Administration Prepares for the True Test of Obamacare

Healthcare policy experts, members of Congress, and analysts are fighting over what the Affordable Care Act enrollment figures mean for the success of the healthcare reform. What is indisputable is that the number of people that have selected a marketplace plan through the insurance exchanges set up under the auspices of Obamacare amount to less than half of the total signups predicted by the nonpartisan Congressional Budget Office for the entire six-month enrollment period. So far, three months have elapsed since the exchange system launched.

But, aside from the hard numbers, there is little agreement. Some argue that the numbers show an increased momentum in signups, which suggests the December 1 relaunch of the federal healthcare website gave Americans a measure of confidence in the exchange system, prompting more and more people to enroll. After all, the CBO forecast noted that enrollment would start slowly, with “significant peaks in December.” While it is impossible to deny that enrollments did spike in December — of the total 1.1 million total enrollments through the federal exchanges, 975,000 signed up between December 1 and the Christmas Eve deadline — critics still worry about the scale of the enrollment numbers. With just around 3 million peopled enrolled, Obamacare has yet to put a significant dent in the number of uninsured Americans.

To Americans in a quandary over whether to enroll in an Obamacare-compliant insurance policy or pay the federal tax penalty, hard enrollment numbers are far less important to their decision making process than how satisfied those that have purchased a plan are with its coverage and affordability. That is why when January 1 dawns, and the policies that have been purchased through the cornerstone provision of the Affordable Care Act become active, the real test will begin. The Obama administration is well-aware of this fact.

At this point in the implementation of the Affordable Care Act, the public relations campaign is still very important. The campaign is so important that the administration, Democratic lawmakers, and advocacy groups are ramping up their efforts. This week, the White House is organizing an offensive that will highlight the stories of Obamacare enrollees who were finally able to receive treatment for ailment thanks to their new coverage, or in other words, the success stories that will convince voters that the reform should not be repealed.  The idea is that these stories will be so compelling to uninsured Americans and those that have had their policies cancelled that they will erase the memories of the glitched-riddled roll out of the insurance exchanges and canceled policies.

“Until now, the only thing you could really market is ‘Susie Smith saved $100 on her premium and now is covered.’ That’s intangible to people,” Drew Hammill, a spokesperson for Democratic Representative Nancy Pelosi of California, told Politico. “But when she goes to the doctor and addresses a blood pressure problem she didn’t know she had, that is a powerful story.” Since the relaunch of Healthcare.gov, White House aides have been collecting experiences, and now there is an opportunity to make use of the stories of people who are happy with their Obamacare coverage.

At the heart of the campaign are the accounts of individual experiences, and White House officials and congressional aides are currently vetting possible candidates whose stories will be told through videos, blogs, press conference calls, and Twitter. Officially, the public relations efforts will begin Sunday with the publication of an opinion editorial in more than three dozen papers authored by Department of Health and Human Services Secretary Kathleen Sebelius.

“If there are millions of people happy with their coverage between now and March, it could turn around the falloff in support for the law after the disastrous roll out and keep skittish Democrats in the fold,” as Drew Altman, president and chief executive officer of the Henry J. Kaiser Family Foundation, told Politico. “But reality will determine whether or not that happens — not messaging.” However, messaging is not unimportant; only a small number of negative experiences can speak louder than dozens of positive stories from people happy with their coverage. Throughout the entire health care reform debate, the same has been true, especially regarding the issue of premium prices. It is because of that reality that supporters of the law — like the White House and Democratic lawmakers — are constructing a public relations offensive.

Administration officials acknowledged to the publication that reversing public opinion about the Affordable Care Act will be no simple task, and it will take much more than a public relations campaign to accomplish that goal. According to the Kaiser Health Tracking Poll from December 2013, just 34 percent of the public holds a favorable view of the Affordable Care Act. It will take actual results for public opinion to change, and as enrollees begin using their coverage on January 1 and the coming weeks, the public at large will gain insight on whether deductibles are too high and on whether insurance customers are satisfied with the doctors and hospitals in their networks.

Other problems could arise during the first few days after Obamacare coverage goes live — some individuals may not yet have received insurance cards, some individuals may try to go to an out-of-network doctor, and some individuals may find that insurance companies have no record of their enrollment thanks to the problems with the exchange websites. But more important is how satisfied people are with the quality and affordability of their coverage.

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