This article was originally published by Kaiser Health News.
Politically, Sens. Rob Portman, R-Ohio, and Mark Warner, D-Va., are not all that far apart. Both are moderates who rejected proposed cuts in Medicaid funds. And yet, in the highly polarized atmosphere of Washington, D.C., they find themselves rallying constituents along diametrically opposed positions.
The dialogue has become President Barack Obama’s Affordable Care Act versus a new GOP bill, called (for now) the American Health Care Act. A love-it-or-leave-it mentality pervades both sides. As angry voters at town halls express their concerns about the state of American healthcare, the senators are reaching out for patient stories to prove their respective viewpoints.
“Let Me Know Your Obamacare Story” Portman’s website asks and—from the introduction—he’s in search of a particular narrative.
“President Obama’s big government healthcare bill was supposed to bend the cost curve down,” Portman’s message reads. Instead, it goes on, the average Ohioan with a healthcare plan obtained through the ACA pays “nearly an extra $100 a month” in premiums.
“That’s money that could be going toward retirement, groceries, and their children’s higher education; instead it’s going to cover President Obama’s costly mandates,” the website says.
Portman could play a particularly pivotal role in shaping the Senate’s healthcare bill because he is a member of the 13-member working group that Majority Leader Mitch McConnell, R-Ky., tasked with writing the first draft.
Warner is in search of a different kind of tale. “Share Your ACA Success Story,” a solicitation that’s been on his website since late February, just weeks after the GOP took control of the House and made repealing the ACA a top priority.
“Help me make the case against repealing the Affordable Care Act,” it states. “Since its enactment, the Affordable Care Act (ACA) has helped millions of Americans gain comprehensive health coverage to protect themselves from life’s many unexpected events.” It cites lower rates of uninsured Virginians.
Portman and Warner are operating in different realities. In Portman’s world, the ACA has failed; in Warner’s, it’s a huge success. “On particularly high-profile issues like this, the parties are coming from different places and speaking to predominantly different constituencies,” said Elizabeth Rigby, an associate professor of public administration and public policy at George Washington University in Washington, D.C. “The idea [that] Rob Portman begins with his assumption and Warner goes to his is actually a pretty understandable dynamic in our current polarized climate.”
Neither senator’s office responded to KHN’s requests for comment.
There is no mystery about human stories’ effectiveness in shaping opinions and helping win debates.
“The stories will usually paint the picture of situations that the audience can empathize with, or see themselves in, or that someone they know has experienced,” said Paul Achter, who chairs the rhetoric and communication studies department at the University of Richmond in Virginia.
One famous example occurred in the early 1990s when health insurers created a memorable advertising campaign about a fictional couple named “Harry and Louise,”whose griping about their medical bills helped sink the Clinton administration’s healthcare overhaul. In 2009, the couple returned in a new campaign sponsored by drugmakers and a healthcare advocacy group to support President Obama’s healthcare plan.
But the notion that the “real” patient stories featured in debates and advertisements reflect constituents’ reality is highly questionable. One Portman constituent, Sarah, complained that she’d sent the senator an email telling him she was dissatisfied with Betsy DeVos’ nomination to be Education secretary, only to receive “robo email” asking if she had any stories of bad experiences with the ACA.
“I almost lost my mind,” she said. An ovarian cancer survivor, Sarah responded to Portman’s email solicitation saying she was grateful for the Affordable Care Act because she no longer worried about her preexisting condition.
“I know you were hoping for an ‘I hate Obamacare’ story, but you won’t get that from me,” she wrote.
Both senators have effectively weaponized their constituents’ stories on the Senate floor. In January, Portman harnessed the power of personal experiences to illustrate problems that he said his constituents have had with the healthcare law.
“There’s a family of five that wrote to me after the cost of his family’s insurance doubled. Another man saw his $100 deductible soar to $4,000 while his premium hit $1,000 a month,” Portman said. “Again, these folks just can’t afford it.”
Warner played the same card in a February speech opposing Tom Price’s nomination as secretary of Health and Human Services. He spoke of an organic farmer in his state who had relied on an Obamacare plan to get healthcare for her family.
“The coverage gains we’ve seen are remarkable, that’s clear from hundreds of Virginians who’ve contacted me with stories,” Warner said.
But in a highly divided electorate—Americans were evenly split over the law in April, with 46% reporting they supported it and 46 percent saying they didn’t—such heartwarming stories may be pushing people apart, rather than pulling them together.