Health Care Messaging

We should all understand the critical importance of educating Americans that the Affordable Care Act (ACA) is a success. The entire conservative philosophy is based on the idea that government cannot handle major challenges like quality, affordable health care for all. That is why right wingers are hysterical about the ACA and are willing to do almost anything to undercut it. The ACA’s success threatens to destroy their entire “government is the problem” narrative.

In the debate against the “repeal Obamacare” extremists, keep two things in mind. First, persuadable voters know almost nothing about the ACA. They simply don’t understand what it is or how it works. Second, voters overwhelmingly believe that the ACA is flawed and needs to be fixed. At the same time, only the conservative base wants to repeal the ACA—persuadable voters don’t support repeal.

Say . . .

For years, our health care system was unfair. Insurance companies charged too much and their coverage was full of holes. We needed a better system. The new health care law, called the Affordable Care Act, is intended to provide you and your family with the security of quality, affordable health care. For most Americans, the law strengthened your coverage—for example, now companies can’t kick you off coverage when you get seriously ill. The ACA isn’t perfect and we need to improve it. But it would be foolish to repeal it. Repeal would hurt you and your family by handing our health care system back to the insurance companies, allowing them to deny coverage because of preexisting conditions, drop coverage when you get sick, and charge women more than men.

Why . . .

Among persuadable voters, nearly everyone will agree with these first three sentences. Then you need to give a very brief explanation of the ACA, assuming your audience knows almost nothing. Persuadable voters tend to be insured and they are worried about their own coverage, not the uninsured. So focus on their concerns, not yours.

Make it clear that you recognize the ACA needs fixing and you will work to improve it. But don’t be too defensive; quickly pivot to the most persuasive point, that we can’t go back to the old, flawed, insurance company-dominated system. This language works:

Say . . .

We must not put insurance companies back in charge of our health care, allowing them once again to deny coverage to people with pre-existing conditions, drop your coverage if you become sick, and charge women more than men.

And so does this:

Say . . .

We must not put insurance companies back in charge of our health care, allowing them once again to discriminate against women by charging women higher rates than men, and by refusing to cover mammograms, screenings for cervical cancer, birth control, and other services.

Here’s a short version:

Say . . .

We can’t go back to letting insurance companies do whatever they want. Instead of repealing the health care law, we need to keep what’s right and fix what’s wrong.

Why . . .

Don’t fall into the right wing trap of letting the choice be between the ACA and something imaginary. Voters don’t have to love the ACA, they just have to understand that it’s better than the real-life alternative—being victimized by insurance companies.

Don’t say . . .

Say . . .

Them

The poor, people in poverty

Give health insurance

You and your family

Hard-working Americans

Families, children, people with disabilities

Don’t deny the security of health care 

Why . . .

As we have emphasized earlier, it is hard to move persuadable voters to support any policy that appears to benefit people other than themselves, their families, and their friends. So whenever possible, talk about how the ACA directly benefits your audience. When the conversation turns to the uninsured, avoid language about poverty because it evokes negative ideas about welfare. Say hard-working and families, children and people with disabilities because it suggests the recipients need and deserve basic medical coverage. And as we have explained above, it’s more effective to say “don’t deny them the security” instead of “give them the security.”

Here are some responses to common anti-ACA talking points:

Right wing argument: Obamacare hasn’t helped Americans.

Say . . .

Actually, it has. The ACA has provided millions of Americans free access to preventive services like check-ups and mammograms; slashed the costs that seniors pay for prescriptions; allowed millions of young adults to stay on their parents’ insurance; ended lifetime limits on coverage; and forced insurance companies to pay $1 billion in rebates to overcharged customers. The ACA enables Americans to get the care they need, when they need it, at a price they can afford. It works.

Right wing argument: Obamacare will increase health insurance costs.

Say . . .

It’s the opposite; the law will save you money. As you know, health insurance companies have jacked up our premiums for years. The Affordable Care Act has many cost controls built into it, including a limit on the percentage that insurance companies can spend for overhead such as executive salaries and marketing. It’s clear that if the ACA was repealed, and the insurance companies were put back in charge of our health care system, that’s when we’d be paying a lot more.

Right wing argument: Obamacare will increase the federal debt.

Say . . .

It’s just the opposite. According to the nonpartisan Congressional Budget Office, the ACA reduces the deficit by $100 billion over the next 10 years and by more than $1 trillion over the following decade. The ACA is good for the economy and is a very good deal for taxpayers.

Right wing argument: Obamacare’s Medicaid expansion will force states to raise taxes.

Say . . .

In fact, states will save money by expanding Medicaid under the ACA. That’s because it reduces wasteful spending, like unreimbursed emergency room care. It will save our state more money than we spend.

Right wing argument: Obamacare will drastically increase costs for young people.

Say . . .

Nonpartisan studies show that the law’s built-in subsidies make health insurance a good deal for young people. Loud cries of “rate shock” are just not true.

Right wing argument: Obamacare cuts funds from Medicare, thereby hurting seniors.

Say . . .

The Affordable Care Act prohibits cuts in guaranteed Medicare benefits. What it reduces is inefficiency, fraud and waste by private insurance companies that profit from Medicare. Saving this money has already strengthened the Medicare Trust Fund. The truth is, the ACA’s supporters are fighting to protect Medicare and the ACA’s opponents have been working for years to destroy Medicare by cutting benefits and trying to privatize the system.
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