President Barack Obama’s got a strategy for Obamacare: make the big sell by talking small.
In a speech on Thursday, Obama got deep into the specifics of the sweeping health care law, from a rule that forces insurers to send rebate checks to some consumers to the price competition in its new health insurance marketplaces— all provisions designed to save Americans money.
The auditor-in-chief routine lets Obama tout how real people have pocketed savings, while steering clear of the many controversies swirling around the law, including a recent decision to extend a requirement for employers.
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While many Democrats say they like the strategy, they wonder if it’s coming soon enough to knock down the latest Republican warnings that the law is falling apart – and with just three months to go until Americans start signing up.
“It’s always like they wait a month too long to say what should have been said a long time ago,” said Democratic strategist Joe Trippi.
Trippi and other Democratic strategists say Obama did what he needed to do — he talked about the ways the health care law is already saving money for people, and how it could save them more money in the near future.
But Trippi conceded there’s probably not much Obama can say to convince young and healthy people to buy health insurance that they’ve never bought before — which is why the law’s individual mandate is so important. That piece is so unpopular, though, that Obama didn’t drop the slightest hint about it.
Health care analysts said it wasn’t surprising that Obama skipped any direct mention of the employer mandate delay — other than a vague references to “glitches” that have to be expected when implementing a complicated law. By glossing over the delay, Obama made it clear that the speech “signals a switch from defense to offense,” said Drew Altman of the Kaiser Family Foundation.
And even if Obama has made those points before, it’s fine with Democrats if Obama just pumps up the volume — because it’s not as if his message has broken through yet, and the Oct. 1 launch date of the new state health insurance marketplaces is fast approaching.
“That’s what’s needed right now — just repetition,” said Democratic strategist Jim Manley, who was a spokesman for Senate Majority Leader Harry Reid when the law was passed.
At times, Obama returned to lofty themes he hasn’t used in years. He compared the law’s implementation struggles with the early opposition to Social Security and Medicare, and declared that health care is “a basic right that everybody should be able to enjoy.”
For the most part, though, Obama talked about the less ambitious part: money in people’s pockets.
He spent much of the time talking about a part of the law that’s obscure and hard to explain, but it’s one of the few benefits people can actually see: the rebate checks people have been getting from insurance companies that don’t spend at least 80 percent of their customers’ premiums on health care, rather than administrative costs.
And Obama painted the rosiest possible picture of the next big round of changes — the new health insurance exchanges where uninsured people will buy coverage, with tax credits to help pay for it if their income is low enough. Democrats always considered these marketplaces the part of the law that was most likely to appeal to Republicans. With competition among different insurers to drive down prices, they figured, what’s not to like?
Republicans didn’t go for it, because they’re opposed to the entire law — so now Obama is trying to sell the public on the idea that the competition will drive premium rates lower. He had two timely selling points: a new report saying premiums in 11 states will be 18 percent lower than expected, and Wednesday’s reports that premiums in the expensive New York market will fall by 50 percent for people who buy health insurance on their own.
”You’re going to see competition in ways that we haven’t seen before. Insurance companies will compete for your business,” Obama said. “In states like California, Oregon, Washington, new competition, new choices, market forces are pushing costs down.”
That’s not all of the states, of course — the word is still out on what the rates will be in the 33 states where the feds will run part or all of the health exchanges. But at a time when most people still don’t understand the law, and Obama’s biggest selling point is a massive expansion of health coverage that hasn’t happened yet, Obama has to jump on every bit of good news he can get.
“We knew from the beginning that several of the key aspects of the law weren’t going to go into effect until 2014, and we recognized that this was going to be a problem in selling it,” said Manley. So the key for Obama, he said, is to keep doing more events that use “the full weight of the presidency to explain the tangible benefits of the law.”
Obama may have had new details on Thursday, but in general, he’s tried most of the talking points before — including the ones about the rebates and how competition will drive down people’s health insurance premiums. He made all of those points last month at a speech in San Jose, Calif., when he was trying to take advantage of reports that California’s Obamacare rates for individuals will be pretty close to what people pay now.
Remember that speech? Of course you don’t — because Obama spent most of the time answering questions about the National Security Agency surveillance program, which had just been revealed.
So Obama’s trying again, hoping nothing else will step on his message. This time, the White House threw its full war-room muscle behind the speech — teasing it in Jay Carney’s press briefing Wednesday and outlining the speech in an embargoed briefing Wednesday night, virtually guaranteeing that the Washington press corps would have to write about it.
That’s more than the Obama administration has often done in the past. Sure, it has talked about those rebate checks before, but usually the Department of Health and Human Services just releases a report and hopes someone notices.
This time, Obama has been beefing up its health care team, adding Clinton administration veteran Chris Jennings — who has been through the presidential speech P.R. routine many times — to help with the preparations for the launch of the main Obamacare machinery in 2014.
Besides the health exchanges, that’s when the guaranteed coverage of people with pre-existing conditions, the subsidies to help people buy health insurance, the expansion of Medicaid in many states, and — of course — the hated individual mandate will all begin.
Obama will have a tough enough challenge in the coming months just explaining how all those pieces together, but it will be even harder if there are more delays or troubles with the infrastructure needed for the law — like the massive “data hub” that’s supposed to let states instantly check people’s backgrounds to see if they’re eligible for Obamacare.
And Republicans are signalling that they’re not going to let Obama off the hook, warning again after the speech about “rate shock” — the threat that Obamacare will raise premiums for young people by requiring health insurers to cover more benefits. The law’s supporters say any changes will largely be hidden by the subsidies most young adults could get.
Trippi says it’s possible that Republicans could use any Obamacare rate hikes to make gains with young voters in 2014, making up for losses they’ve suffered with that voting group over social issues like same-sex marriage. But he’s not convinced that Obamacare will work that kind of magic for them.
And he says it’s more likely that the law’s new coverage and other benefits will become more popular in future years, after the implementation headaches are out of the way — just as the Republican-drafted Medicare prescription drug program is now politically untouchable, even after Trippi and other Democrats spent two election cycles blasting it as a giveaway to big drug companies.
“I think the Republicans know that if they don’t stop it now, it’s going to become unstoppable,” Trippi said.
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