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White House Muddles Obamacare Messaging — Again

President Obama walks off the stage after speaking about the Affordable Care Act during an event in the East Room of the White House on Thursday. Obama argued that the law is holding insurance companies accountable and putting money back into the pockets of consumers.
Susan Walsh

This summer was supposed to be a time to reintroduce the public to the Affordable Care Act and teach people how to sign up for benefits this fall.

But that's not what's happening.

Instead, earlier this month, the Obama administration decided to delay some key pieces of the law, most notably the requirement for larger employers to provide coverage or risk fines, because they couldn't have reporting regulations ready in time for next year's rollout.

Then this week, the Republican-led House voted to delay the so-called individual mandate for a year to match. It was the 39th such vote against the law.

And now some are starting to worry that the White House is getting dangerously off-message.

The administration tried to regroup Thursday: It put President Obama front and center in the White House East Room, surrounded by smiling beneficiaries of the parts of the Affordable Care Act already in effect.

Among those singled out: those who have been on the receiving end of a somewhat obscure provision requiring insurance companies to pay rebates to policyholders if the companies spend too much on administrative costs rather than medical expenses.

"Dan Hart, who's here from Chicago, had read these rebates were happening," said Obama. "But he didn't think anything of it until he got a check in the mail for 136 bucks."

This year an estimated 8.5 million Americans will get rebates thanks to the law's "medical loss ratio" rules. That's actually down from the 13 million who got them last year. And Obama admitted that even those who are getting the checks don't necessarily associate them with the health law.

"I bet if you took a poll, most folks wouldn't know when that check comes in that this was because of Obamacare that they got this extra money in their pockets," he said.

Which is a big part of the administration's messaging problem. According to public opinion polls, many of the law's provisions are extremely popular. But the law itself isn't. Still.

And while the president is talking about a few million people getting refunds of $100 or $200, Republicans have been talking in much more expansive terms.

"A government-run health care system is at its very basis a beginning of socialism in medicine, and we oppose that," said Rep. Pete Sessions, R-Texas, during the House floor debate Wednesday.

At his daily briefing Thursday, White House spokesman Jay Carney derided Republicans' continuing efforts to roll back the law.

Carney said the president is willing to make changes to the law as necessary. "But that is wholly different from this constant and now almost comical effort to spend most of the time in the House of Representatives hoping to repeal in some form or manner a bill that has been passed into law by both houses, signed into law by the president, and upheld as the law by the Supreme Court of the United States."

Still, there's a major difference in the way Republicans talk about the law and the way the president does, says George Lakoff, a professor of linguistics at the University of California, Berkeley and an expert on political messaging.

Lakoff says Republicans talk about the law as a moral issue. "Basically ... they say that democracy is about liberty, the liberty to pursue your own self-interest without you having to take care of anybody else's interests or anybody else having to take care of yours."

But when Obama talks about the health law — at least this week, says Lakoff — "his message was all about money."

And Lakoff says that's pretty much been the president's problem: He's mostly shied away from talking about health care on the same moral terms as have the Republicans.

But he could talk about it from the moral perspective of Democrats if he wanted to, Lakoff says.

"Health care is about life itself, about living a decent life, about living free from fear, and also free from economic fear. Fear of losing your home because you have to pay out of pocket for operations that really ought to be paid for by having health care insurance," he said.

The administration, however, has seemed to be all over the place when it comes to its messaging about the health law.

Of course it's been a lot easier for the Republicans. Their message is pretty much one word: No.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Julie Rovner