The Affordable Care Act may wind up remaking the health
insurance industry, but you wouldn't guess it from insurers'
television ads. Only a fraction of their spending on TV advertising
since July 1 has been devoted to ads acknowledging the changes
underway in healthcare, according to the latest review by Kantar
Media CMAG. Of the five highest-spending insurer advertisers during
the second half of 2013 so far, just one or two have spent any real
money on TV ads referencing the existence of the ACA.
The findings illuminate stark differences in marketing
strategies among the nation's biggest health insurers. While one,
Blue Cross Blue Shield, is eager to use advertising to capitalize
on the unprecedented entry of millions of potential customers into
the market, others are leery of acknowledging a law that is
politically controversial and publicly unpopular. Another
election-year flood of political TV ads critical of the law, which
already has begun in several Southern states and select
congressional districts around the country, may complicate
insurers' marketing efforts.
All of which is troubling for an Obama Administration that has
been counting on insurer advertising to help move the newly
eligible to enroll.
Since July 1, about $306 million has been spent by insurers,
state exchanges and the Department of Health and Human Services on
local broadcast TV advertising, nearly two-thirds of that-$194
million-since October 1. Yet only $55 million of that total has
gone toward ads that either explicitly or implicitly reference the
ACA, with $39 million of that being spent since October 1. Again,
this includes advertising by the state exchanges and HHS.
Blue Cross Blue Shield has been the biggest spender on
ACA-related TV ads by far, introducing dozens of different
commercials in states across the country that recognize healthcare
reform in ways meant to unnerve, irk, amuse or reassure viewers
into choosing Blue. Some of the ads are airing in multiple states;
others are state-specific. (For details, see our memo from October
Contrary to the Blue Cross flight of ads, a single new spot by
Humana makes a vague reference to a deadline for enrollment in the
form of a mother asking, "So, if we don't get our health insurance
before the deadline, what happens, will my son be covered?" Humana
ranks fourth in TV ad spending by insurers overall since July
United Healthcare, Aflac and Cigna, in second, third and fifth
place among health insurers in TV ad spending for the second half
of the year, haven't devoted one televised breath to the ACA.
Beyond Blue Cross Blue Shield's many ads and Humana's one,
smaller regional and local insurers have seized upon the ACA in
their ads, clearly seeing it as a growth opportunity. After Blue
Cross, the brand that has spent the second highest amount on TV ads
that actually recognize the ACA is New York-based Emblem Health.
(For context, both Covered California, the Golden State's
healthcare exchange, and US Department of Health and Human Services
have spent more on ACA-related TV advertising than Emblem has.)
And as we've noted before, a number of new, state-based
nonprofit or "coop" insurer efforts seem to be using the ACA
timetable and the opportunity provided by the online insurance
marketplaces to launch their populist-themed offerings on a level
playing field with larger insurers. These local efforts include
Cooportunity Health in Iowa, Maine Community Health Options,
Minuteman Health in Massachusetts, and other insurer coops in
Colorado, Montana, Nevada and Oregon.
Whether their ads actually recognize the ACA or not, insurers
stepped up their advertising on the eve of open enrollment but have
scaled back more recently. During the week before the enrollment
window opened, ad spending promoting health insurance-including
spending by state exchanges-amounted to $2 million. During the
first week of enrollment, insurance ad spending tripled to $6
million. It peaked close to $8 million in late October then began
to decline, suggesting insurers may be holding back because the
federal enrollment website isn't functioning properly.
As the charts here show, Little Rock and New York make both the
list of markets seeing the highest number of ACA-related insurance
ad occurrences, and the highest number of ACA-related political ad
occurrences. Four of the top markets for political occurrences are
in Virginia, where Governor-elect Terry McAuliffe (D) won a
close race earlier this month, but the top slot goes to Louisville
due to unusually intense early Republican advertising for
Senate Minority Leader Mitch McConnell's 2014 re-election fight in
Mitchell West contributed to this report.