Recently we witnessed what some in the media reported as the “latest blow to Obamacare”: in Halbig v. Burwell, the D.C. Circuit Court of Appeals ruled in a 2-1 decision that the tax credits millions of consumers received to purchase insurance through the federally-facilitated marketplace were illegal. Queue the doomsday headlines declaring the end of the Affordable Care Act (ACA) as we know it. But then just hours later, the U.S. Fourth Circuit Court of Appeals came to exactly the opposite conclusion in a similar case, upholding the legality of tax credits for all Americans who qualify.
So what should those of us focused on reaching consumers make of all this? Judging by the national news coverage alone, it might seem like we need a full-fledged campaign around Halbig to reassure current enrollees that they can keep their tax credits, and to convince skeptical uninsured consumers that they should still enroll this fall despite the legal questions. But the truth is that while the legal questions play out in the courts, Americans across the country – their coverage still in place – are going about their lives unbothered and, in most cases, unaware of the controversy. The simple fact is that incendiary headlines and contentious debates over the Affordable Care Act aren’t new, and they don’t change the fact that people are eager to find quality, affordable health insurance for their families.
We’ve seen this pattern play out repeatedly since the first day of open enrollment. Some observers predicted that the flood of anti-ACA ads would turn off consumers and hold down enrollment. But consumers were less interested in political arguments, and more concerned with how the law would affect them personally, which gave Enroll America and our partners an opening to answer their questions and clear up their confusion. An analysis from the Brookings Institution found that anti-ACA ads may actually have raised public awareness of the new options and encouraged more people to enroll in coverage.
When HealthCare.Gov experienced technical difficulties during the first few months of open enrollment, glitch-by-glitch reports on the website problems dominated coverage. While many predicted doom, the enrollment coalition stayed busy reaching out to consumers in churches, barbershops, and clinics, so we knew first-hand there was still pent-up demand for affordable insurance options. In fact, according to the survey we conducted with PerryUndem in January 2014, 92% of consumers who experienced problems with the website were undeterred by the glitches and either revisited the website or planned to try again.
Rather, the biggest issue that kept consumers from enrolling was the fact that they assumed they couldn’t afford coverage, and simply didn’t know that financial assistance was available. When Mike Perry and Tresa Undem, the researchers who conducted the survey, asked one uninsured woman in their focus group why she hadn’t yet visited HealthCare.gov to shop for coverage, they expected to hear something about the technical glitches or the political vitriol surrounding the ACA. Instead she simply said, “You don’t go shoe shopping if you can’t afford a new pair of shoes.”
That’s why the entire enrollment coalition stayed optimistic about the opportunity that remained, and focused our efforts on spreading the word about financial assistance. By the time enrollment closed with more than 8 million Americans finding coverage through the Marketplace alone, it was clear that sustained negative news coverage and political acrimony did not deter millions of Americans from seeking out their options and signing up for health coverage. Website problems, repeal efforts, negative advertisements, legal challenges – none of these controversies changed the fact that people are eager to enroll in the quality options provided by the Affordable Care Act.
That’s true of this latest controversy as well. Eventually, the courts will settle Halbig vs Burwell – and a poll from Morning Consult found that a majority of Americans agree with the common sense idea that the tax credits are meant for all Americans who need them, no matter where they live. In the meantime the newly enrolled can rest easy knowing that while the cases work their way through the legal system, their insurance and tax credits will not be affected.
As we all start to gear up for the second enrollment period, these experiences hold a clear lesson about what ultimately prevents consumers from enrolling – and what doesn’t. The major barriers to enrollment aren’t political controversies or policy debates. Rather, the biggest obstacle to continued enrollment is simply that many people still don’t know what is available. The woman from the focus group last year wasn’t deterred by the unending declarations that Obamacare was Dead on Arrival, and neither were 8 million others. But there are millions more Americans who still need to hear that affordable health insurance options are ready and waiting for them.