Ad Audit: Health Insurers’ 30 Second Pitch On ‘Bipartisan’ Reform

AD TITLE: “Illness”

SPONSOR: America’s Health Insurance Plans

SUMMARY: The nation’s largest insurance industry group supports “bipartisan reforms” and “universal coverage,” according to this recent ad, but the commercial doesn’t provide policy specifics about what these statements mean.

BACKGROUND: America’s Health Insurance Plan’s seven-figure ad campaign began airing July 20 and will continue until the end of the week. The new ad, “Illness,” was produced by the strategic communications firm Purple Strategies, which includes among its principles GOP strategist Alex Castellanos and Democrat Steve McMahon. Airing nationally on cable networks, the commercial is meant to “tell the American people that the insurance industry is stepping up to do its part for health care reform,” said Robert Zirkelbach, AHIP’s spokesman. It takes a strikingly different tone than the Harry and Louise ads, also financed by insurers, that helped cripple President Clinton’s reform attempt in the 1990s.

SCRIPT: “Illness doesn’t care where you live…or if you’re already sick…or if you lose your job. Your health insurance shouldn’t either. So let’s fix health care. If everyone’s covered, we can make health care as affordable as possible. And the words ‘pre-existing condition’ become a thing of the past…. We’re America’s health insurance companies. Supporting bipartisan reforms that Congress can build on.”

VISUALS AND SOUND: Somber, tightly framed portraits of worried Americans are juxtaposed with scenes of where they live: a “white house on an average American street,” urban “brownstones” and a “single family home,” according to the script’s visual instructions. Inspirational music plays in the background. The sepia-toned montage is interrupted by a white screen with the words, “Let’s Fix Health Care.” The music’s tempo builds. The message gives way to full-color images of optimistic-looking people, including a fireman, a young man in a wheel chair with friends walking nearby, and a family of four sitting on a stoop.

POLICY AND POLITICS: The ad isn’t specific about “bipartisan reforms” but AHIP has taken some detailed policy positions about a health care overhaul. It has repeatedly and vociferously stated its opposition to any government-run insurance plan, and has pressed Congress to avoid taking steps that it says could hurt the employer-sponsored insurance market. On the individual market, AHIP has agreed to guarantee coverage even to people with medical problems, and not to charge them higher rates. But that commitment is contingent on Congress requiring everyone to have insurance, which would bring the industry millions of new customers.

Also, the proposals before Congress still would allow insurers to continue to charge some applicants more than others. But instead of charging more based on medical status, insurers could continue their practice, called “age rating,” of charging older people more than younger ones. Some of the proposals would restrict the practice so that older people couldn’t be charged more than twice as much as younger ones. But in a letter last week to leading House Democrats, AHIP asked Congress to widen the ratio, using five-to-one as an example. That prompted Karen Pollitz, a Georgetown University researcher, to call AHIP’s proposed concession to stop rejecting sick applicants “a subterfuge” meant to distract attention from age rating. Insurers will be able to use age as a “proxy” for health, Pollitz said, and dissuade applicants they don’t want, mainly older ones, through higher prices. AHIP’s Zirkelbach responded, “No longer rating based on health status… has broad support. … People are concerned that they won’t be able to get insurance if they lose their job.” Using age-rating instead will make insurance more affordable for more people, he said.

AHIP has spent $3.9 million on lobbying so far in 2009, representing only a small uptick compared with the same period last year. AHIP kept a seat at the negotiating table by agreeing to work with leading health trade groups toward reducing the growth of health care spending by $2 trillion in 10 years.

This pledge combined with the tenor of the ad and the relatively modest lobbying effort, suggests the insurers’ group will hold its fire on Harry-and-Louise-style attacks of the past, so long as things continue to go the industry’s way. But experts agree the ad will remind politicos: The insurers are watching.