Source: Greenberg Quinlan Rosner

Client: Democracy Corps


Memo: Insurance Companies (PDF - 7 K)

Executive Summary

As the Congress moves to floor action on health care reform, we wanted to highlight some important language and narrative issues - both for producing more intense support and en-gagement and for moving swing-independent voters. This memo focuses on the salience of holding insurance companies accountable, by testing key parts of President Obama’s joint session address on health care reform through the immediate dial reactions of 50 independents and swing voters in Denver, Colorado, the night of the address.


Key Findings


  • Stories of rescission generate strong emotional responses, even among Republicans. Inprevious research, we have emphasized the need for progressives to build a narrative around taking power away from the insurance companies who boost their own profits by denying care when it is needed most, particularly as a means to boost intensity among supporters. But when Obama told the stories of two Americans who had suffered from the insurance industry practice of rescission and had their coverage canceled when they were diagnosed with cancer, he received a strong emotional response across the partisan spectrum. When Obama declared that these practices are “heart-breaking [and] wrong, and no one should be treated that way in the United States of America” we observed one of the largest spikes of the evening, particularly among Republicans whose rating shot from under 40 to nearly 70 on the 0 to 100 scale.
  • Insurance reform - “make the insurance you have work better for you” - spikes among Democrats and wins warm reaction across party lines. Much has been made, including by us, about the need for proponents of reform to clearly explain to those who have insurance how they stand to benefit from reform, with insurance reform being a central portion of this “offer” to the insured. In his speech, Obama did this explicitly and was rewarded for it. Arguing that his plan will “make the insurance you have work better for you,” the president noted that “as soon as I sign this bill,” it will be against the law for the insurance companies to deny coverage because of preexisting conditions or to drop coverage when you get sick. This caused the dials to spike up to 80 on the 0 to 100 scale, with Democrats approaching 90 and independents and Republicans in mid to high 70s.
  • “No one should go broke because they get sick” gives people a powerful offer in health care reform, gets a powerful response from Democrats and reaches all voters. Obama’s remarks on the need to put a limit on out-of-pocket expenses because “in the United States of America, no one should go broke because they get sick” (moral language that echoed his rhetoric on rescission about the un-American nature of citizens being left hung out to dry when they get sick) also generated an intense response across the board, especially among Democrats who, again exceeded 90 on the dials. What is particularly striking about this section of the speech is how closely the different partisan lines track each other. While Democrats have the most intense response, the Republican and independents dials rise in near unison over this entire section of the speech.
  • Independents have powerful reaction to forcing insurance companies to compete in an insurance exchange. Obama’s pledge to create an insurance exchange, “a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices,” also rates highly. In this section, Obama argues that the exchange will increase security by ensuring you have access to quality, affordable coverage if you change jobs or start a small business, and more important, it will make health care more affordable by giving customers “greater leverage to bargain with the insurance companies for better prices and quality coverage.” This causes the overall dial ratings to again spike to near 80. This section was likely one of the key reasons respondents shifted so strongly on the issue of competition and prices. Before the speech, these voters were split on whether Obama’s plan would “increase competition and lower prices for health coverage” (with 44 percent saying it would and 42 percent saying it would not). But after this shift, a full 74 percent said the plan would do just that (versus 24 percent who said it would not) - a 30-point shift, the largest we observed on any measure we tested.
  • Giving same access to health insurance as members of Congress provides powerful rationale and illustrates expanded choice and how the exchange works. It reaches a crescendo when the president notes that this is how Congress gets affordable care and that “it's time to give every American the same opportunity that we've given ourselves.” Perhaps most important here, this was the only time during the speech that the ratings from independents actually rose above those from Democrats.

Click here to read our full analysis on the groups.

Click the video link below to view the dials for this portion of the speech:


On September 9, 2009, Greenberg Quinlan Rosner and Democracy Corps conducted “dial groups” or real-time focus group analysis of President Obama’s address to a joint session of Congress on health care. The groups were comprised of swing voters in Denver, Colorado and were evenly divided among those who initially supported and initially opposed Obama’s health care plan, with an almost equal division between Obama and McCain voters. The testing con-sisted of two parts: First, participants were asked using a dial-meter to rank Obama’s speech in real-time, instantly gauging what he was saying on a 0 to 100 scale, with 0 being extremely negative and 100 being extremely positive. Second, participants rated Obama on a number of measures before and after the speech to see how the speech changed their opinions.