Wednesday, September 06, 2017

Ky. shows what happens after ACA advertising cut

Proponents of the Patient Protection and Affordable Care Act fear that the recent decision to cut advertising will hurt enrollment for 2018, but Department of Health and Human Services officials argue that the money was being spent inefficiently. It's difficult to determine the truth, but research on the state of Kentucky might offer an indicator, and a roadmap for the future of the ACA under President Trump's administration. "Kentucky provides a great test case for what happens when Obamacare transfers from a supportive administration that goes all-in on enrollment to a hostile one that cuts back on outreach," Dylan Scott reports for Vox.

In 2014, then-Gov. Steve Beshear, a Democrat, embraced the ACA and created of the country's best-working insurance exchanges, or marketplaces. State officials worked hard to encourage as many people as possible to sign up for private coverage or Medicaid; many more were newly eligible for Medicaid because of Beshear expanded it under the ACA. The result? "By the end of 2015, as Beshear's tenure came to a close, Kentucky had tied Arkansas for the biggest drop in the uninsured rate under Obamacare, from 20.4 percent to 7.5 percent in two years," Scott reports.

But in December 2015, Republican Matt Bevin was sworn in as governor. He cut off all state funding for ACA advertising, which led to a four-week enrollment with no ads. "That's where a quartet of researchers associated with the Robert Wood Johnson Foundation and the Wesleyan Media Project come in," Scott reports. "They took a look at the difference between strong outreach for the law and the bare minimum — an imperfect but still telling analogue to what Obamacare will experience nationwide this coming year."

After comparing ACA enrollment in Kentucky with ads vs. without ads, the researchers found that TV advertising was responsible for 450,000 weekly page views and 20,000 unique visitors to the exchange website, but made no notable difference in calls to the exchange's call center. In other words, Scott writes, there's empirical evidence to back up the logical assumption that less advertising leads to less engagement and less enrollment. "That's bad news for the health of the marketplaces," he writes. "Sick people are probably going to find a way to sign up for insurance no matter what. It's the healthier people, whose enrollment is essential to keeping costs down for insurers, who are more the targets of Obamacare advertising."

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