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With Health Exchanges Poised To Open, PR Push Draws Scrutiny

In San Jose, Calif., on June 6, President Obama encouraged people to sign up for insurance in the nation's largest health insurance market. (Getty Images)

This weekend marks 100 days until people can begin signing up for new health insurance coverage under the federal health care law. It also marks another milestone: the launch of an enormous public relations effort to find people eligible for new coverage and urge them to sign up when the time comes.

But like everything else about the health law, even this seemingly innocuous effort has been touched by controversy.

Somewhere around 30 million Americans will be eligible to enroll in state health insurance exchanges beginning Oct. 1. But lots of those people don't know it. Earlier this spring, one poll found that more than 40 percent of respondents weren't sure whether the Affordable Care Act was still a law or not.

Among just those without insurance — who have the most to gain — the numbers are even more striking. "Our research showed ... about 78 percent of the uninsured in the county are unaware of these opportunities," says Anne Filipic, president of Enroll America.

The nonpartisan nonprofit's goal is to help educate the public about the health law's insurance opportunities — and how people can take advantage of them.

The group is taking a two-pronged approach, Filipic says. On the one hand, it's seeking out people who are already interacting with the health care system.

"We want to be thinking about how do we have a presence at community health centers or working with organizations that represent doctors to make sure that the word gets out," she says, "so folks can get the information that they need."

But Enroll America, in partnership with dozens of other groups, also plans to go to community settings that don't necessarily revolve around health, like churches, small businesses and fairs.

The outreach is already paying off. Filipic says she got positive feedback just this week from a farmers market in Austin, Texas. "There were some farmers there who were really interested in the information that we had to give them," she says.

One of the key demographics Enroll America will be reaching out to is young adults. That group is considered critical to making the health exchanges work. But it's also considered the most difficult to connect with.

Filipic says her group plans to use social media, celebrity endorsements and other tried-and-true methods to round up the under-30 crowd.

But its research has also uncovered a secret weapon: For young men, it turns out their most trusted messenger is Mom.

"So part of what we're doing is building a program that is working to get those moms across the country the info that they need," she says, "so that when they're sitting at the dinner table at night they can be talking about this."

So far, Enroll America has raised tens of millions of dollars. A lot of that money has come from health-industry backers that don't necessary love the Affordable Care Act.

But those groups do have a financial interest in getting more people insured, says Ron Pollack, executive director of the health consumer group Families USA. "Insurers obviously want to have more clients, and more people have health coverage; that's good business for the insurance industry," he says.

Pollack says having more people sign up for health insurance is also a good deal for hospitals. "They provide a lot of care for people who are uninsured, and that means that the hospital does not get paid for those services," he says.

Similarly, pharmaceutical firms and drugstores also stand to benefit by having more people covered, and they're helping, too.

As are tax preparation groups like H&R Block. That might not make sense, Pollack says, until you think about the fact that "a lot of people are going to get this help through tax-credit subsidies."

Aside from getting financial support, Enroll America is also getting more attention — and more scrutiny, with Congress refusing to give the Department of Health and Human Services any more money to implement the law.

Health and Human Services Secretary Kathleen Sebelius came under fire from Republicans in Congress earlier this spring for urging companies to donate to the group.

"Congress has said, 'We refuse to give you more money to implement Obamacare,' and she's saying, 'Well then if you won't do it, I'll go outside, and I will raise private money, use a private organization, and do it anyway,' " Sen. Lamar Alexander, R-Tenn., said on Fox News in May.

But Pollack, chairman of Enroll America's board, says Sebelius's actions were hardly scandalous.

"This is astounding that this is a controversy," he says. "If you look through all the different precedents of what has occurred in the past, you'll see that this is a common thing."

In particular, he cited the Bush administration's 2005 implementation of Medicare's prescription drug benefit, which was — and is — run by private insurers.

"It was a public-private partnership that involved the Department of Health and Human Services," he says. "The secretary played a very active role — Republican secretary of course — and the pharmaceutical industry."

Starting this weekend, you can expect to hear not just the ongoing debate about the health law but, if Enroll America has its way, a lot more about how it's all going to work.

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Transcript

RENEE MONTAGNE, HOST:

Come this weekend, it will be exactly 100 days until people can begin signing up for health insurance coverage under the new federal health law. It also will mark the launch of an enormous public relations effort to find people eligible for new coverage and urge them to sign up when the time comes. Still, like everything else about the health law even this seemingly innocuous effort has been touched by controversy. Here's NPR's health policy correspondent Julie Rovner.

JULIE ROVNER, BYLINE: Somewhere around 30 million Americans will be eligible to enroll in state health insurance exchanges beginning Oct. 1st. But here's a big problem, says Anne Filipic: lots of those people don't know it.

ANNE FILIPIC: Our research showed that it was about 78 percent of the uninsured in the county are unaware of these opportunities.

ROVNER: Filipic is president of Enroll America. It's a private nonprofit group whose goal is to help educate the public about the health law's insurance opportunities and how they can take advantage of them. The group is taking a two-pronged approach, says Filipic. On the one hand, it's seeking out people who are already interacting with the health care system.

FILIPIC: We want to be thinking about how do we have a presence at community health centers or working with organizations that represent doctors to make sure that the word is out so that folks can get the information that they need.

ROVNER: But they also plan to go to where people congregate in the community - churches, small businesses, fairs, even farmer's markets. One of the key demographics Enroll America will be reaching out to is young adults. They are considered critical to making the health exchanges work and among the most difficult to reach. But Filipic says her group's research has uncovered a secret weapon: for young men, it turns out their most trusted messenger is their mom.

FILIPIC: And so, part of what we're doing is building a program that is working to get those moms across the country the information that they need.

ROVNER: So far, Enroll America has raised tens of millions of dollars. A lot of that money has come from health industry backers that don't necessary love the Affordable Care Act. But, says Ron Pollack of the consumer group Families USA, those groups do have a financial interest in getting more people health insurance.

RON POLLACK: Insurers obviously want to have more clients, and more people have health coverage; that's good business for the insurance industry. For hospitals, they provide a lot of care for people who are uninsured, and that means that the hospital actually does not get paid for those services.

ROVNER: So they, too, would want to participate. Similarly pharmaceutical firms and drugstores also stand to benefit by having more people covered, and they're helping, too. But Enroll America is also getting more attention and more scrutiny, since Congress refused to give federal officials more money to promote the health law.

Health and Human Services Secretary Kathleen Sebelius came under fire earlier this spring for urging companies to donate to the group. This was Republican Senator Lamar Alexander of Tennessee on Fox News.

(SOUNDBITE OF TV NEWS BROADCAST)

SENATOR LAMAR ALEXANDER: Congress has said, we refuse to give you more money to implement Obamacare, and she's saying, well, then if you won't do it, I'll go outside and I will raise private money, use a private organization, and do it anyway.

ROVNER: But Pollack, who chairs Enroll America's board, says Sebelius' actions were hardly scandalous.

POLLACK: This is astounding that this is a controversy. If you look through all the different precedents of what has occurred in the past, you'll see that this is a common thing.

ROVNER: In particular, he cites the Bush administration's 2005 implementation of Medicare's prescription drug benefit, which was and is run by private insurers.

POLLACK: It was a public-private partnership that involved the Department of Health and Human Services. The secretary played a very active role - Republican secretary, of course - and the pharmaceutical industry.

ROVNER: And starting this weekend, you can expect to hear not just the ongoing debate about the health law, but if Enroll America has its way, a lot more about how it's all going to work. Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

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