The next phase of the Affordable Care Act goes into effect next week with the opening of new health insurance exchanges. Brooke and Bob take a look at the messaging war, from the conservative ads advising people to "opt out," to the Obama administration's push to educate people about the new law, and the media's role in covering this protracted battle.
BOB GARFIELD: Now, from the annals of efforts to get toothpaste back in the tube, let's consider the information war raging over a three-year-old law that some lawmakers still can't seem to accept, among them, Texas Senator Ted Cruz, whose unofficial filibuster lent him cult status in some political precincts this week.
SENATOR TED CRUZ: If we continue doing this long enough, we may have facial hair on the floor of the Senate.
BOB GARFIELD: His 21-hour philippic against the Patient Protection and Affordable Care Act, aka, Obamacare, ranged near and far, from Star Wars to Dr. Seuss to Duck Dynasty.
SENATOR CRUZ: This is a show about a God-fearing family of successful entrepreneurs who love guns, who love to hunt and who [LAUGHS] believe in the Americans dream. It's something that, according to Congress, almost shouldn't exist. So I want to point out just a few words of wisdom from Duck Dynasty that are probably good for all of us to hear.
BOB GARFIELD: Although he defied the GOP leadership with his stunt, he stands with his party in opposing the law, which it is, though Senate Minority Leader Mitch McConnell and Minority Whip John Cornyn sometimes still call it a bill. When they heard that the National Football League might partner with the government to spread the word about next Tuesday's opening of health insurance exchanges under the law, the senators wrote the football commissioner, quote, “Given the divisiveness and persistent unpopularity of this bill, it is difficult to understand why an organization like yours would risk damaging its inclusive and apolitical brand by lending its name to its promotion.” It was a slam tackle, and the NFL caved.
CHUCK TODD: I had not seen something like that before.
BOB GARFIELD: Chuck Todd is the political director for NBC News.
CHUCK TODD: It was this letter that essentially, I guess one person would say, warned the NFL that if they got involved, it would politicize them. Others might call it a threat.
SANDHYA SOMASHEKHAR: That said, some of the individual teams, sports teams have said that they’re gonna sign on in their states.
BROOKE GLADSTONE: Sandhya Somashekhar covers the issue for the Washington Post.
SANDHYA SOMASHEKHAR: Like here in Maryland, you’ve got the Ravens saying that they’re going to go ahead and help promote Obamacare in Maryland.
BROOKE GLADSTONE: But then Maryland is friendly to Obamacare. Oddly, even in this interconnected age, what you know or think you know about Obamacare may depend on where you live.
SANDHYA SOMASHEKHAR: The administration has said it's going to rely heavily on the states, which have already started putting ads out on television stations, and they’re also funding a program called the Navigator Program. These are people who will be essentially paid through federal dollars to be available basically 24/7 to help walk people through their options. And that's primarily how they’re going to get the word out.
BROOKE GLADSTONE: Yeah, about those navigators, at least 17 Republican-controlled states have taken steps to rein them in. Florida's Department of Health ordered 60 county health agencies to bar navigators from their premises. Oklahoma's insurance commissioner says that if the navigators perform any of the duties of state-licensed insurance agents, quote, “We will put a stop to it.” Indiana is requiring navigators to take a state exam, undergo a background check and pay up to $175 for a license. Missouri and Ohio, among others, have passed laws restricting what navigators can say.
SANDHYA SOMASHEKHAR: If you live in a blue state, your experience of learning about the law is going to be a lot different than it will be in an, in another state.
BROOKE GLADSTONE: For instance, in blue states ads for the new insurance exchanges under Obamacare sound like this:
WOMAN SINGING: To care for each one, every daughter and son, live long in Oregon.
BROOKE GLADSTONE: In red states, you’re more likely to hear something like this:
ANNOUNCER: Obamacare, tornado, Obamacarenado.
PRESIDENT OBAMA: Normally, this would be pretty straightforward.
BOB GARFIELD: That’s President Obama, talking about his landmark law - not bill - this week at Bill Clinton’s annual Global Initiative Forum in New York.
PRESIDENT OBAMA: But let’s face it, it’s been a little political, this whole - Obamacare thing.
BOB GARFIELD: Kind of an understatement.
PRESIDENT OBAMA: Those who have opposed the idea of universal health care, in the first place, and have fought this thing tooth and nail, through Congress and through the courts, and so forth, are – have been trying to scare and discourage people from getting’ a good deal.
[MUSIC UP AND UNDER]
And some of you may have seen some of the commercials out there that are a little wacky.
WOMAN: Oh, I see you chose to sign up for Obamacare.
WOMAN: Yeah, it’s actually my first time here…
[SOUNDTRACK UP AND UNDER]
BOB GARFIELD: Most notoriously wacky, if that’s the word, are the ones depicting a monstrous grinning Uncle Sam in a doctor's office, donning rubber gloves prior to probing a young man's – or, as in this ad - a young woman's private places.
[AD MUSIC/WOMAN’S SCREAM]
The Uncle Sam ads are made by Generation Opportunity, a Koch brothers-funded group campaigning for people, especially young people, to opt out of Obamacare. Young people are crucial to the law’s success, since the insurance companies can't cover older and sicker people, without younger and healthier people sharing the costs. Generation Opportunity has planned a 20-college tour to throw pizza parties and parlay the message, “Just say no.”
Evan Feinberg, president of Generation Opportunity, on its depiction of Uncle Sam:
EVAN FEINBERG: Well, this ad is meant to be a satire. It’s a satire that is all too real though because on the exchange we’re going to have all of our data, including specific things, like whether or not we’re sexually active, being put into a
massive Federal data hub.
BOB GARFIELD: The idea here is to frustrate the economics of Obamacare by reducing the number of young people in the program, whose premiums actually subsidize the lower premiums for older Americans?
EVAN FEINBERG: No, not at all. Our goal with this campaign is to educate young Americans. Our experience with young people across the country has been that they think they are compelled to buy insurance, no matter what. The law very clearly gives them the ability to pay a small penalty and buy health insurance that is actually gonna be cheaper and a better deal for them.
BOB GARFIELD: How does that work out? The insurance is for more expensive on the private market than even the higher rates that young people would pay under Obamacare.
EVAN FEINBERG: According to the government-released data this week, the lowest cost plan available on the exchange is gonna be at least two to three times more expensive what you can currently get on the private market. So if you take a look at, say, Miami, Florida, a premium for an individual in Florida right now can be as low as $62 on the individual market.
BOB GARFIELD: But it's not just the size of the premium, it's the amount of coverage that it buys. The $62 private insurance that you get does not cover hospitalization, so are you not comparing apples and oranges? In fact, are you not comparing apples and watermelons?
EVAN FEINBERG: I, I’m comparing apples to apples. That much higher premium isn’t buying better health care coverage. It's paying for an older, sicker population’s health care. That’s why they need young, healthy people to sign up.
BOB GARFIELD: What if they opt out of Obamacare and, like tens of millions of Americans, can't get private insurance or can’t get insurance that meets the level of coverage that the Affordable Health Care Act provides and then gets sick?
EVAN FEINBERG: You know, 96 percent of young people that are uninsured don't have a chronic condition, so it’s probably not gonna hurt most of them, if they don't have insurance. But the responsible thing to do is to buy catastrophic coverage to prevent any unforeseen costs.
BOB GARFIELD: Is Generation Opportunity a grassroots group?
EVAN FEINBERG: Yes, we’re a grassroots organization that seeks to empower young Americans to fight for their economic freedom and their future in prosperity.
BOB GARFIELD: Where does the lion’s share of your funding come from?
EVAN FEINBERG: We have many committed supporters, and we’re grateful that there are so many folks in America who believe that the next generation of Americans need to be able to live the American dream and want to fight with us to empower them.
BOB GARFIELD: Where does the lion’s share of your funding come from?
EVAN FEINBERG: Look, like many nonprofits, we respect the privacy of our donors and we’re grateful that they continue to support our efforts to fight for the future of the – of this country.
BOB GARFIELD: You’re aware of the Politico article that, based on IRS documents, traced the funding back to an organization controlled by the Koch brothers. I’m just trying to clear up that point.
EVAN FEINBERG: We disclosed the information required of us. Again, we respect the privacy of our donors, and we continue to be grateful for all those that are committed to fighting with us to help empower the next generation of Americans to fight for their economic future and prosperity.
BOB GARFIELD: Evan Feinberg is president of Generation Opportunity.
BROOKE GLADSTONE: Chuck Todd, chief White House correspondent for NBC News, observes that even though the legislative war was won long ago in Washington, a decidedly unequal battle for hearts and minds continues to rage across the country.
CHUCK TODD: The ratio of anti-health care advertising versus pro-health care advertising is something like five to one. Now, this year you have seen the President's political arm, Organizing for America, spend some money on advertising, trying to push back on the ads that you were describing, trying to rally supporters of the President to call Congress and say, don’t play these games, things like that. But what they haven't done, and I've been surprised by that, is that there haven't been education campaigns on simply the law itself.
BROOKE GLADSTONE: Why do you think there hasn’t been?
CHUCK TODD: We can go back to 2010. Right after the law was passed, Democrats running for reelection were scared of the issue. They didn't spend any money advertising on it. They just hid from it in political ads. The Republicans running against them were more than happy to fill the vacuum.
BROOKE GLADSTONE: Mm-hmm?
CHUCK TODD: So that’s one explanation, right? It was short-term political nervousness. So Democrats begged the White House not to talk about it. The White House went dark. And, you know, the President himself, I mean, if you look at his reelection campaign in 2012, he would tout it, but he wasn't explaining it.
BROOKE GLADSTONE: Now, you got a lot of flak last week, Chuck, for saying that it wasn't the media's job to inform people about Obamacare.
CHUCK TODD: Well, that isn’t quite what I said.
BROOKE GLADSTONE: What you actually [LAUGHS] said –
CHUCK TODD: Yeah.
BROOKE GLADSTONE: - was that the President hadn't done a good job –
CHUCK TODD: Right –
BROOKE GLADSTONE: - of selling the law to the public and that it wasn't the media's job to sell the President’s law. But what is the media's role in educating people about the law, especially in light of the successful messaging by Republicans against it?
CHUCK TODD: I’ll tell you what I think the media’s role is. It’s something that we, we’ve had in the works. Basically, we’re spending a whole week in the run-up to the opening of this and during the opening explaining the law, but explaining the law in a consumer fashion. If you want people to listen to information, you’ve got to take the politics out of it. In this case, you essentially say, okay, what are these exchanges, how do they work?
Now, what got misinterpreted about what I said is I said, I know that there is this feeling out here that somehow the media should be the one to push back on this PR campaign by the Republicans. But, you know, can the media fact-check an entire news organization?
[BOTH AT ONCE/OVERLAP]
BROOKE GLADSTONE: I know, but –
CHUCK TODD: But the fact of the matter is – now, hang on a minute, because I know I got a lot of grief for this, but I really think people didn't understand what I was saying. Somebody took this and then just assumed it meant, oh, we don’t think that the media is calling out the lies of the Republicans on this. My point was, at the end of the day, these folks, they’re not speaking through the media of the Republicans, right? They’re buying this advertising and they’re doing this. My point was they’re treating it like a political campaign. The White House is not treating it like a political campaign. The President of the United States has won an election twice. They know how to run a political campaign. They just haven’t run one on health care.
BROOKE GLADSTONE: The Kaiser Family Foundation did a poll that found that 51 percent of respondents felt they didn't have enough information.
CHUCK TODD: Right.
BROOKE GLADSTONE: Do you lay that entirely at the feet of the White House?
CHUCK TODD: You can lay that at the feet of a lot of people. Is it the White House? Is it the entire Democratic Party? Is it the Republican Party? It’s everybody that’s been involved in this health care issue. Is it because there is confusion sometimes in the decisions that are made? And is it the media? I think we’re all a part to blame in this. I’m not gonna sit here and say we’re not. There’s no excuse to me for an American to claim they’re uninformed. All this information is available.
BROOKE GLADSTONE: You’ve said that the White House made a mistake in embracing the term “Obamacare.”
CHUCK TODD: I think it a complete mistake. I think it politicizes it, puts people in thinking in a blue shirt or a red shirt. You know, this is about health care, not the President and not a ballot box.
[MUSIC UP AND UNDER]
BROOKE GLADSTONE: Personally, I think the media have a little more to answer for here, because the political opponents of the Health Care Act have been free to set a tone that suggests that the law is somehow still in play, as if a duly elected Congress didn’t pass it or a duly elected president sign it. It’s a fantasy, acted out in endless votes for repeal or, lately by bullying the lily-livered NFL, that elicits little more than cynical smirks from the media. But our press is free only because the founders believed it would safeguard democracy, and in times like these, that means safeguarding reality, too.