KHI News Service

Getting the word out about Obamacare

K-State extension will play a role in explaining the Affordable Care Act

By Mike Shields | June 24, 2013

The big push by federal officials to get the word out in the next few months about the Affordable Care Act mostly will bypass Kansas, but even in this generally anti-Obama red state there are organizations and community groups gearing up to inform the public about the new health insurance exchange scheduled to launch on Oct. 1.

“I think that there's a lot of misunderstanding about what the Affordable Care Act is and how it works and there's so much noise from a political perspective that people can't really focus on what it is they need to know” about it, said Roberta Riportella, a professor of community health at the Kansas State University Extension. “What we're going to try to do is cut through that noise.”

Riportella has been on the job at K-State for about three months and for at least the next several will be spearheading an effort to use county extension agents and faculty members to inform the Kansas public about the federal health reform law, particularly the new insurance exchange through which millions of Americans and hundreds of thousands of Kansans are expected to purchase their health coverage.

Dr. Roberta Riportella, the new Kansas Health Foundation Professor of Community Health for K-State Research and Extension.

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The extension is a long-trusted K-State institution with agents working in all 105 counties. They do all sorts of things to help people, ranging from counseling on best farming practices to helping seniors enroll in Medicare Part D drug programs. They teach 4-H kids to make jelly and other skills, give parents tips on home economics, and are the state’s most persistent crusaders against musk thistle and other noxious pests.

Extension role

Over the next several weeks, including as part of their annual training sessions in August in Manhattan at the K-State campus, the agents will be learning details of the Affordable Care Act and how to communicate its meaning to the people intended to benefit from it.

In at least one county, (Shawnee, home of Topeka), there will be as many as three extension agents working to get out the word.

They and their colleagues across the state will be trying to inform a public that still knows relatively little about the law three years after it was passed. A recent poll by the Kaiser Family Foundation showed that most Americans still don’t know much about the law commonly referred to as Obamacare.

“I think it will take a big educational effort and I don't expect everybody to get it by the deadline,” said Cindy Evans, a K-State extension agent who works in Shawnee County. “We'll just have to keep working at it and hopefully, if it turns out to be a good thing, people will tell their friends and family about it. It won't be just an agency like (extension) carrying the message. You’ll need community connections, churches and other groups letting people know.”

Each year for the past six, Evans said, she has worked one on one with seniors to help them enroll or re-enroll in the Medicare prescription drug program. But she said it would be impossible to work individually like that with people on the Affordable Care Act simply because of the thousands expected to use the insurance exchange.

'Keep politics out'

Sue Peterson has served for years as K-State liaison to the Kansas Legislature and she knows very well the revulsion the state’s elected conservative Republicans have for Obamacare. Gov. Sam Brownback campaigned for the job pledging to fight the law "every step of the way.”

“It was envisioned by the United States Congress when they passed the Hatch Act and Smith Lever acts, (that) research and extension would provide information to the public who needed or wanted information. The university, and research and extension provide unbiased scientific research findings or information to the public at large around the state,” Peterson told KHI New Service in an email when asked if she expected the university to face political repercussions at the Statehouse because of extension agents doing their jobs.

Evans said she didn’t want her efforts to be misconstrued as political.

“I think extension's role is going to be what it has always been — education,” she said. “I don't want to be political at all on this. I just want to keep politics out. People have feelings on both sides on whether they think it will work or cost the system too much. It’s not my role in extension to be political. My role in health literacy and senior health counseling, is to just accurately help people understand the law as it is today.

“I’m not trying to take a stand whether it’s good or bad,” Evans said. “My major area is family finance and people spend a lot of money on insurance and health care and I want to help. My role in family finance is to help them make a good financial decision and not be political.”

Marketing blitz?

Federal officials are preparing for a major public awareness campaign to be most evident in August and September that in some ways has already started. Today, for example, the U.S. Department of Health and Human Services announced a new website and a telephone call center in anticipation of the Oct. 1 exchange launch.

But the major focus of the marketing blitz by the feds and national health consumer groups is expected to be in states with high numbers of people without health coverage, including California and Texas.

Sheldon Weisgrau, director of the Health Reform Resource Project in Topeka, said he thought he and Riportella at K-State were about the only two people in Kansas currently working full time at informing the public about the Affordable Care Act, though others including some consumer advocates and officials at the Kansas Insurance Department were doing presentations in addition to their other responsibilities, as are analysts at the Kansas Health Institute, the parent organization of the KHI News Service.

A consortium of the state’s six health foundations, including the Kansas Health Foundation, which is a major funder of KHI, underwrites Weisgrau's work.

“I think at the end of the day the amount of money being put (by all groups) into outreach is helpful but grossly inadequate to the task,” Weisgrau said.

Weisgrau said that’s why he has focused his efforts on speaking to groups that interact routinely with people likely to use the exchange or as Riportella described her work “training the trainers.” Otherwise there would be no way to reach everyone expected to be touched by the law.

Poisoned well?

He said his job was made tougher because of the continuing and often inaccurate political rhetoric unleashed by the law’s opponents, including talk-radio commentators.

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“A lot of things people think they know about this law is wrong,” Weisgrau said. “It’s information fed through the political shouting over the last three years that aren’t true. This seems crazy, but I get questions all the time like: ‘Are we going to have to have tracking chips implanted in our arms?’ The well has been poisoned and we’re working from behind.”

Others said so, too, but in different words:

“People are just unsure what's happening,” said Ethel Schneweis, a K-State extension agent in Dodge City. “I hate to say it, but they're hearing all the negative stuff and hearing all the scary stories, which is what causes them to kind of freak out. They're scared of the unknown more than anything.”

Insurance company efforts

Weisgrau said he hasn’t seen it happen yet, but that he was hoping and expecting the state’s major medical providers and health insurance companies would soon get involved with their own public awareness campaigns since both those sectors have something to gain with more people signed up for coverage.

Mary Beth Chambers is a spokesperson for Blue Cross Blue Shield of Kansas, the state’s largest commercial health insurer and one of three companies certified to offer plans on the coming Kansas exchange. She said the company would have its own marketing campaign related to the exchange.

“We are still in the development stages of our efforts, but, yes, we will be actively involved in marketing and education,” Chambers said.

She said the company’s approach would be “two-pronged.” It plans to do “traditional” advertising as it does for its other plans, including direct mail.

“But we also recognize the need to and value of simply educating Kansas consumers about what they need to know about shopping in the Marketplace — from tax credits, to essential health benefits, no pre-existing conditions to the mandate to carry coverage,” Chambers said.

“To support those educational efforts, we plan to do some "town hall" type meetings throughout our service area and (we) will be enhancing our website with more consumer information and doing more media outreach. Our focus here will be much more on education and less on marketing.”

She also said the national Blue Cross association had an agreement with Walgreens to have “educational brochures and posters” carrying a Blue Cross logo “and very basic consumer information” at all the Walgreens drugstores across the nation during July, August and September.

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