A New Strategy for Selling Health Care

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By now, most of us can agree that Democrats have largely failed to use health care reform as a political boost. The new law remains unpopular with half or more of the U.S. population and it will be one of several critical issues in the upcoming mid-term elections, particularly in districts where freshman, Blue Dog or vulnerable Democrats voted in favor of the Patient Protection and Affordable Care Act.

The law did pass, by the way. Apparently, a lot of voters don’t know this. Ben Smith of Politico got word of what was presented today on a conference call organized by FamiliesUSA, a powerful and well-funded grassroots group that advocated for reform and will provide support for messaging about the law as its implemented. A PowerPoint presentation discussed on the call led Smith to rightly note that a messaging shift on health reform is underway.

The PowerPoint slides were put together by a group called the Herndon Alliance, which does opinion research and counts as “partners” high-profile pro-reform groups like SEIU, AARP and the Center for American Progress. A spokesman for FamiliesUSA did not want to comment on the content of the presentation – which amounts to a back-stage pass to pro-reform messaging strategy – and said FamiliesUSA was not involved in assembling the presentation, merely that FamiliesUSA “provided Herndon the platform to present this information.”

In the presentation, which can be found on the Herndon Alliance web site, pro-reform advocates are advised to “avoid overheated rhetoric,” keep it simple and talk about the law as something that can be improved upon. It also acknowledges what now seems obvious: “Straightforward ‘policy’ defenses fail to be moving voters’ opinion about the law.”

Surprisingly, the presentation says that voters need to be reminded that the health reform bill actually passed the Congress and is now law. It says many “non-college educated women” and Latinos, in particular, don’t realize this. The really interesting material, however, can be found in a much longer Herndon document, also available online.

This document – based on focus groups – asserts, “Those not aware that it passed have among the lowest resistance to repeal. They don’t realize any changes have been made, so there is nothing to defend or hold onto.” Another section says “Advocates had hoped that the poor economy would make it a good time for reform, but actually people think it’s a bad time.” Some parts of the new law will impose a tax on Americans making more than $200,000 per year. According to the longer presentation, this fact is worth touting: “Voters respond positively to the wealthy paying more…

Another section:

Use a transition message to meet them where they are and relax their defenses. Even low information voters have been exposed to a lot of
negative messages about health care reform, and they generally start from a position of apprehensiveness, fear, and doubt. Advocates should not be
afraid to concede that the law is not perfect, or “not the law any of us would have written.” This helps make any message to follow more relatable and
credible. Follow-up with a positive statement like “but it does some good things…” and briefly describe the key provisions described above.

In this context, voters what to move on and improve the law rather than repeal it. The language of “improve” works better than “fix,” “repair,” or “innovate” because it is positive and forward-looking.

The longer version of the material includes lot more fascinating information, like that AARP has lost a lot of credibility as a trusted source, bashing insurance companies doesn’t really work anymore and elderly men are more skeptical of reform than elderly women.

The shorter PowerPoint presentation also includes a helpful of “Don’t”s:

-assume public knows the health reform law passed or if they know it passed understand how it will affect them;
-list benefits outside of any personal context;
-barrage voters with a long list of benefits;
-use complex language or insider jargon;
-use heated political rhetoric or congratulatory language;
-say the law will reduce costs and deficit

This last one is curious. Democrats worked hard to get a favorable score on the legislation from the Congressional Budget Office, figuring a big selling point of the law would be that it reduces the deficit. This part of the sales pitch is apparently not as helpful as they predicted.

None of the material in either Herndon document is earth-shattering. It’s no secret that a lot of voters don’t know what’s in the law or how it will affect them. Everyone knows that seniors are worried about Medicare cuts. That a presentation like this exists is also not noteworthy. (Check out this anti-reform messaging memo from last year.) What’s significant here is that the Democrats’ messaging strategy on health care so far has been basically a waste of time and there’s a sizable effort underway among advocacy groups to salvage that effort, change strategies and possibly win over some more voters between now and the November mid-terms.