To: Senate Democratic Caucus From: DPCC Re: Going on Offense on the Affordable Care Act

Republicans have made it clear that they intend to continue their series of targeted strikes against the Affordable Care Act (ACA) as part of their efforts to repeal the law and go back to the days when insurance companies were in charge, fine print put millions of Americans at financial risk, and insurers could deny coverage to children with pre-existing conditions, charge women more than men, and run up premiums. In order to counter their efforts, the DPCC has compiled some messaging ideas to highlight the benefits of the Affordable Care Act and generate positive press and social media coverage.

Guidance

The Affordable Care Act (ACA) is already working to bring down health care costs and offer affordable coverage to millions of Americans. Health care spending is growing at the slowest rate on record, and at just 1% health care price inflation is the lowest it has been in 50 years.

Despite the fact that fewer than 6% of Americans are in the individual market, and even most of them will qualify for financial help to buy new policies, Republicans have focused attention on the small minority of those who have had negative experiences as part of their campaign to undermine and repeal the law. There are actions Democrats can take to address the Republican attacks and go on offense.

First, the most effective way to counter the Republican efforts is to highlight the positive stories of Americans who have successfully enrolled for affordable coverage through the Health Insurance Marketplaces. Nearly 27 million people have shopped for health insurance online, and from the end of October through mid-November the number of people who have enrolled has nearly doubled.

Democrats need to find their stories in each state and aggressively publicize them so that people can see the law is delivering on its promise. That means inviting constituents to share their stories through e-mail, office websites, or through conversations with caseworkers.

Second, we cannot let people forget the good that the ACA is already doing for millions of Americans. Using social media and direct outreach with our allies in the advocacy community, we must continue to identify news stories about the ACAs successes and connect with the 105 million Americans who no longer have to worry about the financial threat of lifetime caps, 17 million children with pre-existing conditions who have gained coverage, and three million young adults have been able to stay on their parents policies. Their stories will provide us with the ammunition we need to rebut Republican claims that the law isnt working.

Next, once weve collected these stories, we need to aggressively publicize them so Americans can see that the ACA is delivering on its promise. That means sharing stories with local media, and launching online campaigns on Twitter and Facebook highlighting the people in your state who have obtained coverage. Working together with the White House over the next few weeks, Democrats can stem the tide of Republican negativity with our own ACA success stories.

The problems with the Healthcare.gov website are not acceptable, and we should continue to aggressively press the President to fix them. While that process is under way, another action Democrats can take is to help their constituents enroll in a health insurance plan by promoting alternatives to the website and helping individuals find local, in-person assisters who will walk them through the shopping process and help them obtain coverage.

And finally, we must also continue to create a clear contrast with Republicans, who are so obsessed with the ACA that they were willing to shut down the government and threaten our economy just to try to stop it. 58% of Americans still want the ACA to work, and repealing the law remains unpopular. Democrats can continue to drive this contrast by highlighting the local consequences of repeal on seniors, families with children who have a pre-existing condition, and others who would lose the protections the law provides.

Five Action Items

1. Collect Stories of People Who Got Covered Under the Affordable Care Act

The most effective messengers to rebut negative stories promoted by Republicans will be those who have successfully used the Health Insurance Marketplaces to get health insurance they either didnt qualify for or couldnt afford before the ACA. We can use these stories to address Republican attacks head on. Some options for collecting stories include:

Dedicated E-mail Address: In order to collect stories, you may want to consider creating a dedicated e-mail address, such as gotcovered@senator.senate.gov, for constituents to submit stories and list the e-mail address prominently on your web page.

Casework Collection: Encourage your case work staff to keep a running log of people who contact your office with positive stories or who successfully receive your assistance.

Use an Online Web Form: Please let the DPCC know if you would be interested in using or promoting an online webform that will allow constituents to submit their stories and contact information. An example of such a form can be found on Get Covered Americas website by clicking HERE. The DPCC can work with interested offices to explore the establishment of such a site. Collected stories can then be shared with local media (with constituent permission, of course). They can also form the basis of a strong online campaign.

2. Collect Thank You ACA Stories There are millions of Americans who have already taken advantage of the laws consumer protections. Stories of families that had previously been unable to obtain coverage because of pre-existing conditions, no longer have to worry about lifetime caps threatening their financial stability, or seniors who are saving money on prescription drugs will demonstrate that the law is working and Republicans are wrong to push for repeal. These stories are out there millions of them and its up to us to publicize them. Options for building a library of stories could include going online on Facebook, Twitter, and other social media sites to ask individuals to share their positive stories. These invitations should provide prominent and specific details about the e-mail address, phone number, or website where individuals should submit their stories. You may want to create a generic submission address or designate a member of your staff as the story bank point of contact. Collected stories can then be shared with local media (with constituent permission, of course). They can also form the basis of a strong online campaign (such as the one described below). Sample headlines and tweet:

[SENATOR] STANDS WITH [STATE] FAMILIES WHO NOW HAVE HEALTH COVERAGE UNDER THE AFFORDABLE CARE ACT
Thanks to the Affordable Care Act, [Stateans]No Longer Have to Worry About Being Denied Coverage or Charged More for Pre-existing Conditions [Senator] Urges [Stateans] to Share Their Stories at ThankYouACA@[Senator].senate.gov Sample Tweet: Stacy can stay on her parents plan and keep her health coverage. Share your story at ThankYouACA@[Senator].senate.gov [link to Stacys story] 3. Launch a #GotCovered Online Campaign ACA advocates are using social media to promote the stories of people who have obtained affordable coverage thanks to the ACA and the Health Insurance Marketplaces. These stories are being organized using the hashtag #gotcovered, and are being amplified across the country. We suggest leveraging this ongoing campaign by having Senators meet with individuals who have positive ACA stories, and tweeting or facebooking a video or Vine of the conversation, or a photo with the Senator and individual holding a #gotcovered sign to show that the ACA is achieving its goal of expanding affordable coverage. Sample Tweet: Virginia #GotCovered and cut her monthly health insurance costs in half. RT to share her story! [link to photo or video] To maintain momentum behind positive stories, we also suggest creating a section on your website that features a new Got Covered Today story of an individual who has had a positive experience enrolling for coverage under the Affordable Care Act. These stories should be short and highlight the improvement in coverage. For an example, CLICK HERE to see a post describing the experience of a Colorado woman who no longer has to worry about losing her coverage if her job changes thanks to the Affordable Care Act. In addition to stories that you collect through your offices efforts, the DPCC can assist you in finding media reports and connecting with national organizations to identify positive stories and coverage.

4. Provide a Solution by Promoting Neighborhood Enrollment As the Administration continues to work on fixing HealthCare.gov, it is possible for individuals interested in purchasing health insurance to shop for coverage with the assistance of trained navigators and certified application counselors. To date, more than 19,000 assisters have been trained by the Centers for Medicare & Medicaid Services. Each assister undergoes a rigorous training process, including privacy training, and is tested to ensure theyre prepared to help you

enroll in the Marketplace. The White House recently published information promoting the use of assisters HERE. Options to promote neighborhood enrollment could include:

Enroll in Your Neighborhood Link: In order to publicize these options and continue to help people enroll, consider embedding an Enroll in Your Neighborhood link on our website that will allow individuals to find navigators and assisters near them.

Promote Neighborhood Enrollment Locations: Consider promoting the use of these facilities via newsletter, or hold a press conference at several locations to ensure that people know where to go locally to shop for and enroll in health insurance.

5. Release a Report on the Consequences of Repeal If Republicans succeed in their targeted strikes on the law, they would take away protections that say 17 million American children with pre-existing illnesses can no longer be denied coverage by insurance companies, 6.6 million seniors have saved on prescription drugs because of the donut hole fix, and 105 million Americans no longer have lifetime limits on their health coverage. The DPCC can work with your office to release a report that highlights Republican efforts to sabotage the law, the state-by-state impact of repeal, and local resources that can help individuals obtain coverage. The report could be released in a press conference featuring individuals who have already benefited from the consumer protections in the ACA. DPCC materials on ACA benefits can be found HERE. Sample headlines:

[SENATOR] UNVEILS REPORT REVEALING THE CONSEQUENCES OF REPUBLICAN PLAN TO REPEAL THE AFFORDABLE CARE ACT FOR [STATE] FAMILIES
Republican Repeal Would Mean Higher Costs, [x] Fewer Seniors Paying [y] More for Prescription Drugs, [x] Children With Pre-Existing Conditions Losing Coverage