美国国家公共电台 NPR With ACA Plans A Tougher Sell, Insurers Bring On The Puppies（在线收听）

ARI SHAPIRO, HOST:

Starting tomorrow, people can purchase health insurance for 2018 on the Affordable Care Act's marketplace. Republican efforts to scrap the law are causing a lot of confusion for people. And the Trump administration has dramatically cut money for outreach. In a moment, we'll hear how an insurer in Florida is trying to reach out to Latinos. First, Will Stone from member station KJZZ reports on an Arizona group trying to reach millennials.

WILL STONE, BYLINE: Diane Brown's careful to steer clear of politics when giving her pitch on health care.

DIANE BROWN: I'm not going to talk about the good, the bad of the Affordable Care Act or Obamacare.

STONE: But that can prove difficult when it's basically the reason she's here at a community college east of Phoenix.

BROWN: Health insurance is affordable. I think there's a lot of misnomers that are out there.

STONE: She says she hears the Affordable Care Act is dead, or no insurance plans are available. Neither is true. Brown heads the Arizona Public Interest Research Group, part of a grassroots coalition advertising open enrollment. These days, that means cutting through the confusion.

BROWN: And, again, we really encourage you to help spread the word through your student organizations, through your personal networks. If you...

STONE: She's speaking to students today to get the message to the coveted but difficult-to-reach millennials. They tend to be healthier and less expensive. And insurance pools need them to help pay for older and sicker people. But the Trump administration has slashed this year's outreach budget for the ACA. At the end of her presentation, one student raises his hand. What happens to pre-existing conditions?

BROWN: Great question. Pre-existing conditions are still covered.

STONE: His name is Edward Wilkins - 23 years old. He and his mother have coverage through the ACA. And her recent cancer diagnosis has him worried about the law's fate.

EDWARD WILKINS: I know insurance is going to be more expensive for next year for sure.

STONE: Ask him why he thinks that, and he brings up the decision to cut off certain subsidies to insurers.

WILKINS: I think I heard recently about Trump actually signed something about getting rid of that.

STONE: And he's right that the president did cut off some payments to insurers. But that is a different impact, depending on where you live. In Arizona, rates are virtually unchanged. Marcus Johnson is with Vitalyst Health Foundation, one of the nonprofits leading Arizona's ACA outreach effort.

MARCUS JOHNSON: Arizona could be given the award for most improved right now. In past years, we have seen rate hikes. But this year, we're actually seeing a significant stabilization of the marketplace.

STONE: And many people will also get a subsidy. But making sure young people know that requires going to them, Johnson says.

JOHNSON: We are doing a lot of outreach efforts to schools, to colleges, to community colleges to make sure that people at least are aware of the options that are available.

STONE: The stakes are even higher because in most states, enrollment only lasts for six weeks. For NPR News, I'm Will Stone in Phoenix.

SAMMY MACK, BYLINE: I'm Sammy Mack in Miami. And here, part of the game plan for Penny Shaffer is puppies.

PENNY SHAFFER: Ah, the puppies.

MACK: Shaffer is the South Florida regional market president for Florida Blue, which ensures about a million people through healthcare.gov.

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UNIDENTIFIED MAN: (Speaking Spanish).

MACK: The puppies she's referring to are tumbling around in this YouTube commercial, while the announcer pitches affordable plans and personalized service.

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UNIDENTIFIED MAN: (Speaking Spanish).

MACK: According to a Commonwealth Fund analysis, Hispanics have seen the biggest drop in uninsurance rates of any ethnic group since the Affordable Care Act was passed. One zip code in the heart of Cuban Miami saw the most marketplace sign-ups in the country a couple of years ago. Florida Blues got a lot of potential customers here. But first, they have to reach them. Enter the really stinking-cute puppies perfect for sharing on the internet.

SHAFFER: It's hard to resist puppies, right? Let's just be honest.

MACK: Shaffer says Florida Blue is also promoting the ACA by leaning on its experiences from the first years of the insurance marketplaces, when the company worked with community organizations and got the word out at events like health fairs.

SHAFFER: We're doing it again. We will literally have thousands of seminars across the state to make sure that people understand it's still the law of the land.

MACK: And, Shaffer says, Florida Blue has a responsibility to help people understand what it is they're being told to buy.

SHAFFER: Particularly down here, you have a changing population every year who don't have the relationship to the U.S. health system until they've come here and become citizens and such.

MACK: Florida Blue is spending about the same in marketing as last year. But, Shaffer says, they expect to spend more dollars in heavily Hispanic South Florida, where there's a big, competitive market - so more puppies in Miami.

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UNIDENTIFIED MAN: (Speaking Spanish).

MACK: For NPR News, I'm Sammy Mack. And that story is part of a reporting partnership with NPR, local member stations and Kaiser Health News.