Why Obamacare’s Success May Hinge on Moms and Cheeky Ads

Who's winning, who's losing, and why.
Oct. 24 2013 5:01 PM

Mother Knows Best

Even once healthcare.gov is fixed, Obamacare’s success may hinge on moms and cheeky ads.

Presumably one day large numbers of people will seamlessly sign up for health care on the newly created health care exchanges. When that day comes, the Obama administration will still face its primary challenge: getting large numbers of bros—that is to say, healthy, 18- to-29-year-old single men—to sign up for Obamacare.

The economics of the Affordable Care Act make bros matter a lot. Like any insurance pool, the state exchanges will depend on buy-in from young, healthy people, who are cheaper to insure, to ballast premiums. Of the 7 million people the White House wants to sign up for the exchanges by next March, about 2.7 million of them are under the age of 35. The problem is many young people either don’t see the value in signing up for the exchanges or don’t understand how they work.

And that’s why this ad from a nonprofit promoting Colorado’s health exchange is so genius:

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“Keg stands are crazy,” the ad reads. “Not having health insurance is crazier. Don’t tap into your beer money to cover those medical bills. We got it covered.” Another bro-care ad reads, “My girlfriend broke my heart, so me and the bros went golfing. Then my buddy broke my head. Good thing Mom made sure I got insurance.”

State organizations—like the creators of the “brosurance” ad—are faced with the same basic conundrum as Monday Night Football advertisers: How do you convince young men to buy something they don’t think they need? The brosurance ad was created by the Colorado Consumer Health Initiative as part of a campaign targeting groups of people who hit the insurance “sweet spot”—people who aren’t poor enough to qualify for Medicaid but are unemployed or don’t get insurance through their work.* Other ads feature a pregnant woman, a bike-riding hipster, and an athletic middle-aged rock climber.

Adam Fox, the group’s director of strategic engagement, says the publicity the brosurance ad has garnered shows the type of viral approach these PSAs need to have if they are going to reach young men. “This is a demographic that hasn’t really been successfully marketed to in health insurance,” Fox says. “If people aren’t going to look at it, they’re not going to learn anything.”

So, the success of Obamacare doesn’t just hinge on enrolling sick people (or a functional website, for that matter). Ultimately, young people will decide how much they and everyone else will pay depending on how many of them buy into the exchanges.

It isn’t necessarily a tough sell. In one poll, 70 percent of people under 30 said having health care was “very important” to them. Still, many young people are skeptical of whether it’s cost-effective to sign up for the exchanges, even though most of them will be eligible for subsidies. A 21-year-old in California making less than $34,470 will receive at least some help from the government to pay for a silver plan. Those who make more than $34,470 (or 300 percent of the federal poverty line) will have to pay at least $216 a month and won’t receive any federal subsidies. They can also turn down the exchanges and pay a $95 fine for the first year.

Aside from cheeky ads, how can states get young men to buy in? Enter Mom. Mothers make the health care decisions in 80 percent of families, and they’re the most effective “messengers” to persuade their kids to sign up for health care. Anne Filipic, who leads the nonprofit group Enroll America, says men may be the ultimate target for groups promoting the exchanges—they are more skeptical of health insurance and tend to visit the doctor less—but they’re focusing on women because of their decision-making role. “The messenger matters a lot,” Filipic says. “The most effective thing we can do is get moms and women the information, so in their day-to-day conversations they can be spreading the word.”

Enroll America surveyed young people and asked who they were most likely to trust talking to them about health care. For young women, “someone like me” was the most persuasive messenger. For young men, it was their mom, followed by their spouse or girlfriend. That’s why the Obama administration has promoted the exchanges on mom-friendly media like allrecipes.com, Good Morning America, and Elle magazine. The group MomsRising is even recruiting mothers to proselytize on the law’s benefits for young people through its “Wellness Wonder Teams.” The AARP has created a site called Your Mom Means It (or, en Español, Tu Mama Sabe), with e-cards for moms to guilt their kids into signing up for the exchanges. “I don’t mind being the reason you get health insurance,” one reads. “You’re the reason that I drink wine out of a box.” Another: “As a reward for signing up for health insurance, I’ll defriend you on Facebook.”

Winning the support of moms has become its own battleground between pro- and anti-Obamacare groups. In dueling videos, Americans for Prosperity and Organizing for Action compete to capitalize on mothers’ attention to their young children’s health. Anti-Obamacare groups are also targeting young people, like Generation Opportunity, which gave a tongue-in-cheek “Youth Defender Award”  to the creators of healthcare.gov for preventing people from signing up for the exchanges. (You may also remember the group’s creepy Uncle Sam ads from September.) The White House worked with Funny or Die on a Scandal spoof, and Rep. Darrell Issa used Lolcats, that memetic workhorse, to make fun of the Obamacare help line.

Of course, cat GIFs don’t do it for everyone. Young people aren’t a monolith. There are high school dropouts and those with graduate degrees; those who are covered by their parents’ insurance and those who aren’t; single men and pregnant, married women; young people who’ve never broken a bone in their body and others who have cancer. Whether or not they sign up for government health care or pay a penalty is ultimately up to them. But everyone will be better off if the bros decide to get those totally jacked biceps state-insured.

Correction, Oct. 25, 2013: This article originally stated that the brosurance ad was created to target people who aren't poor enough to qualify for Medicare. It targets people who aren't poor enough to qualify for Medicaid.

Emma Roller is a Slate editorial assistant. Follow her on Twitter.

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