This week, the Obama administration unveiled a new public information campaign to educate Americans about the new health insurance choices available under the Affordable Care Act. The campaign includes public events and a new web site designed to encourage eligible Americans to enroll in newly created health insurance exchanges this fall. Thus far, public education efforts have focused on the “nitty gritty” details of eligibility, benefits, and cost sharing for the new insurance options. Supporters of the ACA, however, face a much more daunting task if the law is to reach its potential – ultimately, businesses must opt to maintain current levels of coverage, and uninsured individuals must decide to comply with the new individual mandate to purchase health insurance. Neither is a given, for as many news stories in recent weeks noted, businesses are carefully weighing their options; if a substantial percentage of firms opt to pay penalties rather than offer workers insurance coverage, or reduce the number of workers eligible for coverage (e.g, by limiting opportunities to work 30 or more hours per week), the cost of the ACA will quickly outstrip projections, as employers effectively outsource their health insurance costs to the federal government. If millions of currently uninsured (or underinsured) workers sign up for subsidized coverage through public exchanges, rather than purchasing private employer-sponsored coverage, the rollout of the ACA could spark new calls for cost-cutting, whether in the form of higher cost-sharing, reduced eligibility, or benefit reductions.
If businesses and individuals decide that they’d be better off financially by ignoring the new mandates, and paying the resulting penalties, the cost of the ACA will skyrocket, while millions of young, healthy Americans remain uninsured. While it’s important to provide Americans with a user’s guide to the new exchanges, it’s far more important to persuade them of the need to purchase coverage in the first place.Public education campaigns must channel the spirit of the Three Musketeers by persuading the public to embrace their motto of “all for one, one for all.”