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‘Refuse to enroll’ effort seeks to disrupt Obamacare

With time running out, opponents of the Affordable Care Act have taken to the airwaves in Ohio and elsewhere with ad campaigns not only attacking the bill’s merits but also actively encouraging uninsured Americans not to sign up for coverage under the health care law.

The Obama administration has acknowledged the success of the law, commonly referred to as Obamacare, depends in large part on broad-based participation in federal and state-run health exchanges that will begin selling government-subsidized health plans to the uninsured on Oct. 1.

The anti-enrollment campaigns reflect the resignation and desperation of many Obamacare opponents who have given up hope of a government repeal or court-ordered injunction to stop full implementation of the law beginning next year.

“I don’t think the law can be repealed until we have another president,” said Twila Brase, president and co-founder of Citizens’ Council for Health Freedom. “I do believe the law will go into effect, but that doesn’t mean it has to be successfully implemented.”

To that end, Brase launched the “Refuse to Enroll” campaign earlier this month on her daily radio show, “Health Freedom Minute,” which is broadcast on more than 350 stations nationwide, including the American Family Radio Network with stations throughout Ohio.

The campaign informs listeners — including many of the estimated 1.5 million uninsured Ohioans — that the law does not require them to buy health insurance on the exchanges, only that they obtain health coverage or pay a nominal tax penalty for being uninsured. The penalty is less than $100 for an individual taxpayer next year.

“Contrary to popular belief, non-enrollment in the exchanges does not result in any penalties; fines are only for failure to be insured,” said Brase, whose organization claims the law will limit consumers’ choices, threaten their privacy and increase the cost of health insurance. “We look at the law as being unconstitutional because it’s a government takeover of health care, so we want to make it difficult for the law to function as its proponents want it to.”

Brase is not alone.

The conservative group Americans for Prosperity, which has a chapter in Ohio, has launched another campaign attacking Obamacare with television and online ads that began airing in Ohio last week.

One 30-second spot features a mother with two children asking, in reference to Obamacare: “What am I getting in exchange for higher premiums and a smaller paycheck?”

“The American people have serious questions and concerns about the negative impact of Obamacare,” Americans for Prosperity President Tim Phillips said in a statement. “We feel it’s important to provide education on the true consequences of government intrusion into the private health care decisions of families, and provide a counter to disinformation that’s out there.”

The renewed push to thwart Obamacare comes at a time when the government and a number of advocacy groups have also stepped up their efforts to promote the health care law, especially in states such as Ohio where the health exchange will be run by the federal government.

Community health centers across the state were recently awarded nearly $4 million in federal grants for patient outreach under the health care law, and the government is preparing to award an additional $2.3 million in grants to community groups in Ohio to become so-called “health navigators” who will be trained to help people sign up for insurance on the exchange.

The Ohio Department of Insurance, which has until July 31 to approve health plans submitted for sale on the exchange and submit them to the federal government for review, won’t actively promote the exchange.

But groups such as Enroll America — a national coalition of health insurers, hospital associations and community health centers — and the Universal Health Care Action Network of Ohio have picked up the slack by sending volunteers to knock on doors and spread the word at health fairs and other community events across the state.

Kathleen Gmeiner, Ohio Consumers for Health Coverage project director at UHCAN Ohio, recently posted a letter on her blog outlining the need for public outreach regarding the law and criticizing Obamacare haters.

“A good marketing campaign is a critical component of the roll-out of any major change,” Gmeiner wrote. “These (anti-Obamacare) ads use the skill that money can buy to make people doubt that they can find an insurance product that they can afford.”

For the negative ads to be effective, they must discourage young, healthy individuals from enrolling in the exchanges, said John Bowblis, a health economist at Miami University.

Private insurers selling plans on the exchanges must enroll young people who would pay premiums but have fewer claims to offset the cost of caring for older, sicker Americans and those with preexisting conditions, Bowblis said.

While many young people already choose not to pay for insurance, even if they can afford it, perhaps just as many young people working low-wage jobs with no health insurance would rather not take the risk, Bowblis said.

Bridging the knowledge gap will be a challenge for both sides.

A new survey from CVS Caremark found that while there has been an overall increase in awareness of the health care law, many of those eligible to enroll in health exchanges are asking for help. Still others are unaware that they could be eligible for subsidies.

Bowblis said the negative ad campaigns could backfire by raising awareness of the health exchanges and government subsidies that defer the cost of insurance for many low-wage young workers, he said.

“I have a feeling that these campaigns will actually benefit Obamacare because they will attract attention,” Bowblis said. “Say it gets on ‘The Daily Show with John Stewart’ or ‘The Colbert Report.’ Young people watching those shows are going to be more likely now to at least know about the exchanges. They may not have been thinking about this at all, but this gets them to be more aware that this insurance is available.”

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