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ACA TV: Not the Nudge Obama was Looking For?

Public Affairs Policy 11.14.2013 / 15:00

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Website issues, marketing choices limit TV ad firepower behind enrollment effort

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 1.)

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 1.

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 Kentucky.

Mitchell West contributed to this report.

Source: Kantar Media

Editor's Notes

To inquire about this study, contact us.

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