Since the Affordable Care Act (ACA) was passed in 2010, its opponents have spent an estimated $450 million on political ads attacking the law, according to Kantar Media's CMAG, which analyzes spending on advertising. Supporters have spent a tiny fraction of that amount. Kantar says opponents have outspent those who favor the law by 15 to 1.
While those attack ads likely cost some Democratic members of Congress their jobs in 2012, a new report indicates that, crazy as it sounds, those ads may have contributed to the success of the health care legislation this year.
The Obama administration had hoped that at least seven million Americans would sign up for coverage on the federal and state health insurance exchanges during the six-and-a half-month enrollment period that ended in April.
Because of the difficulty most people had with the exchanges' websites last fall, that goal seemed unattainable. But as those problems were resolved, the enrollment numbers rose steadily. By mid-April, more than eight million people had signed up.
Last week, a researcher at the Brookings Institution released a report suggesting that all those negative ads actually helped the Obama administration blow past its enrollment projections.
After analyzing the negative spending and ACA enrollment on a state-by-state basis, Brookings Center for Technology Innovation Fellow Niam Yaraghi found a striking, counterintuitive correlation: there has been a positive association between anti-ACA spending and ACA enrollment in many states. It turns out that the more negative ads people were exposed to, the more likely they were to enroll in a health plan.
It seems that P.T. Barnum's maxim -- "I don't care what they say about me as long as they spell my name right" -- is at work here.
After controlling for state characteristics such as low per-capita income population and average insurance premiums, Yaraghi said he found a positive association between the anti-ACA spending and the ACA enrollment.
"This implies that anti-ACA ads may unintentionally increase the public awareness about the existence of government-subsidized service and its benefits for the uninsured," Yaraghi wrote in his report, "Have the Anti-Obamacare Ads Backfired?"
Perhaps not surprisingly, the four states with the highest per capita spending on anti-Obama care ads so far are Kentucky, Arkansas, Louisiana and North Carolina, where hotly contested Senate races are underway. Senate Majority Leader Mitch McConnell, R-Ky., is hoping to hold on to his seat while Democrats Mark Pryor of Arkansas, Mary Landrieu of Louisiana and Kay Hagan of North Carolina are facing serious re-election threats.
The balance of power in the Senate could be determined by the outcome of those contests. In at least two of those states -- Arkansas and Kentucky -- enrollment in Obamacare plans exceeded expectations. Although Yaraghi said that the negative ads had the most positive impact in terms of enrollment in blue states, there were impressive gains in several red states in addition to Arkansas and Kentucky.
His findings were consistent with another state-by-state analysis released last week by the personal finance social network WalletHub, which looked at the rates of uninsured in each state before and after Obamacare. WalletHub found that nationally, the uninsured rate has fallen 3.66 points, from 17.87 percent before Obamacare to 14.22 percent now.
WalletHub found that the biggest changes for the better were in a mix of red and blue states. Arkansas's uninsured rate decreased 7.10 points, Kentucky 8.35 points, Rhode Island 8.73 points and Oregon 10.54 points. Red West Virginia saw its rate drop the most: 10.74 points.
Yet another study, this one by the Kaiser Family Foundation, which tracks public opinion on the ACA every month, found that in June, more Americans said their opinions of the law were based on their own experience or that of their family and friends than on what they've heard in the media. KFF president Drew Altman wrote in a Wall Street Journal column last Tuesday ("Why the Political Heat on the ACA is Cooling") that the enrollment success and changes in public opinion -- and the decline in media interest in Obamacare -- seem to be contributing to a change in the tone of Congressional campaigns.
"Some Republicans seem to be shifting their midterm strategy to focus less on the ACA and more on other issues they have with the president and the direction of the country," Altman wrote.
That could change, of course. Obamacare likely will be back in the headlines when health insurers announce their rates for 2015 a few weeks before the November elections. But as more time goes by, running against the law will diminish as a winning strategy.