By Alex Ruoff
Obamacare supporters are scrambling to fill the nearly $80 million void in television and radio advertisements left by the Trump administration’s decision to cut spending on getting people to sign up for health insurance this fall.
Progressive groups, supporters of the health law, and Democrats are gathering funds and volunteers to promote this year’s open enrollment period, the 45 days when most individual health insurance plans will be sold. They expect to fall far short of what was spent in previous enrollment periods and worry that millions of Americans will be left without insurance as a result.
“There is no way these groups will ever be able to make up for what the government is not doing,” Lori Lodes, who ran open enrollment outreach for the Obama administration during the open enrollment periods for 2015 and 2016 coverage, told Bloomberg BNA Sept. 15.
One Democratic super PAC, the Democratic Coalition, announced it has raised $7,000 for an advertising campaign for open enrollment so far but hopes to raise more in the coming weeks. A spokeswoman for the Democratic National Committee told Bloomberg BNA that it will direct volunteers to local projects to promote open enrollment but doesn’t currently have funds dedicated to television or radio ads. Democrats in Congress plan to host events leading up to and during open enrollment as well.
Groups like Families USA that have long promoted open enrollment told Bloomberg BNA the announcement of the cuts to promotion spending caught them by surprise. They’re reaching out to donors in hopes of helping navigators, the groups paid to give in-person assistance to those trying to buy insurance who also saw a funding cut this year.
The Department of Health and Human Services announced Aug. 31 it would cut its promotional budget for the upcoming open enrollment period to $10 million, from $88.8 million the previous year. The HHS also announced it would cut navigator grants to $36.8 million, down from $62.5 million the previous year.
An agency spokeswoman said there’s little evidence the money was effective in encouraging people to buy insurance. After five years of Affordable Care Act promotion, most people who would sign up are already aware of the health law’s benefits, Caitlin Oakley, a spokeswoman for the HHS, said Aug. 31.
Since the first open enrollment period in late 2013 for coverage in 2014, the annual insurance sign-up season has stood as a measurement of the health law’s effectiveness and stability.
The first open enrollment period premiered with a flurry of television and radio ads, coupled with billboards and in-person events with administration officials. The HHS spent $95 million that year introducing the country to the ACA and the importance of buying insurance, according to data provided to Bloomberg BNA by the HHS (see chart above).
The HHS spent much less the next two years, $57 million for the open enrollment period covering 2016 and $51 million for the open enrollment period covering 2017.
Much of these promotional efforts went into simply alerting people about the basics of open enrollment: when people can buy insurance, where they can go to buy insurance, and whether they’re eligible for insurance subsidies, Lodes said. There’s also the need to convince people they need insurance, which can be tricky for the young and healthy, she said.
There are 39 states that rely on the federal health insurance marketplace, HealthCare.gov, in some form. Few of these states do their own outreach and the 11 states with their own exchanges have varying levels of promotional budgets. California, for example, will spend $122 million on outreach in 2017, according to a report released by the states.
Television and radio advertising were key to the success of the ACA during early open enrollment periods, according to a study published in Health Affairs in March. Without them, millions of Americans may simply not be aware they need to renew their insurance coverage.
There are likely to be modest increases in enrollment in Obamacare plans in coming years because the federal government has reduced spending on outreach efforts, according to a report released Sept. 14 by the Congressional Budget Office. The report also predicted the country’s individual health insurance market would remain stable in coming years, with few or no areas of the country left without insurers offering coverage.
Some advocates are pushing lawmakers to require the HHS to spend more on promotion this year. Liz Hagan, associate director of coverage initiatives at Families USA, told Bloomberg BNA her group is pushing to include the money in a bipartisan health insurance market stabilization package being developed by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.).
Rep. Frank Pallone Jr. (D-N.J.) told Bloomberg BNA he and other House Democrats will push the Trump administration to restore the promotional funds and the navigator grants, but he doesn’t expect progressives can force the issue outside of legislation.
Groups that previously volunteered to encourage people to purchase marketplace plans are preparing to do their own promotional efforts, but they have scant resources to buy ads. Organizations like Young Invincibles, Out 2 Enroll, and Indivisible are partnering with Families USA to do some promotion, mostly via social media or events, Helen Kalla, a spokeswoman for Indivisible, told Bloomerg BNA via email.
The Democratic Coalition is launching a social media campaign in the coming weeks, backed by donations, to encourage young people to buy insurance, Nathan Lerner, founder of the super PAC, told Bloomberg BNA Sept. 14. The group won’t have millions of dollars, but it’s hoping to energize anti-Trump supporters, he said.
“We don’t necessarily need millions of dollars to run a successful campaign that has impact,” he said.
However, partisan groups like the Democratic Coalition, Indivisible, and the DNC may be limited in their reach, Lerner said. The anti-Trump message may not be effective everywhere and super PACs have restrictions on communicating with political candidates and certain organizations, he said.
The DNC, as a political organization, is limited in how it advocates for some public causes around the country, a DNC spokesperson told Bloomberg BNA. The group is reviewing how it can promote open enrollment but will largely rely on encouraging local candidates and Democrats to do the heavy lifting of getting the word out.
Tom Perez, head of the DNC, will likely make appearances on radio and TV promoting open enrollment, focusing on areas with large populations of black and Hispanic Americans, which tend to have higher uninsured rates.
None of these efforts, however, can replace the work that can be done by the federal government, Lodes said. Most people trust information that comes from government sources, she said.
Additionally, the federal government is the only single entity that knows who signed up for insurance via the federal health insurance marketplace, HealthCare.gov, and who has showed interest in buying insurance, Lodes said.
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