Administration doing lower-key outreach on health-insurance sign-ups Three months before the debut of HealthCare.gov last year, Hollywood celebrities huddled with President Obama at the White House over their plans to urge Americans to buy health coverage under the Affordable Care Act. The president took to late-night television himself to spread the word. And on the eve of the launch, an op-ed by the nation's top health official appeared in major newspapers across the country, proclaiming that "better options for better health are just a click . . . away." But now, as the second sign-up time arrives this weekend for Americans to buy health coverage through the law's insurance marketplaces, the administration's high-wattage 2013 sales campaign has given way to a 2014 strategy that is shorter, more targeted and lower-key. Last Friday afternoon, when Obama held a conference call with nearly 7,000 enrollment workers and volunteers nationwide, the session did not appear on his public schedule. And on Saturday, the opening day of what will be a three-month sign-up period this time, the president will be in Australia. This downshift partly reflects the fact that less federal money is available this year for advertising and other marketing of the health-care law. For their part, administration officials and their allies in this outreach work say research emerging from the exchanges" first year is teaching important lessons about which messages and messengers are most potent in motivating consumers to become insured. "We are doubling down on the things that worked," said Tara McGuinness, a senior White House communications adviser. Nevertheless, the more-tailored efforts to promote health coverage coincide with what will be, in some ways, a harder mission this year. In a series of videos released by Kaiser Health News, experts give advice ahead of open enrollment season. The health law's insurance marketplaces open November 15. Kaiser Health News The first year, the goal was simply to get people to sign up for coverage. This time, the administration has a dual mission: urging people to renew their insurance while trying to attract uninsured people who ignored the marketplaces last year. Groups that remain disproportionately uninsured, including Latinos and young adults, tend to be especially difficult to reach and to know relatively little about the insurance exchanges and the subsidies that are available. Meanwhile, the administration must try to build confidence in HealthCare.gov, the online federal insurance marketplace that faltered spectacularly at first. Federal health officials have since made considerable efforts to improve it. The first open-enrollment period of the insurance marketplaces, a central aspect of the health-care law, began in October 2013 and ran for six months, twice as long as the sign-up time that begins Saturday. The health plans are available to people who cannot get affordable health coverage through a job and to small businesses, which often struggle with high insurance rates. About three dozen states are relying on the federal exchange while the rest are running their own exchanges. After the rocky start last year of HealthCare.gov and a few of the state exchanges, the administration's "focus has been so much greater on . . . making sure the Web site works and all the mechanics of the experience works," said Ron Pollack, executive director of Families USA, a liberal consumer health group. "It has not been as emphatic in terms of the external outreach" to consumers. Lisa Hamler-Fugitt, executive director of the Ohio Association of Foodbanks, said she wishes there had been more public service announcements about the second open-enrollment period, particularly about improvements to HealthCare.gov. The food bank association is one of dozens of organizations across the country that have received federal grants this year to provide consumers with enrollment help in person at health centers and other community sites. The second round of "navigator" grants amounts to a little less than last year's - $60 million, compared with $67 million - even though these assisters need to work this year with new customers and returning ones. The amount of money for television, radio and digital advertising available to the Centers for Medicare and Medicaid Services (CMS), the agency overseeing HealthCare.gov, is less than half as much as last year, according to a senior administration official, speaking on condition of anonymity about figures that have not been made public. Last year, the agency bought television ads in individual markets with large concentrations of Latinos, young adults and other groups with large numbers of people who are uninsured. This year, the television advertising buys will be national, focused on networks such as ESPN and Comedy Central that young people tend to watch and events such as the Latin Grammy Awards, said Lori Lodes, communications director for CMS, which is within the Department of Health and Human Services. Administration officials said they made a strategic decision this year to mostly wait to draw attention to the exchanges until near to the time when people can enroll. "We do have limited resources," Lodes said, "and we really want to have that conversation with consumers when they are ready to have it." HHS Secretary Sylvia Mathews Burwell met with Philadelphia residents the day before Halloween and held two public events in Ohio on Thursday. She also did a Google hangout Tuesday with Latino bloggers. Four other members of the president's Cabinet are fanning out across the country through the weekend to try to get out the message to sign up. In contrast, in the weeks before the launch of HealthCare.gov last year, then-HHS Secretary Kathleen Sebelius traveled to Texas alone three times and to Florida five times - both states with large groups of hard-to-reach Latino residents. Administration officials said they have gained a more precise understanding about which messages are most effective. Some movie and sports stars will help again this year, but officials said it is now clear that such figures proved helpful mainly in alerting the public that the marketplaces existed. Their role was less useful in prodding the uninsured to buy health plans than were plain messages that the new coverage is affordable. Ann Filipic, president of Enroll America, a nonprofit group that works closely with the administration, said it also is clear from last year that many consumers cannot figure out how to buy insurance through the marketplaces without face-to-face help. So this time, part of Enroll America's focus, as well as the administration's, has been to cement ties with grass-roots groups that provide such assistance. That was the point of the president's conference call a week ago with 6,700 volunteers and organizations from all 50 states who will be working to educate people about the marketplaces and help them enroll through the marketplaces. First lady Michelle Obama is scheduled to hold two similar calls Friday, with outreach workers specializing in signing up young adults and with a group of doctors, nurses and other providers of care. Because of the way money is available under the health-care law, states that are running their own insurance marketplaces this year have more federal grant funds for outreach than most of the others. The grants are allowing California's insurance exchange, for instance, to sponsor a nine-day bus tour leading up to Saturday's opening day. Other states, however, will face special challenges this time. Maryland, for instance, has rebuilt a flawed computer system and will need everyone who got a subsidized health plan already to re-enroll in order to keep their financial help.