The state agency guiding President Barack Obama's health care overhaul, Covered California, faces a monumental task to reach millions of people without insurance and sway them to sign on, while overcoming geographic, language and cultural barriers.
Nationwide spending on publicity, marketing and advertising to promote the health overhaul could hit at least $684 million, according to data compiled The Associated Press from federal and state sources. About one in four of those federal dollars will be targeted for California, or more than $174 million, according to the AP review.
Additionally, the California Endowment, a private health foundation, expects to spend $130 million of its own money for ads and other enrollment efforts aimed largely at Hispanics, in a campaign coordinated with the state.
"Like most public programs that have been tried in California, this could fail on the difficulty in doing outreach and enrolling people," California Endowment spokesman Daniel Zingale said.
With food stamps and other programs that help lower-income people "we have a terrible track record in this state on public-program enrollment," he added.
With at least $86 million earmarked for ads, Covered California is counting on global marketing firms to get the job done: Weber Shandwick and Ogilvy Public Relations. According to Covered California, ads will appear in multiple languages on TV, radio, newspapers, billboards and social media.
Weber Shandwick, which is managing the ad campaign, is expected to earn $12 million in fees over two years. Ogilvy's contract for public relations is pegged at $18 million.
Stanford University political scientist Bruce Cain said he was unaware of any comparable effort to sell a government program to a hard-to-target population in the state.
"The really important selling job will be with younger, healthier voters who are going to get hit with the (insurance) mandate on top of a really bad job market. Many may opt to pay the fine rather than enroll, and that could throw things off massively," Cain said in an email, referring to the government penalty residents could face if they refuse to enroll in health insurance.
About 16 percent of Americans are uninsured. An estimated 2.3 million state residents will enroll in a health plan through Covered California by 2017, according to the agency.
Open enrollment begins in October, with the health care exchanges in full operation by January.
California's per-capita ad and public relations spending, $4.68, is among the highest in the U.S., the AP review found. Twenty-one states have budgeted less than $1 in per-capita spending.
The goal is to make sure the message gets out to potential enrollees, whether they are "at work, at home or in the car," Ogilvy project manager Kevin Slagle said.
The program also will have to overcome public skepticism at a time when polls show most Americans have a dismal view of Washington and are unaware of how to approach the health care reforms.
"If the government said Bassett hounds have long ears, people would take out their rulers to check it out," said Jack Pitney, a political scientist at Claremont McKenna College.