If there were fairness in this world, Rita Rizzo would be a media star.
Rizzo, 60, owns a management consulting firm for nonprofit groups and government offices in Akron, Ohio, with her husband, Lou Vincent, 64. Vincent, who suffers from Type 2 diabetes and high blood pressure, has gone without health insurance for 10 years. "We got 30 denial letters," Rizzo told me last week.
Three years ago, Rizzo got a hip replacement. Her own insurance premiums were going to rise by $500 a month, to about $800, so she chose instead to triple her deductible to $6,000 to keep the increase to a mere $150 a month.
The couple used a $5,000 tax-deductible health savings account to cover her out-of-pocket expenses; Vincent's medication, which ran to $178 a month; and his blood work-ups, at $2,400 a year.
In December, Rizzo signed up for Obamacare. She now has a policy that covers her and Vincent together, including all his meds and lab work, for $379 a month, with a $2,000 family deductible.
"I feel like I died and went to insurance heaven," she says.
But you haven't heard Rizzo's story unless you tuned in to NBC Nightly News on New Year's Day or scanned a piece by Politico about a week later. In the meantime, the airwaves and news columns have been filled to overflowing with horrific tales from consumers blaming Obamacare for huge premium increases, lost access to doctors and technical frustrations — many of these concerns false or the product of misunderstanding or unfamiliarity with the law.
While Rizzo was working her way to thousands of dollars in annual savings, for example, Southern California Realtor Deborah Cavallaro was making the rounds of NBC, MSNBC, CNBC, CBS, Fox and public radio's Marketplace program, talking about how her premium was about to rise some 65% because of the "Unaffordable" Care Act. What her viewers and listeners didn't learn was that she hadn't checked the rates on California's insurance exchange, where (as we determined for her) she would have found a replacement policy for less than she'd been paying.
With the March 31 deadline for 2014 enrollment in individual health insurance just days away, more questions are being asked about the mismatch in publicity about the Affordable Care Act by its opponents and supporters.
The millions of beneficiaries of the measure — families excluded from insurance because of high premiums or preexisting medical conditions, low-income individuals made newly eligible for Medicaid, seniors receiving a new subsidy for prescriptions, women granted the legal right to affordable maternity coverage for the first time — seem to be absent from the news media or political ad campaigns. But you can't turn on your TV without seeing a well-produced 30- or 60-second spot featuring a purported tale of woe.
"Why aren't Democrats taking this simple approach to defending Obamacare?" asked Slate.com in a recent headline.
It's a good question, but the answer is that the approach isn't all that simple.
"This is a difficult environment to sell this product," says Robert J. Blendon, an expert on policy marketing at the Harvard School of Public Health. "There's lots of anti-government feeling; the IRS is at the lowest point in its public standing, and people are asking if it's going to be checking up on them. People are very cynical."
Indeed, Rizzo says that when she tries to tell her story online, including through items on the Huffington Post, "I hear in response, 'You're a media plant' or 'You're an Obama plant' or 'You're not a real person.' I've heard some really crazy stuff."
The botched rollout of HealthCare.gov last fall made the marketing task even harder in two ways. First, it played into the opponents' "master narrative that government can't do anything right, that it's too intrusive in our lives," in the words of Andy Goodman, co-founder of the Goodman Center, a Los Angeles organization that advises nonprofits on how to get their messages out.
Second, it prompted the Affordable Care Act's supporters, including insurance companies, to defer their own pro-Obamacare advertising campaigns until the website could be fixed. The rationale, reasonable enough, was that there was no point in encouraging people to sign up for insurance as long as the enrollment portal was sealed shut.
But the delay in getting the website operating was a gift to opponents, whose anti-ACA ads ran unchallenged for weeks. "The opponents were able to get out the doubt early," Blendon says, "and once people form opinions, they're very hard to change."
Other factors make telling a positive story harder than a negative one. Of course, there's the news media's constitutional preference for stories of pain, suffering and conflict over sweetness, light and good cheer.
Also, when a program is aimed at changing the status quo, it's always easier to undermine the effort by identifying its problems rather than to promote it by playing up its goals.
"If you want to show something is flawed," Goodman says, "you just have to point out one flaw." Against that argument, supporters of the Affordable Care Act would have to make the case that it's perfect — and nothing ever is perfect.