Communicating in the Aftermath of 'Repeal and Replace'

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Today's effective communicators must be comfortable with change, learn how to anticipate it, and adapt messaging to key audiences. This was never more apparent than with the Affordable Care Act, where they were tasked with getting the right message to the right audience, at the right time.

Last year, news coverage on the ACA inundated Americans as Congress put forward an initiative to repeal and replace the healthcare law, but with no success. During the 2018 marketplace enrollment period, Americans experienced a dramatic shift in messaging — from the Obama administration, which had supported the law and encouraged people to “get covered,” to the Trump administration, which opposes the law and emphasizes where it falls short.

Because of this, fewer people were expected to sign up for coverage. Surprisingly, 8.8 million Americans did.

This could be because communicators anticipated and adapted.

See also: Former HealthCare.gov comms staffers fill in for the government with ACA campaign

Americans received clear and repeated messages, tailored for them through TV, radio, newspapers, social media, advertising, and healthcare.gov.

Today, the ACA remains law, but its future is uncertain. The new tax bill eliminates the individual mandate. Rules are being considered to make it easier to buy short-term insurance plans. States struggle to attract insurers.

Uncertainty and potential changes to the ACA will continue, as will the need to ensure that uninsured Americans, those renewing coverage, and healthcare workers are aware of potential changes ahead.

For communicators, this means constantly reevaluating how to best reach target audiences with clear, consistent messaging in the ever-evolving marketplace.


Brittney Manchester, a senior associate director for APCO Worldwide, was a senior adviser at the Centers for Medicare and Medicaid Services in both the Obama and Trump administrations



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