WASHINGTON How do you convince millions of average Americans that one of the most complex and controversial programs devised by government may actually be a good deal for them?
With the nation still split about President Barack Obamas health-care law, the administration has turned to the science of mass marketing for help in understanding the lives of uninsured people, hoping to craft winning pitches for a surprisingly varied group in society.
The laws supporters will have to make the sale in the run-up to an election the 2014 midterms. Already, Republicans are hoping for an Obamacare flop that helps them gain control of the Senate, while Democrats are eager for the public to finally embrace the Affordable Care Act, bringing political deliverance.
It turns out Americas more than 48 million uninsured people are no monolithic mass. A marketing analysis posted online by the federal Health and Human Services Department reveals six distinct groups, three of which appear critical to the success or failure of the program.
Theyre the Healthy & Young, comprising 48 percent of the uninsured, the Sick, Active & Worried, (29 percent of the uninsured), and the Passive & Unengaged (15 percent).
The Healthy & Young take good health for granted, are tech-savvy, and have low motivation to enroll. The Sick, Active & Worried are mostly Generation X and baby boomers, active seekers of health-care information and worried about costs. The Passive & Unengaged group is mostly 49 and older, lives for today, and doesnt understand much about health insurance.
The challenge for the administration is obvious: signing up lots of the Healthy & Young, as well as the Passive & Unengaged, to offset the higher costs of covering the sick and worried.
Uninsured middle-class Americans will be able to sign up for subsidized private health plans through new insurance markets in their states starting Oct.1. Uninsured poor people will be steered to safety-net programs such as Medicaid.
Coverage under the law takes effect Jan. 1. Thats also when the legal requirement that most Americans carry health insurance goes into force. Insurance companies will be barred from turning the sick away or charging them more.
The new law is mainly geared to the uninsured and to people who buy coverage directly from insurance companies. Most Americans in employer plans are not expected to see major changes.
Administration officials say they see an opportunity to change the national debate about health care. They want to get away from shouting matches about the role of government and start millions of practical conversations about new benefits that can help families and individuals.
The HHS marketing materials reveal some barriers to getting the uninsured to embrace the law.
The Healthy & Young lead busy lives and tend to be procrastinators. Plus, why would they need health insurance if theyre full of vigor? The Passive & Unengaged fear the unknown and have difficulty navigating the health-care system. The Sick, Active & Worried dread making wrong decisions.
Marketing for the new system will start this summer, going into high gear during the fall after premiums and other plan information becomes public.
Theres already widespread concern that the new coverage costs too much, because of a combination of sicker people joining the pool and federal requirements that insurers offer more robust benefits. A recent study by the Society of Actuaries forecast sticker shock, estimating that insurers will have to pay an average of 32 percent more for medical claims on individual health policies.
The administration says such studies are misleading because they dont take into account parts of the law that offset costs to individuals and insurance companies, along with other provisions that promote competition and increase oversight of insurance rates.
Senate Republican Leader Mitch McConnell of Kentucky says Democrats have been predicting for years that Americans would learn to love the health-care overhaul and that has not happened. McConnell had his picture taken next to a 7-foot stack of Obamacare regulations recently to underscore his disdain.
I agree that it will be a big issue in 2014, said McConnell. I think it will be an albatross around the neck of every Democrat who voted for it. They are going to be running away from it, not toward it.