Who's Winning the TV Ad Messaging Wars on Health Care Reform?

The fight for Obamacare repeal is moving on two separate, but parallel tracks. One is a legislative track to a future and final Republican health care reform bill; a bill that can make it through the Senate, reconciliation with the House and onto the president’s desk to be signed into law. That path is full of lots of twists and turns – both expected and unexpected.

The other track is the messaging surrounding the bill we do have – the Republican legislation (AHCA) that passed the House in early May. While the AHCA sits in legislative limbo, trying to move its way down the legislative track, both sides are attempting to define it/spin it to their benefit.

Republicans have a bigger, tougher task on the messaging front. Recent polling shows that the AHCA is super unpopular. Even among Republicans the bill is getting tepid support. But, a number of Democratic strategists and long-time Hill campaign vets that I spoke with over the last couple of weeks are worried that Democrats won’t take advantage of this opportunity to make this bill as toxic for Republicans in 2018 as Republicans made Obamacare radioactive for Democrats in 2010. One plugged in Democrat worried that Democrats weren’t capable organizationally or financially to “flood” the zone with anti-AHCA advertising.

In the 2010 cycle, the GOP went on offense against the law, while Democrats were mostly silent on promoting it. According to data supplied to the Cook Political Report from Kantar Media CMAG, a nonpartisan tracker of political TV advertising, there were more than 420,000 ads aired on broadcast TV and national cable mentioning Obamacare/ACA that ran in 2010.
 

Type of Ad Number of Ads Aired Percent of Total Ads Run
Anti-ACA
380,397
89%
Pro-ACA
49,127
11%
Total
420,524
 


KANTAR MEDIA CMAG DATA – 2010

Of those, there were 320,397 ads attacking/criticizing Obamacare. Meanwhile, less than 50,000 ads were aired that supported the law. In other words, of all the political/advocacy advertising on the issue of Obamacare in 2010, almost 90 percent of it was negative.

The constant attacks didn’t fundamentally alter the views Americans had of the new law. Obama signed the ACA into law in March of 2010. Kaiser Foundation Polling taken in April of that year found the law slightly more popular than unpopular (46 percent favorable to 40 percent unfavorable). By November of 2010, opinions of the law didn’t change much (42 percent favorable to 40 percent unfavorable).

However, many Democrats argue that the incessant attacks were critical in ginning up the GOP base and depressing Democratic intensity. And, while the bill didn’t become wildly unpopular overnight, it also didn’t gain in support either.

With these 2010 ad wars still fresh in the memory of campaign operatives, both sides are busy trying to shape the contours of the Obamacare repeal debate. And, at this point, those on the anti-AHCA side have put up more ads attacking the bill than those on the pro-side have in defending it. However, the disparity is not nearly as large as it was back in 2010, when the anti-side completely drowned out the pro-side.

Kantar Media CMAG tracking for broadcast TV and National cable from March 1 to May 22 found that of the 64,484 spots that had mentioned AHCA, 57 percent (36,743 spots) were negative or anti-AHCA and 43 percent (27,741) were positive/pro-AHCA. The Kantar Media CMAG estimate on spending, however, shows the two sides basically even – at least when it comes to spending on broadcast TV and national cable – with $9.6 M on the anti-side and $10.2M on the pro-side. Note that these figures don’t represent digital or radio ad buys.

The message in the attack ads focuses heavily on things like the “age tax” (insurers can charge older individuals up to five times as much as younger people) and the lack of guaranteed coverage for pre-existing conditions (there’s a penalty for individuals who don’t keep continuous coverage).

The pro-reform ads emphasize “more choices, better coverage” and a protection for people with pre-existing conditions (the new law allows states to set up so-called risk pools for states that waive the current pre-existing rules).

Type of Ad Number of Ads Aired Percent of Total Ads Run
Anti-AHCA
36,743
57%
Pro-AHCA
27,741
43%
Total
64,484
 


KANTAR MEDIA CMAG DATA 3/1/17 – 5/22/17

 

 

And, despite Democratic fears that the GOP cavalry would swarm in and overpower the underfinanced progressive forces, almost all of the funding for the pro-AHCA advertising is coming from one source, the American Action Network, a GOP nonprofit aligned with Speaker Paul Ryan. Of the $10.2M spent on pro-AHCA ads like this one, $7.7M –or 76 percent– came from AAN. Other stalwarts of the GOP outside money world, like the Koch Brothers-backed Freedom Partners, have been silent. The Club for Growth has aired just 30 pro-AHCA ads.

Meanwhile, the Democrats have a number of groups running ads attacking the bill. The biggest spenders are Alliance for Healthcare Security, which has aired over 12,000 spots like this one, at an estimated cost of $4.8M. The next biggest spenders are Patriot Majority USA, who’ve run 2,360 ads for a cost of $425,000 and Save My Care, which has run 14,342 ads like these, for $3.6M. About 15 percent of all anti-AHCA ads have been run by Democrat Rob Quist who is running in Montana’s At-Large special election.

In politics, good messaging on policy is as important as its creation and implementation. Democrats spent a lot of political capital getting their health care bill passed in 2010, but spent little financial capital defending it. Meanwhile, Republicans have spent heavily over the last few years in attacking the current law, but are now forced to defend their own bill that’s currently unpopular. Of course, not all is rosy for Democrats. The announcement this week that Blue Cross is leaving the Kansas City metro market, combined with rising premiums in many of these markets is a reminder of the real problems facing the current health care system. As unpopular as the AHCA is today, between now and mid-October a lot of voters will get a (mostly unpleasant) reminder that Obamacare is still in force.

As the bill winds its way through the legislative process a lot that will get changed/added/altered. But, the images, and messages that are being sent now can take hold and, like an invasive weed or bamboo, be very difficult to uproot in the future.