Take a look at these numbers: Texas, where Gov. Rick Perry steadfastly refused to establish a marketplace, also known as an exchange, has 6.1 million uninsured people. Washington state has less than 1 million. But they will have the same amount of money for Obamacare outreach.A critical problem here is that the largest percentages of uninsured people are in states like Texas and Florida, so that's where the most outreach is needed, and where the funds are most stretched. Additionally, while the critical 19-29 age group would be likely to participate in the exchanges, that will only happen if they actually know they exist. Right now, only about one in four is aware that they'll have the opportunity to sign up this fall for insurance starting Jan. 1.
When the Obama administration handed out two sets of grants for exchange outreach and enrollment this month, Texas received a total of $20.8 million, according to the U.S. Department of Health and Human Services. Washington state, on the other hand, which established its own exchange and had therefore access to much more generous federal funding, will spend $20.4 million on its marketing efforts, according to state officials.
Or look at another state: Colorado’s entire population is smaller than Texas’s uninsured population, but Colorado is spending more money (more than $21 million) marketing Obamacare. [...]
HHS did award this month a $41.2 million contract to Weber Shandwick, a public relations firm, for a national marketing campaign—but that figure, intended to help reach roughly two-thirds of the country, is still dwarfed by what states like California ($290 million) are spending for their campaigns. The White House is also depending on non-profit organizations like Enroll America and Families USA to pick up some of the slack.
The other issue is that in a lot of these states, like Kentucky, what people are hearing about Obamacare is disinformation: You'll go to jail if you don't participate, or the government decided not to do the exchanges at all in this state, or it's going to cost so much you won't be able to get insurance, anyway. And in some of these states, legislatures have actually taken action to try to prevent the feds from doing effective outreach and education.
Estimates from 19 states suggest that Obamacare enrollments are going to exceed CBO expectations, but those huge enrollments are mostly coming from states like California that have set up their own exchanges, have the money, and have the desire to make this work. That'll help with the overall success of the law, but it's in the red states where it could fail, or at best flounder for a few years before catching on. Because if it can get a foothold, if it can operate relatively successfully in those states for a year or two, it will catch on.