There are two big reasons why Republican lawmakers would want to pick a fight over a $4.5 million federal grant to do outreach educating the public on new insurance options under the federal health care law. One is that it’s a largely symbolic anti-Obamacare proxy fight that plays well with the base (#StopTheAds!). The other is that they are desperately hoping that the law will fail, and blocking the outreach may harm the implementation of Obamacare – though at the cost of denying constituents information they need and potentially jacking up premiums for Arkansans shopping on the Health Insurance Marketplace in the future. 

But…it’s a little awkward to come and say that! So instead, when Republicans* in the Legislative Council declined to “review” the grant money last week — leaving the outreach funds in limbo — we got arguments like these, that don’t hold up to a moment’s scrutiny. After the jump, let’s take a look…


*Worth noting that review only requires a majority of a quorum at the Leg Council, and Democrats aren’t showing up…also worth noting that lesiglative review is purely symbolic and Gov. Mike Beebe could simply choose to ignore the symbolic vote and proceed with the contract.

Outreach doesn’t work
The most embarrassing version of this argument came during Monday’s Legislative Council meeting when Sen. Gary Stubblefield said that direct mailers were a waste of money because they would only be thrown away. The very next day, Stubblefield’s argument was revealed as total poppycock: the Department of Human Services announced that after sending out a single one-page piece of direct mail on enrolling in the “private option” to 132,000 households, an incredible 54,400 adults responded. Of course, Stubblefield should have known better. An aggressive direct mail campaign helped Stubblefield get elected! If outreach, direct mail, and advertising don’t work…that should come as curious news indeed to the outside groups that spent millions in Arkansas on the 2012 election. 

In short, in order to implement this policy — both the Obamacare Marketplace and the “private option” approved by a super-majority of the legislature — Arkansas needs to inform citizens about their options. I’m going to go out on a limb and say that countless firms operating in the U. S. of A. are right and jokers like Stubblefield are wrong: if you want to get the word out, advertising is money well spent.


Maybe outreach and ads could work but only if you do it our way. Cousin argument to the above. Some Republican lawmakers recognize that if they say that advertising is an ineffective way to spend money, it will make them sound stupid. So instead they argue that these particular ads won’t work. Maybe you’ve seen that “Get In” slogan. They don’t like it!

The campaign thus far seems solid to me, but I’m going to be honest here and say that I don’t know anything about marketing so maybe I’m wrong. But do you know who else doesn’t know anything about marketing? The Arkansas Legislative Council! You know who might just know something about marketing? Mangan Holcomb, the local marketing firm that AID contracted with to develop this campaign. Indeed, Mangan Holcomb developed the message via research, focus groups, polling data, etc. This is where Arknasas Republicans’ propensity for micro-managing policy runs headlong against conservative dogma. We’re left with the strange spectacle of lawmakers insisting that the legislature can do a better job at developing an effective outreach campaign than a private firm that the state contracted with. 


Enough is enough! Around $4 million has already been spent. So, Rep. Kim Hammer and others say, outreach accomplished! Never mind that the outreach campaign was specifically designed to be a two-part process, with a second phase, originally set to begin on October 1 when the Health Insurance Marketplace launched, transitioning into the nuts and bolts of how to enroll. This is a little bit like suggesting that a Hollywood studio mount an aggressive campaign prior to a movie’s release and then pull the campaign the day the film comes out. Seriously, if this demagogue thing doesn’t work out for him, Hammer should go into marketing.

(Though he voted against review, Rep. John Burris, a key Republican backer of the “private option,” pointed out the folly of the approach the legislature has taken: “Is it good business to show up halfway through a business plan that has been before us for months, and lop off the back side of the business plan, and act like we’re doing something good?”)

Taxpayer dollars shouldn’t be spent on advertising. We’ve heard various versions of this throughout the debate, that there is something especially pernicious about advertisements (by the way, the outreach budget includes funds for lots of outreach activities outside of media advertising — the AR Health Connector web site, their Facebook page, informational materials, direct mail, outreach events, etc. — but never mind that for now). In fact, public programs spend money on outreach, including advertising, all the time. One might oppose military policy but it would be rather silly to oppose “Be All You Can Be” ads. After all, ensuring that enough volunteers enroll in the armed forces is a legitimate policy goal. As much as some GOP lawmakers may hate it, Obamacare and the “private option” are the law, and enrollment is a legitimate policy goal. Recently an Americans for Prosperity flak tried out some hypothetical hypocrisy on this front: “And maybe school choice should get taxpayer funded ad campaigns huh?” he tweeted. Great example! (Gotta love AFP, always unwittingly making precisely the opposite point than what they intended.) Of course charter schools spend public money on outreach, including advertisements, to inform families about options and try to enroll students! In fact, the analogy helps to clarify the issue: Many oppose policies which create charter schools, but as far as I know there is no corresponding effort to ban existing charter schools from attempts to spread the word about their existence to families. That would be absurd. 

The outreach campaign is propaganda. Several Republicans have told me that they tried to convince AID to get rid of the “rah rah stuff.” Again, it’s useful to remember that this federal grant exists to serve a policy goal: informing citizens about new health care options and encouraging eligible folks to enroll. I can’t imagine how to convey that message effectively without being positive about health insurance. Particularly since, for low-income uninsured people, the message is genuinely good news: they can now get insurance heavily subsidized or with no premium at all. Should we try out, “Obamacare sucks — now sign up!” instead? Or maybe something like this


Think about how ridiculous this line of argument is. There is no claim that the outreach campaign is untruthful; the claim is that it’s too positive. Advertisements! Too positive! To use the two examples above, is “Be All You Can Be” propaganda? I would just call it…advertising. The Army’s goal is to attract volunteers to enlist. “Rah rah” works! Or charter schools — shockingly, their outreach often makes the extremely positive pitch that charter schools have particular virtues. If we spend public funds on outreach, assuming it’s accurate and truthful, the test shouldn’t be neutrality, it should be efficacy. 

TRAINWRECK!!! In previous posts, we’ve already mentioned the various formulations of stuff like this, from Rep. David Meeks — after incorrectly stating that U.S. Sen. Max Baucus said the law would be a train wreck, Meeks says, “I definitely don’t want to spend more money to try to get people to board this train.”  This is an especially laughable use of an out-of-context quote from Baucus, who was in fact worried about people not having enough information about the law if outreach wasn’t properly funded

But here’s the really ludicrous part: Meeks and his allies claim they are somehow protecting citizens from big bad Obamacare by keeping them in the dark. But what is he protecting them from? Uninsured people will have the opportunity to shop for insurance, often heavily subsidized. For people who qualify for the “private option,” they’ll gain coverage without paying a premium at all. They’re not going to get attacked by a rape clown if they sign up, they’ll get health insurance. Even if one thinks that Obamacare is a bad law that will bring ill effects, there is zero sense in which keeping uninsured people uninsured somehow protects them from Obamacare. If Meeks thinks that people won’t like the new options, why is he trying to keep them from getting information to decide for themselves?

Don’t spend our hard-earned tax dollars on ads for Obamacare! A federal grant does ultimately come from federal taxpayers so, okay (though of course Arkansas takes in more than our taxpayers pay out on net). But we’re talking about $4.5 million in federal money (nothing out of the state budget) to inform citizens about a multi-billion dollar program that will function less well if citizens aren’t informed. Meanwhile, according to AID, the money cannot be returned to the feds in any case, and it cannot be spent on anything else. Not to mention the fact that this is federal money that would end up going to various businesses here in Arkansas. But yeah, enough is enough, etc. 

Maybe possibly some day Obamacare may go away so best to do absolutely nothing now. The base has been fed some wildly unrealistic promises about de-funding Obamacare, so I can’t really blame someone like Sen. Bryan King suggesting that the state shouldn’t move full-speed ahead on Obamacare given all the “uncertainty.” But the facts on the ground are these: enrollment has begun for the Health Insurance Marketplace and the “private option.” The former has had some extremely severe glitches in the electronic signup process (though I’d argue that early glitches/confusion increase the need for outreach resources). As of today, it seems to be improving. Hundreds of thousands of uninsured Arkansans have new options. They need information. The state could proceed under the assumption that King’s wildest anti-Obamacare dreams may some day come true. Dealing with the actual reality on the ground seems the more prudent course (though, alas, for folks like Rep. Justin Harris, “There’s no reality right now.)”

Who knows if these ads are working! In fairness to the Republicans who made this argument last week, at the time of the Legislative Council meeting, AID officials did not yet have metrics on the campaign’s effectiveness. But now they do, and the data suggests that the outreach campaign has been very effective at increasing awareness, though there’s still much work to be done. 

Our constituents don’t want no stinking Obamacare ads! Rep. Stephen Meeks sent me this tweet, “…maybe, just maybe we’re representing the will of our constituents.” I have no doubt that if you ask people in his district whether they want to spend money on Obamacare ads, most would say no. I’m skeptical that governing by push-poll results makes sense (what if you asked his constituents, “the federal government has given Arkansas money to inform citizens about new health care options—if we don’t spend it, it will go to waste.”) But I have a bigger question: who is Meeks listening to? Only the Tea Party activists who shout loudest and donate money to his campaign? What about the 15 percent of Faulkner County residents living in poverty? What about the 20 percent who have no insurance? Notice the asymmetry here: Meeks is hearing from angry political activists. But the people who stand to lose by blocking outreach money are, by definition, the very people who aren’t following the health care debate closely. There are thousands of people in Meeks’ district who will be eligible for heavily subsidized or zero-premium heath insurance. Again, I understand that Meeks and many of the people he represents hate Obamacare. But trying to keep folks from finding out about new opportunities for affordable health care doesn’t hurt Obama, or stop the law — which is here whether Meeks likes it or not. It just hurts the low-income uninsured. They’re Meeks’s constituents too.