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The highs and lows of selling Obamacare


This post originally appeared on Slate.

Like all retailers, the president is rolling out a big post-Thanksgiving sale. With the healthcare.gov website up and running on Cyber Monday, he's launched a three-week campaign to save Obamacare. On Tuesday he began by trying to remarket the product, touting the Affordable Care Act's broad benefits and reminding people why he went to all this trouble in the first place. "For too long, few things left working families more vulnerable to the anxieties and insecurities of today's economy than a broken health care system," Obama said. On Wednesday the president explained how the health care law fit into his effort to resuscitate the American dream for the middle class, a project he's been grinding away with mixed success since his 2007 campaign. Then, at a second Wednesday event, the president attended a White House Youth Summit to push up health care enrollments. This is part of the nitty-gritty of convincing enough young, healthy Americans to participate in the federal exchanges so that the insurance pools aren't glutted with older, sicker Americans, driving up premiums. No soaring rhetorical heights here; this is the earthbound task of trying to make the law work. On Thursday evening, the president sits down with MSNBC's Chris Matthews at American University to pitch to that younger audience again.

These are the highs and lows of what it means to be President Obama right now. One minute he is speaking about the sweep of history, and the next he resembles a late-night television pitchman. In advance of Obama's Wednesday Big Theme speech, the president's aides were advertising it as an echo of the self-consciously grand one the president gave two years ago in Osawatomie, Kan., which itself was an echo of Teddy Roosevelt's "New Nationalism" speech delivered in the same spot 100 years ago. For presidents, the topics don't get much bigger than the American dream or much more vital than correcting the disparities between the rich and the poor. This is oratory that requires a pretty line or two. But if the president actually wants to achieve his dream of improving the economic condition of millions of Americans, it's going to happen through the plodding business of bringing Americans into his health system one at a time. He doesn't need to move people to tears; he needs to move your 27-year-old son Joey to get off the sofa, open his laptop, and buy insurance.

This sprint for enrollees explains why the White House is launching its public relations campaign before the system is fully functional. Despite claims last week that the website would work as intended for the vast majority of people, insurance companies are still complaining that they are getting faulty information. If that's the case, then the website patches are supercharging an existing flaw and swamping insurance companies with more bad information. That loose-stitching would suggest caution in any private enterprise, but the administration is under political and operational pressure. They have to show that the site is working, and they have to increase the number of people picking plans to make up for the two months when enrollment was not up to the pace required to make this grand experiment fly.

But if everything rides on the president inspiring Joey, things don't look good. A poll released Wednesday from Harvard's Institute of Politics showed just how wary young Americans are of Obamacare. Fifty-seven percent of millennials disapprove of it. By a 5-1 margin they believe that health care costs will increase, and by 2-1 they think the quality of their care will worsen. Among 18- to 29-year-olds currently without health insurance, less than one-third say they're likely to enroll in the Obamacare exchanges. "It almost seems to me that it's almost cool to be opposed to health care reform," says John Della Volpe, director of polling at the Institute of Politics.

President Obama's approval rating is 41 percent among younger voters, down 11 points. But the bigger problem with selling health care reform to younger Americans is that the pitch is coming from a distrusted institution: the government. "Not only do you have a questionable product, but it's being 'sold' by a questionable institution where there is less trust today than there was yesterday," says Della Volpe. This is why the administration has tried so hard to sell the law though social media and sports and entertainment figures.

Despite these hurdles, convincing younger, healthy Americans to sign up is the most promising path the president has to meeting any of the goals of his larger economic vision for the middle class. His other routes are stalled. The president has a number of policy proposals he says will help Americans: early childhood education, raising the minimum wage, pouring more money into education and training. These and other initiatives aren't moving in Congress, no matter how many speeches the president gives. By contrast if younger Americans sign up, the Affordable Care Act will survive, and if that happens, it will benefit millions of Americans who have been on the losing side of an economy where incomes have flat-lined and where 95 percent of the income gains since the recession have gone to the top 1 percent.

For a president with low approval ratings and little hope of making progress with congressional Republicans, the prospects for new achievement are bleak. But that doesn't mean he can't get something done. The one law that can do the president the most good has already passed. Now he just needs to sell, sell, sell.

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