title: The Volume Of TV Advertisements During The ACA's First Enrollment Period Was Associated With Increased Insurance Coverage.
abstract: The launch of the Affordable Care Act was accompanied by major insurance information campaigns by government, nonprofit, political, news media, and private-sector organizations, but it is not clear to what extent these efforts were associated with insurance gains. Using county-level data from the Census Bureau's American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics. We found that counties exposed to higher volumes of local insurance advertisements during the first open enrollment period experienced larger reductions in their uninsurance rates than other counties. State-sponsored advertisements had the strongest relationship with declines in uninsurance, and this relationship was driven by increases in Medicaid enrollment. These results support the importance of strategic investment in advertising to increase uptake of health insurance but suggest that not all types of advertisements will have the same effect on the public.
authors.affiliation: Pinar Karaca-Mandic (pkmandic@umn.edu) is an associate professor in the Division of Health Policy and Management, School of Public Health, University of Minnesota, in Minneapolis.
authors.forename: Pinar
authors.initials: P
authors.lastname: Karaca-Mandic
authors.affiliation: Andrew Wilcock is a doctoral student in the Division of Health Policy and Management, School of Public Health, University of Minnesota.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wilcock
authors.affiliation: Laura Baum is project manager of the Wesleyan Media Project in the Department of Government at Wesleyan University, in Middletown, Connecticut.
authors.forename: Laura
authors.initials: L
authors.lastname: Baum
authors.affiliation: Colleen L. Barry is the Fred and Julie Soper Professor and Chair in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland.
authors.forename: Colleen L
authors.initials: CL
authors.lastname: Barry
authors.affiliation: Erika Franklin Fowler is an associate professor in the Department of Government at Wesleyan University.
authors.forename: Erika Franklin
authors.initials: EF
authors.lastname: Fowler
authors.affiliation: Jeff Niederdeppe is an associate professor in the Department of Communication at Cornell University, in Ithaca, New York.
authors.forename: Jeff
authors.initials: J
authors.lastname: Niederdeppe
authors.affiliation: Sarah E. Gollust is an associate professor in the Division of Health Policy and Management, School of Public Health, University of Minnesota.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Gollust
mesh_terms: D000328:Adult; D000329:Advertising; D019352:Censuses; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data; D008402:Mass Media / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act; D014481:United States
keywords: advertising; health reform; insurance coverage; uninsurance