STEVE INSKEEP, HOST:
Today is the deadline to sign up for health insurance under the Affordable Care Act, or at least to begin the process. Nationwide, more than six million people have enrolled.
DAVID GREENE, HOST:
This morning, we're zooming in on a single state: New Hampshire. Surveys in that state show the law is unpopular, yet enrollments for individual health care plans have greatly exceeded expectations. Here's NPR's Tamara Keith.
TAMARA KEITH, BYLINE: When Lisa Kerrigan heard people talking about the Affordable Care Act, it was never anything good.
LISA KERRIGAN: I had thought I was going to be hit with this huge bill every month, and I wasn't going to be able to afford it. You know, I've never been able to afford health insurance before, and I was really, really hesitant going into it.
KEITH: Kerrigan lives in Rochester, New Hampshire with her two young daughters. She's 25 years old and runs a daycare and pre-school called Where the Child Things Are.
KERRIGAN: I mean, I love what I do. It just doesn't pay very much.
KEITH: And it doesn't come with health insurance. This made Kerrigan the ideal target for a sophisticated campaign in New Hampshire aimed at getting people to sign up for coverage.
KAREN HICKS: Before we wrap up, we're going to get a draft of the survey, the post-enrollment survey, circulated.
KEITH: Karen Hicks is the project manager for Covering New Hampshire, which got federal funding to promote the law. Hicks is leading what has become a weekly war room meeting for the effort.
HICKS: We used all of the learnings from the last two or three presidential cycles and really applied it to this campaign.
KEITH: Hicks was a senior adviser to Hillary Clinton in 2008, and is a seasoned grassroots political strategist. She and her team used commercial databases to identify and target 50,000 households most likely to be uninsured. They did polling and focus groups to hone their message.
HICKS: And I remember being struck by this in the first set of focus groups that we did, was that we put the chart of financial eligibility in front of people, and you literally saw people sort of go from having their hands crossed, sitting back in their seat, to leaning in and looking, and then when they could locate themselves on the chart, it just changed the whole tone of the conversation.
KEITH: As a result, that chart showing affordability is on every brochure and piece of mail the campaign produced. The daycare manager, Lisa Kerrigan, saw one of those brochures. She had heard the website to sign-up process was terrible. New Hampshire is one of about three dozen states that chose not to create its own marketplace, so residents have to use the glitch-plagued HealthCare.gov. But she tried it on a whim, just to see how bad it really was. Less than an hour later, Kerrigan had signed up for a plan that cost her just $37 a month.
KERRIGAN: And I have a $170 deductible, which is nothing. And I have $5 co-pays and $10 prescriptions. It's wonderful.
KEITH: Kerrigan later agreed to have her story used in some of the marketing materials. And there are certainly people with less positive stories to tell, those who don't qualify for tax credits, or find their doctor or nearby hospital isn't in the network. Still, more than 21,000 people had chosen a plan as of the end of February, significantly exceeding the federal government's enrollment projections, but the state's success may come with an asterisk. Steve Norton is executive director of the New Hampshire Center for Public Policy Studies.
STEVE NORTON: One possible explanation is that health insurance costs are quite expensive here in New Hampshire, and the offerings on the exchange are less expensive.
KEITH: Meaning it's possible people who already had insurance traded their existing coverage for government-subsidized plans. That won't be clear for quite some time. Charlie Arlinghaus, president of the Josiah Bartlett Center and a critic of the law, is unimpressed by the New Hampshire's numbers.
CHARLIE ARLINGHAUS: A small state is easier to target.
KEITH: And, Arlinghaus says, New Hampshire is both small and homogeneous.
ARLINGHAUS: A state with fewer language barriers is easier to target, and a state with well-off consumers who are more likely to be aware of the law and the mandate is also more likely to sign people up.
KEITH: He points out you had some of the state's most qualified political professionals with a multimillion-dollar budget encouraging people to do something that's required by law, even if it remains an unpopular law. Tamara Keith, NPR News.
INSKEEP: Now, one reason for the law's continued unpopularity was trouble with the federal government's healthcare.gov website. Many problems have been fixed, but here we are on the deadline to enroll, and the site was down for several hours early this morning. Officials say it's been fixed.
NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.