HEALTH CARE - Persuading the Young on ACA Enrollment

"Administration Plays to Young in Health Push" by MICHAEL D. SHEAR and TANZINA VEGA, New York Times 3/19/2014

Russian troops were rolling through Crimea when Denis R. McDonough, the White House chief of staff and a foreign policy expert, was deployed on a mission to do media outreach.  But the focus of Mr. McDonough’s calls to local talk radio stations was not geopolitical tensions in Eastern Europe, it was health care.

Mr. McDonough chatted with Andy Baskin and Jeff Phelps, hosts of a popular sports talk radio program on WKRK-FM (92.3) in Cleveland, about the coming N.F.L. draft, basketball at the White House and his days playing college football in Minnesota.  Mr. McDonough then pitched a new website featuring games, videos and superstar athletes explaining the benefits of health insurance: a sports-themed portal to HealthCare.gov.

“We’ve all seen it happen,” said Mr. McDonough, promoting the portal, GamePlan4Me, to the hosts of “Baskin & Phelps” and their mostly young, mostly male audience.  “Somebody’s playing hoops, and they blow out a knee or something.  And then all of a sudden, if you don’t have health care, you’re going to bankrupt yourself.”

Persuading millions of young people — especially African-Americans and Latinos — to buy insurance using HealthCare.gov is consuming every spare moment at the White House as President Obama and his aides race against a March 31 deadline, when enrollment ends for the year.  They are waging their final public relations push with a zeal that underscores how critical success is for Mr. Obama’s political legacy, and how far behind they remain.

Officials have scaled back their original estimate of signing up seven million people, to six million.  But according to enrollment figures released Monday, more than one million sign-ups will be needed to reach the reduced goal by the end of March.  And there is concern that the administration still needs a larger proportion of 18- to 34-year-olds, the young and presumably healthy people whom insurance companies need as customers in order to keep premiums reasonable for everyone.

In an effort to reach young men, the White House is trying to turn March Madness into a frenzy about health care coverage as well as basketball.  Mr. Obama’s N.C.A.A. tournament bracket, released on Wednesday, was accompanied by a “16 Sweetest Reasons to Get Covered” bracket. LeBron James, the Miami Heat star forward, is starring in 30-second ads promoting HealthCare.gov that will air during the college basketball games.

On Thursday, Mr. Obama will urge daytime TV viewers to sign up for coverage in an appearance on “The Ellen DeGeneres Show” from the White House.  In the past three weeks, Mr. Obama has met with YouTube personalities in the Roosevelt Room, hosting some of the younger generation’s online favorites: a science geek, a drunken chef and an Obama impersonator.  He dialed into Rickey Smiley’s hip-hop radio show and sat down in the Diplomatic Reception Room for separate interviews with the comedian Zach Galifianakis and a health care expert from WebMD.

“We are going to leave no stone unturned,” said Valerie Jarrett, a senior adviser to the president and the leader of the White House public engagement office, which is coordinating the Affordable Care Act effort.  “Our goal is to meet people where they are.”

Michelle Obama, the first lady, urged people to sign up in an appearance at a health center in a black neighborhood in Miami, and made the pitch on ABC’s “Good Morning America.”  Vice President Joseph R. Biden Jr. plugged the health care site at Mary Mac’s Tea Room in Atlanta.

From January until the end of March, the Centers for Medicare and Medicaid Services, which runs the HealthCare.gov site and administers the Affordable Care Act, will have spent $52 million on paid media, officials said.  Conservative opponents of the law have concentrated their spending on ads focusing on Democratic candidates and sowing doubts about the viability of the law.

The final push comes at a time when the administration is juggling other priorities.  On March 6, at the height of the crisis in Ukraine, Mr. Obama spoke on the phone with President Vladimir V. Putin of Russia for an hour before going across town to urge Latinos to enroll during a town-hall-style meeting at a museum broadcast on three Spanish-language television networks.  He returned to the White House a couple of hours later to announce the first sanctions on Russia.

“We’ve organized our outreach in a way so we can take care of the non-A.C.A. business that needs to be taken care of while devoting a great deal of time and energy to this effort,” Ms. Jarrett said.

Outside of Washington, the president’s allies are staging a final surge to enroll as many people as possible.

The targets in the last few days of the campaign are young people and minorities, with a particular focus on Hispanic and black youths — two crucial groups that are more likely to be underinsured, officials said.  On a conference call last week with almost 3,000 pastors, Mr. Obama declared it “crunchtime” and asked them to do whatever they could do to urge members of their churches to sign up.

At a small church in the Tampa, Fla., neighborhood of Sulphur Springs, the Rev. Timothy Wynn took up the challenge on Sunday.  In front of about 50 parishioners, he delivered a sermon that combined his religious guidance with a pitch for insurance.

“I know you came here for the word of God, and I’m going to give you the word of God,” he said.  But before delivering that word, the pastor asked his parishioners, most of whom are black, to take out their cellphones and text friends to remind them to come to the church and sign up.  He also asked them to go to the church’s Facebook page and “like” an open-enrollment flier there.

“Can you do that for me?” he said.  “God not only cares about our spiritual being, he cares about our physical being as well.”

At the back of the church, All Nations Outreach Center, two health care “navigators” were positioned at tables with stickers and information pamphlets about how to sign up.  At the end of the service, about 10 people stopped to ask questions.

Tiffany Pate, 33, a hairstylist in Brandon, Fla., who was the sole person to enroll on site, said that while she already had health insurance, her new plan would save her $50 a month.  “It made sense,” she said of the switch.

In addition to trying to galvanize clergy and black mayors around the country, the Obama administration has been working hard to attract African-Americans and Hispanics through such media efforts as interviews on popular black and Hispanic radio programs like “The Steve Harvey Morning Show” and “Erazno y La Chokolata,” a Spanish-language program based in Los Angeles.  It has also begun social media campaigns in English and Spanish and hosted Google chats.

“People get busy in their daily lives,” Ms. Jarrett said.  “But as you approach a deadline, it’s easier to get people’s attention and say, ‘OK, come on now, you only have a few weeks left.  It’s time to get serious about this, go on the website, explore your options and sign up.’ ”

Though the administration is spending heavily on airtime, it is also courting unpaid endorsements that might go viral on the Internet.  In late February, nine stars of hit YouTube videos were invited to a conversation about health care at the White House.  Among them was Michael Stevens, the star of “Vsauce,” a popular video show about science that regularly gets millions of views online.

“The 15- to 35-year-old group is the heart of my audience,” Mr. Stevens said in an interview.  “The White House made it clear they want to talk to everyone.”

His wonky videos ask questions like “Why do we kiss?” and “What if you were born in space?”  He is working on a special video about the science of assessing risk — and the need for insurance.

Another YouTube star at the meeting was Hannah Hart, whose show “My Drunk Kitchen” is irreverent and hugely popular.  An episode about making a grilled cheese sandwich while tipsy has gotten more than three million views, and a brunch episode, during which Ms. Hart repeatedly downs mimosas as she cooks pancakes and eggs, has gotten two million.  In a video she made after leaving the White House meeting, Ms. Hart plugged the president’s website for her viewers.

“If you want to show your body that you love yourself, go ahead and sign up for health insurance at HealthCare.gov,” she said.

“I’m simply talking to all my friends who are independent business professionals who think they are going to live forever,” she continued.  “Get covered!”

Since it was posted on March 4, her video has been seen about 250,000 times.