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Marketing health care reform

It seems as if everyone has an opinion about the Affordable Care Act, aka Obamacare. Given all the debate, it's ironic that the success of the law depends so much on publicity.

The crucial day is Oct. 1. Enrollment for health insurance exchanges will open. Americans will be able to see what policies are available at what prices. They will compare them directly and choose which best fits their needs and pocketbook. Subsidies will defray the cost for some needy families.

California chose to create an exchange that works for Californians, whether they live in Sonoma, Los Angeles, Crescent City or anywhere in between. Only 15 other states did the same. The rest will accept a cookie-cutter system run by the federal government.

The states that punted, most of which are run by Republicans furious at President Barack Obama's health care success, likely will rue the decision when they see California successfully serving residents without Washington interference.

First, though, success needs to happen. The immediate challenge is letting people who are eligible to participate know about their options. Those people tend to come from disaffected, disconnected groups. They are unemployed. They are young adults who still believe themselves nigh invulnerable. They are the working poor who earn enough to scrape by but have little leftover to pay for insurance.

Young, healthy people, especially, must participate. Without them, the insurance exchanges won't work. Obamacare is predicated on the notion that maximizing participation in the risk pool across all ages and health will spread costs and keep premiums affordable.

The White House has turned to the team that reached young people during Obama's 2012 re-election campaign. In an unprecedented marketing blitz for a federal law, television and radio ads, billboards and door-to-door marketing are underway. Federal and state agencies will spend hundreds of millions of dollars promoting Obamacare.

California has Covered California, the state agency that will operate the exchange and is doing its own marketing. (Online at coveredca.com.) A state audit reports that the Covered California spent $89 million on marketing and outreach during the last fiscal year and will spend $106 million this year.

The audit concluded Covered California is doing a good job preparing for Oct. 1. Its management is solid; it is meeting federal requirements; and its outreach appears to be succeeding. The audit found a few places for improvement, but nothing that will prevent the state's insurance exchange from giving Californians an option on time.

Covered California hopes to enroll 2.3 million state residents in a health plan through the exchange by 2017. If it succeeds, the state will set an example for the nation, as it has so many times before.

Obamacare is the law of the land, upheld by the U.S. Supreme Court. Americans need to know not how many dozens of times Republicans in the House of Representatives voted to undermine it but how they can get affordable health insurance.