Insurers, exchanges go all out to explain Affordable Care Act

The Obama administration, state agencies, and insurance companies have readied aggressive marcomms campaigns as a six-month enrollment period into health-insurance exchanges is set to begin.

The Obama administration, state agencies, and insurance companies have readied aggressive marcomms campaigns as a six-month enrollment period into health-insurance exchanges mandated by the Affordable Care Act is set to begin on October 1.

They're doing so amid significant confusion about the public health exchanges, a key component of President Barack Obama's Affordable Care Act. A Wall Street Journal/NBC News poll published this week found that an overwhelming number of respondents – 70% – didn't understand the healthcare overhaul or only comprehended part of it. Only 31% said they thought the health-insurance-reform law was a good idea.

More than three years after Obama signed the Affordable Care Act into law, the political wrangling over the issue has not stopped. On Friday morning, the Republican-controlled House of Representatives passed a federal budget bill that would strip all funding for the healthcare reform law. With the Democratically controlled Senate likely to ignore the bill, the move sets up another political battle with the Affordable Care Act at its center.

Nancy Hicks, associate director of the North American healthcare practice at Ketchum, says a big part of the lack of consumer understanding is due “to the long roll-out of the law.”

“The Affordable Care Act was signed into law in March 2010, and the main part of it, the exchanges, are only now set to open,” she explains. Ketchum is working with New York State's insurance exchange, known as NY State of Health.

Peter Segall, MD of Edelman's Washington, DC, office, adds that because many of the benefits of the law for regular Americans have been only theoretical to date, media coverage and discussion “has mostly been focused on the politics of it. In a sense, it is like we are constantly reliving the debate of the law's passage, which just precipitates and exacerbates a state of mind about it,” he says.

Segall explains that “the ACA has become largely symbolic of what each side thinks of the other,” adding that could change if media coverage focuses on how successful the exchanges are for consumers.

Edelman is working with a number of clients on the issue, but Segall declined to provide names.

Insiders note that the Obama administration has recently focused its messaging on the economy, rather than selling the public on the Affordable Care Act. However, in late September and early October, the federal government will launch a massive awareness blitz for the health-insurance marketplaces, with Weber Shandwick handling a public education and outreach effort. The campaign will have an emphasis on paid media and digital outreach, while creative elements are being finalized.

In a statement to PRWeek, the Centers for Medicare and Medicaid Services say that “starting October 1, millions of Americans will be able to access quality, affordable health coverage for the first time, and we will continue educating and informing the uninsured of this opportunity.”

Weber declined to comment for this article.

Sixteen states, as well as the District of Columbia, have established their own health-insurance exchanges. Communications leaders at a number of state-operated insurance exchanges tell PRWeek that their campaigns include significant PR pushes, aimed at connecting the uninsured with experts who can help them select a plan and enroll.

Richard Sorian, ?director of communications for education and outreach at the District of Columbia Health Benefit Exchange Authority, contends that “public understanding is growing.”

He notes that the marketplace is providing information to people online, over the phone, and in person.

“We also have a team of trained experts known as DC Health Link Assisters, who will be deployed through the city to work with people one-to-one to answer questions and help them apply for, compare, and enroll in a quality affordable plan,” he says.

The DC exchange has also partnered with insurance brokers and organizations such as the Washington Chamber of Commerce, the Greater Washington Hispanic Chamber of Commerce, and the Restaurant Association of Metropolitan Washington, to connect with residents.

It also launched the DCHealthLink.com Web site, which includes information about consumers' rights, benefits, and responsibilities, including for small business owners. A call center will also be open 24 hours starting October 1, and the group will also distribute printed materials to retail establishments, medical clinics, churches, and other organizations.

The exchange has developed a specific strategy to reach groups with a high rate of people without coverage, including young adults who had been covered under their parents' plans – often referred to as “young invincibles” in the media – and Hispanic and black men.

“We are working with Weber Shandwick on many of the initiatives,” he says. One effort is a partnership with Major League Soccer franchise DC United.

Cover Oregon, an exchange created in 2011, has targeted the roughly 560,000 state residents without health insurance. A challenge for the agency was to raise awareness of its existence, since internal polling at the start of this year showed only 10% of its population knew Cover Oregon existed, says Ariane Holm, senior PR specialist at Cover Oregon.

It launched an integrated marketing campaign earlier this year focused on raising the organization's profile, including broadcast spots of homegrown musicians such as Matt Sheehy and Laura Gibson singing songs about Cover Oregon.

Media relations helped to amplify the spots. “We really wanted to build awareness because people had heard of Obamacare but not of Cover Oregon,” Holm explains.

The organization also rallied stakeholders to spread the word, including more than 3,000 insurance agents and community organizations. This was a particularly important component for Cover Oregon because residents are required to go through certified community partners or agents to apply for insurance through the exchange, says Holm.

This month, messaging has shifted to the savings consumers could realize from enrolling in more affordable plans and the peace of mind that comes with that. In October, it will focus on the logistics of enrollment.

Public affairs agency Metropolitan Group is helping with the campaign, Holm confirmed.

David Kochman, communications director for Blue Cross and Blue Shield of North Carolina, says the insurance company has launched one of its largest integrated campaigns to date on the topic, recognizing this is a major communications challenge for many stakeholders.

“There has been such a blast of political noise, both for and against, that when you combine that with a complicated industry like insurance, it becomes something the public just wants to tune out,” he explains. “A lot of folks don't even know it is the law; they think it got overturned by the Supreme Court.”

But Kochman adds that, “We're starting to see the tide turn a little bit now that the marketplace is opening.”

The company set up a website that features online tools and videos about healthcare reform, and it also has a robust event strategy in place. Events range from town halls to screenings of popular movies such as Man of Steel for Blue Cross customers. Before the film, customers watch a video about healthcare reform and can speak with insurance representatives.

The organization also created a mobile unit, where consumers can log on to iPads to get more information, which has travelled to sporting and cultural events.

Capstrat, a Raleigh, NC-based firm purchased by Ketchum at the start of the year, is BlueCross and BlueShield's PR agency partner on the campaign.

Kochman explains that while the insurance company has targets and projections for enrollment numbers, “there is a lot of mystery to this.”

“There are about 1 million uninsured customers in North Carolina eligible for this new marketplace, but it is unknown how many of them will actually show up and enroll,” he adds.

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