Promotion of the Affordable Care Act is like sausage making described in Upton Sinclair’s “The Jungle.”   In both cases a questionable product is pieced together from noxious ingredients, as is dog food. 

ACA enrollment is far below expectations.  The ACA audience faces uncertainty about services cost and quality, a botched rollout, and America’s youth know their role is to subsidize the sick and elderly. 

A flawed rollout can be fixed.  Public anxiety over cost and quality can’t be fixed without atypical political candor and years of health plan experience.  Beyond repair are the ACA clauses that kick millions out of the health plans they wanted to keep.  America’s youth will be victimized until they age out — for them “hope and change” has become a rubber crutch.   

So, how does a politician whip the rightfully suspicious voters into action?  Entertainment!  The White House’s Hollywood friends were funded to produce a major fantasy.  The plot is predictable – a vacuous feel-good, nothing to do with health care.  It skips over ACA problems.  It emphasizes style over substance and sells the sizzle, not the steak.  Hollywood’s message is about affiliation with personalities they think young Americans should admire, i.e. join us “cool kids” by signing up for Obamacare.  Some use invented language and rap lyrics to sell the dog food.  In other cases, they use personalities who tell us they hate America.  Hollywood is inserting this drivel into social media whenever it can.  If youth think about the concerted attempt to distract them from the real issues, they’ll be insulted — a Harvard poll of youth suggests they are thinking.

The Centers for Medicaid and Medicaid Services (CMS) issued a contract to prisoner activists to promote Obamacare enrollment as a post-parole step, but Congressional alarm prompted CMS to quietly wriggle out of the deal.  In 2012, CMS contracted for a $20 million Obamacare advertising blitz through PR firm Porter Novelli.  Breaking the promise of being lobbyist-free, CMS hired a lobbyist to promote Hill acceptance of Obamacare “navigators.”  Navigators are hastily-trained $15 per hour workers who will guide low-income people enrolling in ACA – a measure thought necessary due to enrolment’s complexity.  HHS made a $58 million grant to 1,100 community organizations to supply the navigators.  Those community organizations had already received $150 million in community organizer help from HHS.

The White House also bought $5 million worth of help from WebMD on Obamacare promotion including “physician training,” videos, and long articles on the topic.  Understandably, WebMD has been reluctant to discuss the details in fear that professional conflicts may be perceived.  The NFL declined a White House request to endorse Obamacare, but the Baltimore Ravens accepted $130,000 to do the deed.  Dan Rooney, owner of the Steelers and President Obama’s previous ambassador to Ireland, agreed to have the Steelers promote Obamacare

Individual states are making their own Obamacare commercials.  Some avoid the distraction of camera-hound “personalities.”  The state of Kentucky is spending $11 million to promote its health exchange.  Oregon is spending $10 million on Obamacare promotion.  Colorado is spending $21 million.  Nevada is expected to spend $2.8 million.  Connecticut is to spend $6 million.  California is expected to spend $86 million on Obamacare adverts.  New York plans to spend $40 million.  When other states report in, the total will be “real money” by Washington standards.

The TV commercials and social media inserts will attract some enrollees, but so far interest levels are low and enrolment much lower.  On the other hand, the White House has almost unlimited funds. Experience says it will spend whatever it takes to avoid revealing that ACA fails to meet public approval.

Alan Daley writes for the American Consumer Institute Center for Citizen Research