State Health Insurance Exchanges Hope To Woo Urban Minorities
Tomorrow it begins again – open enrollment for Obamacare. Two very successful state health insurance exchanges, Connecticut's and California's, are both intent on reaching people who avoided signing up last year – especially young Latinos and African-Americans.
"The big takeaway for us last year was that the uninsured were really pocketed in a couple of key, large cities," says Jason Madrak, the chief marketing officer of Access Health CT, in Connecticut. In light of that, he says, the exchange has changed its ad strategy.
"We've dialed up some of the more locally-focused efforts while we've dialed down some of the broader efforts," he says.
The uninsured people Madrak's trying to reach tend to be young, male, urban and Hispanic or African American. They also "aren't really consumers of traditional media," he says.
They don't necessarily read the big daily newspapers and they don't watch mainstream TV, so they can be harder to reach. So Madrak is spending his media money on ads in community newspapers and on local television and radio.
Reaching potential customers is the first half of the job. The second half is figuring out what to tell them. One emphasis is on money, like in this TV ad with a barber asking his customer if he has health insurance. When the customer says, "No, I can't afford it," the barber says, "Now, you can, with Access Health CT, since you may quality for help to pay for your coverage."
Madrak says the messages of ads that appear later in the open enrollment period, as people are starting to think harder about choices, will be more specific about the cost of the insurance.
"If I say 'affordable,' nobody really knows what that means," he says. "If I say, 'I can get you a plan for 20 bucks a month with tax credits,' that means something to somebody at that point."
California health officials are also deploying a new and (they hope) improved campaign to woo Latinos. Last year, Covered California made a series of missteps.
First, the exchange had only a handful of Spanish-speaking counselors at the call centers. And the Spanish advertising campaign was riddled with cultural oversights.
Among the worst gaffes: Some Latinos who worried that signing up would get undocumented relatives in trouble were shown a written promise from President Obama to the contrary – a note that, unfortunately, was printed on letterhead of U.S. Immigration and Customs Enforcement.
Covered California says it has learned from those mistakes. Peter Lee, the executive director, says this year, the agency is doubling down on making sure Latinos get the right messages.
Some of Covered California's ads detailing the benefits of insurance are in Spanish.
"We're actually spending more money on outreach, education, and marketing this year for a three-month period than we spent for six months last year," he says.
The agency has hired 200 new call center counselors who speak languages other than English, Lee says. It is enlisting more trusted community organizations to allay fears about deportation. And it's rolling out a new ad campaign tailored specifically to Latinos.
"Every person you see [in these advertisements] that is a Spanish speaker is a Latino who got coverage through Covered California this last year, and it made a difference in their lives," says Lee.
This new video commercial shows pages of immigration documents flying into a safety vault – accompanied by verbal assurances that the application process is confidential.
But the main challenge, Lee says, is persuading Latinos to buy something they don't believe they need or is worth the price.
"They've adjusted to a culture of coping," he says. "We need to go from a culture of coping to a culture of coverage."
Still, a woman in a recent focus group in Connecticut showed Madrak that even the best messages might not work.
"She said, 'Listen, I saved everything that you guys sent me,' " Madrak says. " 'I have a box of postcards and letters that you sent me because it has the phone number on it and I wanted to save it.' And we said, 'Did you call?' And she said, 'No, I never called.' And we said, 'But you saved it all!' And she said, 'I know, I knew it was important; I just never got around to actually doing it.' "
That, Madrak says, is the big, continuing challenge.
Open enrollment runs from Saturday, Nov. 15, and goes through February 15, 2015.
This story is part of a reporting partnership with NPR, WNPR, KQED and Kaiser Health News.
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Transcript
DAVID GREENE, HOST:
Open enrollment for the Affordable Care Act resumes tomorrow and runs through February 15. Both Connecticut and California are viewed as running very successful exchanges.
RENEE MONTAGNE, HOST:
Both state governments fully supported the law. But even with statewide ad campaigns and outreach efforts, people still went without health insurance. And many of those were from minority groups.
GREENE: We'll hear about California in a minute to see how that state's changing its outreach efforts to Latinos. But we'll begin in Connecticut where Jeff Cohen of member station WNPR reports on the changes made there.
JEFF COHEN, BYLINE: The state said the first year of Obamacare cut the number of Connecticut's uninsured by half. But it estimates that another 70,000 or so people are still uninsured.
JASON MADRAK: The big takeaway for us last year was that the uninsured were really pocketed in a couple of key, large cities.
COHEN: That's Jason Madrak, the chief marketing officer at Access Health CT, the state's health care exchange. So, he says, they're changing their ad strategy.
MADRAK: We've dialed up some of those more locally focused efforts while we've dialed down some of the broader efforts.
COHEN: His work this year has focused on 10 towns, many of them clustered around Hartford, New Haven and Bridgeport. The people he's trying to reach tend to be younger, male and are Hispanic or African-American. But it turns out they're also harder to reach.
MADRAK: These are individuals in these remaining cities that actually aren't really consumers of what I would call traditional media.
COHEN: They don't read the big dailies. They don't watch mainstream TV. So Madrak is spending his media money on ads in community newspapers and on local television and radio. Reaching potential customers then is the first half of the job. The second half is figuring out what to tell them. One emphasis is on money. Here's a TV ad with a barber and his customer.
(SOUNDBITE OF ACCESS HEALTH CT AD)
UNIDENTIFIED ACTOR #1: (As character) Do you have health insurance?
UNIDENTIFIED ACTOR #2: (As character) No, I can't afford it.
UNIDENTIFIED ACTOR #1: (As character) Now you can with Access Health CT, since you may qualify for help to pay for your coverage.
COHEN: Madrak says the ad will soon talk about real dollar amounts.
MADRAK: If I say, affordable, nobody really knows what that means. If I say, I can get you a plan for 20 bucks a month with tax credits, that means something to somebody at that point.
COHEN: Still, a woman in a focus group showed him that even his best message might not work.
MADRAK: She said listen, I save everything that you guys send me. I've got actually a box of the post cards and letters you sent me because it has the phone number on it, and I want to save it. And we said well, did you call? And she said no, I never called. And we said, but you saved it all. She said, I know, I knew it was important, but I just never got around to actually doing it. So it becomes a big challenge.
COHEN: That challenge begins again tomorrow. For NPR News, I'm Jeff Cohen in Hartford.
APRIL DEMBOSKY, BYLINE: And I'm April Dembosky in San Francisco. Last year, California's insurance exchange, Covered California, made a series of missteps in its attempt to enroll the state's Latino population into health plans. It was kind of like watching a bad run on a TV game show. First, the agency had only a handful of counselors at their call centers that could speak Spanish.
(SOUNDBITE OF BUZZER)
DEMBOSKY: Their Spanish advertising campaign was riddled with cultural oversights.
(SOUNDBITE OF BUZZER)
DEMBOSKY: Finally, Latinos who were worried that signing up would get their undocumented relatives in trouble were shown a promise from President Obama to the contrary, printed on letterhead from Immigration Enforcement.
(SOUNDBITE OF BUZZER)
DEMBOSKY: Covered California says it has learned from those mistakes. Executive Director Peter Lee says this year, the agency is all in on a new approach.
PETER LEE: We're actually spending more money in outreach, education and marketing this year for a three-month period than we spent for six months last year.
DEMBOSKY: The agency hired 200 new call center counselors who speak languages other than English. It is enlisting more trusted community organizations to allay fears about deportation, and it's rolling out a new ad campaign tailored specifically to Latinos.
(SOUNDBITE OF TV AD)
UNIDENTIFIED ANNOUNCER: (Speaking Spanish).
DEMBOSKY: This new ad shows pages of immigration documents flying into a safety vault.
(SOUNDBITE OF TV AD)
UNIDENTIFIED ANNOUNCER: (Speaking Spanish).
DEMBOSKY: Lee says the main challenge is convincing Latinos to buy something they don't think they need.
LEE: They've adjusted to a culture of coping.
DEMBOSKY: He says the state's goal is to shift from a culture of coping to a culture of coverage. For NPR News, I'm April Dembosky in San Francisco.
GREENE: The stories you just heard are part of a reporting partnership with NPR local member stations and Kaiser Health News. Transcript provided by NPR, Copyright NPR.
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