters canceling their policies in recent weeks, the jury is out for many people about whether the Affordable Care Act (ACA), also known as ‘Obamacare,’ is a good thing, or not. 

Millions are required to sign up for coverage by March 31 or pay a tax penalty. This means more and more people are confronting the realities of the issue each day. 

A recent Kaiser Family Foundation poll found 55 percent of people now say they have enough information to understand the law’s impact on their families, up 8 percentage points in just one month. Part of the reason is that advertising about how to get coverage is beginning to register.

The positive and negative stories, the winners and the losers, will dominate the news cycle for months as more and more people are impacted. In an effort to bolster positive messages, supporters of the law have begun a public relations campaign—Hollywood style. 

The California Endowment, a private foundation that is spending millions to promote the federal health care law, has provided a $500,000 grant to ensure TV writers and producers have information about the ACA that can be stitched into the plot lines of shows watched by millions.

The aim is to produce compelling prime-time narratives that encourage Americans to enroll, especially the young and healthy, Hispanics, and other key demographic groups needed to make the overhaul a success.

“We know from research that when people watch entertainment television, even if they know it’s fiction, they tend to believe that the factual stuff is actually factual,” said Martin Kaplan of the University of Southern California’s Norman Lear Center, which received the grant.

The 18-month grant, to the Lear Center’s Hollywood Health & Society program, will be used for briefings with staff from television shows and to track health overhaul-related depictions on prime-time and Spanish-language television.

For those who could benefit from coverage, “we want them to get the facts. We don’t believe the government alone can break through with those facts,” said David Zingale, a California Endowment senior vice president.

Rollout Start

According to the Obama administration, an estimated 500,000 people would enroll for subsidized private insurance within the first month, but the Affordable Care Act’s complicated website rollout has made reaching this number unrealistic. 

A different prong of Obama’s coverage expansion seems to be doing fairly well. It’s an expanded version of Medicaid, embraced so far by 25 states and the District of Columbia. 

At least 240,000 people had enrolled in or applied for the expanded safety-net program as of the third week of October, according to an informal survey by The Associated Press.

The greatest beneficiaries of the new law are those with pre-existing conditions who have previously been unable to find affordable insurance. 

Cecilia Fontenot of Houston, a part-time accountant in her early 60s, has diabetes, high blood pressure, and high cholesterol. 

Fontenot is looking forward to getting insurance through the new individual marketplace, but she is still waiting to get the details of her new coverage after using a call center in order to avoid problems with the website.

New Plans

About 5 percent of Americans, or about 15 million people who buy directly from an insurer in the market for individuals and some small businesses, have been issued cancellations of their policies. 

Officials said these consumers aren’t getting “canceled” but “transitioned” or “migrated” to better plans because their current coverage doesn’t meet minimum standards. They won’t have to go uninsured, and some could save a lot if they qualify for the law’s tax credits.

They can buy different policies directly from insurers for 2014 or sign up for plans on state insurance exchanges. 

While lower-income people could see lower costs because of government subsidies, many in the middle class may get rude awakenings when they access the websites and realize they’ll have to pay significantly more.

Those not eligible for subsidies generally receive more comprehensive coverage than they had under their soon-to-be-canceled policies, but they’ll have to pay a lot more.

Individual health insurance policies are being canceled because the ACA requires plans to cover certain benefits, such as maternity care, hospital visits, and mental illness. The law also caps annual out-of-pocket costs consumers will pay each year.

In the past, consumers could get relatively inexpensive, bare-bones coverage, but those plans will no longer be available. Many consumers are frustrated by what they call forced upgrades as they’re pushed into plans with coverage options they don’t necessarily want.


Philip Johnson, 47, of Boise, Idaho, was shocked when his cancellation notice arrived last month. The gift-shop owner said he’d spent years arranging doctors covered by his insurer for him, his wife, and their two college-age students. After browsing the state exchange, he said he thinks he’ll end up paying lower premiums but higher deductibles. He said the website didn’t answer many of his questions, such as which doctors take which plans.

“I was furious because I spent a lot of time and picked a plan that all my doctors accepted,” Johnson said. “Now I don’t know what doctors are going to take what. No one mentioned that for the last three years when they talked about how this was going to work.”

Democratic lawmakers are coming under increased public pressure to delay the individual penalties associated with not buying a plan. A letter last Wednesday from America’s Health Insurance Plans warned against further delays, and for now Health and Human Services Secretary Kathleen Sebelius is heeding the insurers. She said the website should be running smoothly by the end of November, leaving people enough time to meet the deadline. 

At the same time, at least 10 Democratic lawmakers have signed a letter asking Obama to delay the date required for insurance signups. 

“The law is getting more and more real for people,” said Drew Altman, president of the Kaiser Family Foundation. “A lot of this will turn on whether there’s a perception that there have been more winners than losers. … It’s not whether an expert thinks something is a better insurance policy, it’s whether people perceive it that way.”

The Associated Press contributed to this report.