Oops! Did Ads Opposing Obamacare Increase Enrollment?

Opponents of both the Affordable Care Act (ACA) and the Democrats who made it happen have spent mountains of money trying to turn Americans against the law. But in the process, one study shows, anti-Obamacare ads may have actually increased the number of people who signed up for health care plans.

In states that saw some of the highest anti-Obamacare spending, the more money that was spent on TV ads presenting Obamacare in a negative light, the more people signed up for coverage, according to Niam Yaraghi of the nonpartisan Brookings Institution in Washington, D.C.

Over the past four years, opponents of Obamacare have spent a whopping $418 million in TV ads opposing the new law, according to an analysis by the nonpartisan Kantar Media CMAG in May. The ratio of negative to positive ad spending on the law has been a massive 15-to-1.

The hostile ads may have been successful in turning public opinion against Obamacare, President Barack Obama and congressional Democrats. But they don't appear to have scared voters away from joining the compulsory health insurance scheme. Nationwide, more than 8 million signed up to buy health insurance over the exchanges in the initial enrollment period.

Yaraghi compared the enrollment rate of eligible people in each state with the amount of money spent on anti-Obamacare ads there. He then took into account important variables like per capita income and insurance premium rates. He found that in states with Democrats running for re-election in competitive races and therefore attracting the most spending to denigrate Obamacare—states like Louisiana, Arkansas and North Carolina—enrollment actually went up.

"I observe a positive association between the anti-ACA spending and ACA enrollment," Yaraghi wrote in his study, published Wednesday.

This wasn't true across the board, however. States with Republican Senate incumbents saw the opposite trend, with increased anti-Obamacare spending apparently leading to lower enrollment.

Still, Yaraghi wonders if the onslaught of advertisements may not have backfired by alerting people to the availability of affordable health care. "This implies that anti-ACA ads may unintentionally increase the public awareness about the existence of a governmentally subsidized service and its benefits for the uninsured," he wrote.

Yaraghi has a second theory too. "In the states where more anti-ACA ads are aired, residents were on average more likely to believe that Congress will repeal the ACA in the near future. People who believe that subsidized health insurance may soon disappear could have a greater willingness to take advantage of this one-time opportunity."