Political Animal


November 21, 2012 2:12 PM The Dangerous Cycle Of Ignorance About Obamacare

By Ed Kilgore

Sarah Kliff has an important article in today’s WaPo about the extraordinarily low levels of information about the Affordable Care Act among the people most affected: the uninsured. And it’s a problem for everybody:

States are rushing to decide whether to build their own health exchanges and the administration is readying final regulations, but a growing body of research suggests that most low-income Americans who will become eligible for subsidized insurance have no idea what’s coming.
Part of the problem, experts say, is that people who will be affected don’t realize the urgency because the subsidies won’t begin for another year. But policy decisions are being made now that will affect tens of millions of Americans, and the lack of public awareness could jeopardize a system that depends on having many people involved. Low enrollment could lead to higher premiums, health policy experts say. Hospitals worry that, without widespread participation, they will continue getting stuck with patients’ unpaid medical bills. And advocates say the major purpose of the Affordable Care Act - extending health insurance to more Americans - will go unmet if large numbers of vulnerable people don’t take advantage of it.

We can thank our Republican friends for some of this problem, given the extraordinary amount of misinformation they’ve made available on Obamacare. It also doesn’t help that many states are led by GOP governors and legislators who instead of trying to educate citizens on the new law are cheerleading for its failure. And on top of everything else, Republican members of Congress, under the guise of oversight, are fighting administration outreach and public education efforts.

So much of the educational effort will be borne by a new group called Enroll America, backed by the health care industry and philanthropic organizations:

In the coming months, the group will begin an advertising campaign meant to encourage Americans to sign up for the health-care law’s subsidized insurance coverage. Still in its planning stages, it is likely to start in the summer or fall of 2013, just before the state-based insurance marketplaces open for enrollment.
The still-unnamed campaign is likely to put more intensive resources toward a handful of key states. Those could include Florida and Texas, which have a combined 10 million uninsured residents, and have made little effort to do such outreach.

And that’s the most annoying part of the whole anti-Obamacare campaign: it’s the public officials in the states most in need who have so deliberately and egregiously failed to perform their responsibilities. Wherever possible, some payback in 2014 would be most appropriate.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • RollaMO on November 21, 2012 2:23 PM:

    Of course, this wouldn't be an issue if the Obama administration hadn't committed political malpractice in rolling the ACA out in the first place. Horrible, horrible salesmanship. Yes, there was a boatload of money fighting health reform, but we all knew there would be, and where was the strategy to counter the misinformation? Ugh.

  • Mimikatz on November 21, 2012 2:42 PM:

    On a much smaller scale, this is kind of like the transition to digital TV. People needed to be educated about it, they needed their fears assuaged, and they needed to be persuaded to sign up, I.e., get the equipment they needed. It got done, and this can too, if people can get the word out. It isn't just the uninsured, but businesses who don't understand and have been misled by those with an axe to grind, and people who are on the edge of qualifying for subsidies if one or another contingencies happen.

    Kathleen Sibelius and HHS seem to have been ready to go as soon as the election was over, but a PR campaign is now definitely needed.

    PS. I heard a guy on TV yesterday who had studied happiness say that the two absolutely essential things for someone to be happy are compassion and gratitude. Something for all of us to think of tomorrow and always.

  • boatboy_srq on November 21, 2012 2:57 PM:

    [I]tís the public officials in the states most in need who have so deliberately and egregiously failed to perform their responsibilities.

    It's also the local industries (or what remains of them) still committed to a right-to-work employment model (hell, Georgia Pacific and ExxonMobil, this means you) and a Conservatist Xtian community too obsessed with the outward signs of Righteousness (or lack thereof) to take note of the inner rot (or otherwise). It's also home to a lot of small businesses who have been ill-educated on the healthcare options they had pre-ACA, and aren't expecting much because they have never had much.

    We may need more responsible - and responsive - pols in red states. But we need more responsible employers and less Reichwing moral whinging as well, and we're far less likely to get either of those than we are to get the elected officials the ACA would need.

    In a way, it may well be for the best that these states forbore from creating healthcare exchanges: given how badly they've done with healthcare in general to date, the mechanisms they would have created have a very poor probability of performing as well as the ones in states that do what they're doing.

  • danimal on November 21, 2012 2:59 PM:

    "Wherever possible, some payback in 2014 would be most appropriate." Republicans are assuming that 2014 will be a repeat of 2010. They may be in for a rude shock as liberals appear to have learned the lesson and seem to understand they need to stay engaged. Also, the economy is turning positive, so the bitter anger of 2010 is not likely to be the same driver in 2014 it was in 2010. Last, ACA is the law of the land, and by fall 2014, all the attempts to gut Obamacare are going to look like the GOP is taking away something from Americans, rather than introducing death panels and socialized medicine. Don't assume the GOP playbook from 2010 will lead to the same results.

  • psinfl on November 21, 2012 3:18 PM:

    In the meantime we all need to learn the mechanics of enrolling and be able to explain them coherently to our friends and neighbors to help them understand what this means to them. If they hear it from us they will not be afraid and will not be discouraged from enrolling.

  • Quaker in a Basement on November 21, 2012 3:21 PM:

    "The Dangerous Cycle of Ignorance"?

    I hope they wearin' they helmets!

  • Daniel Kim on November 21, 2012 3:48 PM:

    This is the same result that we've had on any number of other important issues, from acid rain, cigarettes and cancer and even the Bush Administration tax cut package. Sowing ignorance is a very efficient way to counter the facts. As the tobacco executive famously said:

    "Doubt is our product."

  • Rick B on November 21, 2012 5:17 PM:

    I live in Rick Perry's Texas, and last week he notified HHS that Texas was not going to establish the health insurance exchange. That means that the federal government, by law, will set it up.

    The positive aspect of that is that the conservative-dominated Texas government has proven itself repeatedly as utterly incompetent about all aspects of governing. But what this does is require a federal government takeover of the health insurance market. As good as that outcome will ultimately be, it is going to be the basis of Rick Perry's run for a fourth term as governor in 2014.

    The Democrats have been extracting political money from Texas in order to use it to fund elections in more winnable states, so there is not a great Obama-type GOTV operation here yet.

  • Martin on November 21, 2012 5:30 PM:

    I don't think we are ignorant at all!What you will find is that they The IRS will take some if not all of your tax return to pay for people to take part in this "care".It will not be "free" as people who are in the giveme giveme group think it will be.Then the long waits and lines that we will have to endure because of this.And wait till you hear how it will affect the debt of this nation that can't even pay for it's post office.Socialism is what it's called folks and it is not going to make this nation better!Ignorant?!I think not It's already been tried in other nations in days gone by and found to be wanting in reality!

  • castanea on November 21, 2012 5:34 PM:

    Shorter emoprog answer: "I blame Obama for all his successes because if we'd only nominated [insert name of an unelectable but super-idealistic progressive here] in 2008, we would have everything we ever wanted, and a pony too!"

  • mb on November 21, 2012 9:27 PM:

    Two words: Public Option. Three words: Medicare for all.

    Face it, Obamacare (as a truly national healthcare solution) is doomed because it was and is a conservative answer to the healthcare problem. It is a Rube Goldberg solution that preserves the worst of the current system, i.e., private insurers, at the expense of a simple straight forward basic healthcare option. Too many moving parts, imo, and too many choke points. It appears that, between the GOP governors and the House, it is not going to be too difficult to frustrate the roll-out of Obamacare nationwide. At least in red states.

    It is going to interesting, though, to see what happens when the disproportionate share payments to hospitals in red states stop -- but their obligation under EMTALA to treat all comers doesn't. There's going to be some busy state hospital association lobbyists.