On October 1, Americans will be able to buy health insurance at the government-run exchanges created by the Affordable Care Act. However, even though the legislation passed three years ago, that's still a tight deadline: More than four in 10 people aren’t even sure that Obamacare is law.
"Really, we’re starting from negative in trying to get people enrolled in health care. We’re starting from less than zero," says Ben Stein, co-founder of Mobile Commons (and not that Ben Stein). Stein’s company is fighting ignorance about Obamacare with a technology many people use every day: the text message.
Mobile Commons’ product is essentially a library of tested text messages, called Enroll, along with a software platform for sending them that’s already been used by the Obama campaign and the nonprofit Mayors Against Illegal Guns. The customers for "Enroll
America" are organizations that want to get people insured, including insurance companies, nonprofits, and the exchanges themselves.
The idea came to Stein this spring, when he came across some striking data. "I started looking at the population who is going to benefit the most from the Affordable Care Act," says Stein. The demographic groups he pinpointed were young people, minorities, and underserved communities. "I said, ‘I’ve seen these graphs before,'" says Stein. They were the populations most likely to use text messages.
But the advantage of the medium isn’t just familiarity. It’s also simple enough to allow for easy automated responses, a back-and-forth that would become overwhelming if you used email. (Consider: Have you ever written back to a campaign email from "Barack Obama"?)
But will it work? Stein points to studies showing that text message reminders helped patients remember to take their HIV medication, quit smoking, and find the nearest flu shot. But he admits that educating people about insurance will take more than just nudging.
"Insurance is incredibly complicated, and there’s no way to explain everything and really get someone to their optimal plan via text messaging," says Stein. He sees text messages, instead, as a tool to provide basic facts—the law exists, if you don’t buy insurance you’ll pay a fine, these are the documents you’ll need to buy it, etc.—and lighten the load for the small army that will be doing outreach and fielding questions come October.
In the end, like the health care exchanges themselves, we won’t really know if it’s working after October 1st. "We need to actually be testing what’s working," says Stein. "This is something that’s never been done."