Health care sales pitch; Insurance now a must.

Byline: John J. Monahan

As the state's groundbreaking new mandatory health insurance law takes effect today, marketing programs by health care insurers and providers competing to sign up hundreds of thousands of people that currently have no insurance have moved into full swing.

Their sales pitches are backed by strong messages from state health insurance officials that those without insurance may, come January, face the first phase of tax penalties that back up the mandate. Consumers, meanwhile, are being asked to sort through an expansive menu of available insurance plans and prices to choose an insurer.

State officials implementing the law through the Massachusetts Health Care Connector Authority emphasized, as the July 1 implementation date approached, that they view the first six months of the law as a "grace period" during which uninsured people should study their options and make plans to begin paying for health insurance.

"There's just been a tremendous amount of activity out there" in the marketplace, said Fallon Community Health Plan spokesman Robert F. Nolan Jr. He noted the extensive news coverage, public service education campaigns, advocacy by community health groups and insurance brand advertising unfolding around the implementation date.

Besides Fallon, plans certified by the state as meeting minimum coverage are being marketed in Central Massachusetts by Neighborhood Health Plan, Harvard Pilgrim Health Care, Blue Cross Blue Shield of Massachusetts and Tufts Health Plan.

A state Web site, MAhealthconnector.org, allows people to directly compare insurance plans and benefits, and each provider has detailed information about its products on its Web site; information is also available by telephone.

Sharon Torgerson of Harvard Pilgrim said that company is using radio spots and targeted marketing to "drive people to our Web site or to call us." The company has a dedicated phone line for new health insurance plan inquiries.

Ms. Torgerson said the company is highlighting low-cost plans for young adults, which are allowed under the new reform law for those 19 to 26 years old with premiums as low as $106 per month. It is also using e-mail marketing and encouraging people to use the state connector authority's Web site to comparison shop.

Harvard Pilgrim's marketing also highlights availability of fitness club reimbursements, savings on eyewear, massage therapy and Weight Watchers.

Mr. Nolan said Fallon has upped its advertising budget substantially for its marketing effort.

"We've had print and radio ads out there inviting folks to call our 888-PWR-FCHP line," he said, where a special unit established for the new health reform products can answer individual questions and provide information about prices, plans and the expanded levels of insurance available as part of the reforms.

"We've been getting a couple of hundred calls a day," he said.

Detailed information on insurance and specific plans is also available on the Fallon Web site. Two postcard-type mailings to targeted groups of residents and a special mailing of the Fallon member magazine, with a special wrapper about the benefits the company's plans offer, recently were sent to 100,000 homes.

There were also television and radio spots in May and June focusing on the Fallon brand name and the community-based medical provider systems behind its plans.

At this point, Mr. Nolan said, those shopping for insurance seem to be valuing a chance to speak to a knowledgeable representative to ask questions and get direct answers over the phone. "We have put a lot of emphasis on the human touch," he said.

He said the promotions and marketing have been in high gear since May and will likely peak late in the year as the penalties loom larger for uninsured consumers. "We expect it to continue at a certain level, and we are also anticipating a fourth-quarter push as people recognize there are some financial issues to do with the personal exemptions."

The state is spending $3 million on its own public education media blitz, with hundreds of spots running between innings of Red Sox broadcasts that promote the need for the uninsured to get covered; kiosks with information are also being set up at supermarkets, banks and drug stores around the state.

A recent consumer survey by the Harvard School of Public Health, with funding from the Blue Cross Blue Shield of Massachusetts Foundation and the Kaiser Family Foundation, found increasing support for the new health reform law as people have learned more about it.

That survey of 1,003 residents between May 29 and June 10 was conducted by the Harvard School of Public Health. It found that 67 percent of people who had heard of the state health reform law supported it while 16 percent opposed it. While 52 percent said they specifically supported the individual insurance mandate in a similar poll last September, 57 percent said they support the mandate now, with 36 percent opposed to it.

Drew E. Altman, president of the Kaiser Family Foundation, an independent charitable foundation supporting universal health care, said the results were encouraging.

"Given reports of sticker shock and ongoing debate about the law, we might have expected overall support to fall. But, in fact, support is widespread and has gone up," Mr. Altman said of the survey findings. "If Massachusetts succeeds, it will have a big impact on the momentum for national health reform," he said.

Robert J. Blendon, professor of health policy at Harvard School of Public Health, said the survey revealed some areas of public concern and a level of acceptance of the overall reforms that surprised him.

"Because there have been a number of problems and debates over pricing policies and the benefits" of the minimum insurance plans required, he said, "we were not sure how positive or negative people in the state would be at this stage." He said he was somewhat surprised that the individual mandate remains the most controversial issue. But, he said, "it still holds majority support."

He said the survey also showed that many people are still unsure when they have to obtain insurance. While the law says they must have insurance by today, unless they fit into a narrow group of 60,000 or so for whom insurance has been deemed unaffordable, the grace period for penalties will advance the penalty deadline to Jan. 1, 2008, for enforcement when taxes for 2008 are filed in 2009. "Very few people knew when they would actually have to have it and were not clear at all when they had to enroll without facing a penalty," he said.

The survey also indicated worry about introduction of plans in the state for those who are not eligible for subsidized insurance, plans that have high deductibles. He said those kinds of plans were not allowed in the state in the past and consumers are not familiar with the lower insurance levels they offer.

"I think this will be a continuing issue in the state," Mr. Blendon said. "How do you get a plan affordable without subsidies, where the deductibles don't look worrisome to people?"

The survey, he said, showed some consumers are surprised to learn how much of their medical care they will have to pay for with a high deductible plan. "There was a bit of benefit shock for people who thought they should be getting closer to first-dollar coverage," he said.

Noting numerous calls at the national level for universal health coverage among Democratic candidates for president, Mr. Blendon said, "The lessons learned here will have enormous significance."

"This is the real underpinning for all these candidates saying they can do all this" as the state actually implements what remains just a hope for future action at the national level, he said.

Contact John J. Monahan by e-mail at [e-mail].