The Most Popular Health Care Topics of Discussion

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Zignal Insights: Monitoring The Affordable Care Act

The Affordable Care Act (ACA) is one of the most prominent political issues in American politics. The statute, passed in March 2010, is a significant overhaul of the US healthcare system. The law established healthcare exchanges which opened for enrollment in October 2013 with several technological failures. The final enrollment date was March 31, 2014. The flawed rollout period only added to the controversy. The divisiveness of the ACA resulted in a surge of traditional and social media reporting, allowing us to capture a segment of modern American political discourse. THE RESULTS M E T H ODOLOGY Zignal Labs maintains consistent monitoring of many topics and sectors relevant to our business and strategic interests. One of the topics that we have followed with interest is the Affordable Care Act release and the conversation surrounding it. This particular issue is one of the most prominent in the American political system and warranted in-depth monitoring. We began our monitoring on January 17, 2014. Our search is made up of terms related to the Affordable Care Act, associated hashtags, and synonymous terms such as Obamacare. We added a second layer of Boolean search to capture the Key Issues surrounding the Affordable Care Act, such as Enrollment Numbers, Health Insurance Exchanges, and the Medical Device Act. During the course of the study from January to March 2014, there were 6.3 million mentions related to the ACA; the vast majority of mentions were via Twitter, with 4.9 million mentions during the study March was the month with heaviest traffic, at more than 2 million mentions Sentiment hovered around 50% regardless of the increase and decrease in total mentions; Kathleen Sebelius s resignation on April 10 caused the highest spike of negative sentiment in the conversation Obamacare was consistently the most widely used term in the debate, with nearly 5 million mentions Opponents and supporters used the dueling hashtags FullRepeal and GetCovered 2

On March 31, this rate more than doubled, reaching over 170,000 mentions throughout the day at an average rate of 7,134 mentions per hour. Total Mentions Chart for March 31, 2014 On April 1, total mentions gradually rose, with more than 175,000 mentions per day and maintaining an average rate above 7,000 per hour. The coverage at this stage was primarily surrounding the results and whether or not the Administration had reached its goal of 7 million people enrolled in the healthcare exchanges. Total Mentions Chart for April 1, 2014 Further, at 4:30 pm, the conversation again spiked when President Obama publicly announced that 7 million people had signed up using the healthcare exchanges enacted by the law. 3

The conversation focused on the Healthcare.gov website and sentiment was steady Healthcare.gov was consistently the most top issue becuase it had repeatedly crashed during the enrollment period and is a major source of information on the law. However, the second most talked about issues varied by month. Top Issues Sentiment In February, Individual Mandate became one of the top issues, because the Obama administration announced that the deadline to sign up for individual health insurance or be penalized had been pushed back until 2016. Top Issues with Sentiment during the month of February 2014 Enrollment Numbers became one of the top issues during the month of March because of the release of official enrollment numbers in health care coverage through the government exchanges. Top Issues with Sentiment during the month of March 2014 Overall Sentiment While sentiment went up and down, it hovered around neutral throughout the months. Sentiment reached its lowest level on April 10th. The stories about Secretary of Health and Human Services Kathleen Sebelius s resignation caused this increased negativity. Sebelius, who was in charge of the rollout of the ACA was also one of the most unpopular figures in the Obama administration. Historical Sentiment from January 17 through May 2014 4

As the March 31 deadline for enrollment loomed, the volume increased Healthcare.gov is a federal website that serves as a marketplace where individuals can compare health insurance plans, learn about available public subsidies, and sign up for coverage. March 31, 2014 was the enrollment date for the uninsured to purchase health insurance through federal healthcare exchanges. The month of February began with high traffic, but slowly began to decline throughout the month. The early high points of the conversation were a result of a report by the Congressional Budget Office on the negative effects of the Affordable Care Act on the jobs market. Total Mentions Chart for the month of February 2014 During the month of March, the conversation continued to grow as the deadline for enrollment in the healthcare exchanges was at the end of the month. Total Mentions Chart for the month of March 2014 On March 30 alone, there were over 64,000 total mentions throughout the day, at an average rate of 2,687 per hour. Total Mentions Chart for March 30, 2014 5

Trending Stories and Influencers reflect partisan lines Trending Stories Trending stories were often split between opponents and supporters of the ACA. For instance, in the month of January, Healthcare.gov had the most shared story on social media, with a story about the enrollment eligibility being shared nearly 200,000 over several months. But, the third and fourth most shared stories were articles opposing the ACA, claiming that it is increasing unemployment. Healthcare.gov was consistently a top trending story and a most shared site during the five months of the study. Trending Stories Influencers While supporters of the Affordable Care Act achieved the top trending stories, social media influencers were predominantly opponents. Among social media influencers, Peter M. Abraham, was consistently a top influencer, with over 50,000 mentions over the course of the study. A MO NG THE MOST S HARED S ITES, HUFFI N GTO N P O ST WAS A CO N SISTE NT WINNER. The Huffington Post was one of the most shared sites during the course of the study. Most Active Social Authors Most Shared Sites 6

Internet culture weighs in on the ACA The conversation surrounding the ACA included references to popular entertainment. The most popular tweets for the months of February and March were comparing the failures of ACA to sports. Stephen Colbert, a popular comedian, had the most popular tweet overall with a tweet containing a joke about the enrollment numbers that got more than 4,000 retweets. Tweet from Stephen Colbert from April 1, 2014 that became the top trending story for the entire 5 month period Popular Tweets from February 2014 Popular Tweets from March 2014 7

Popular hashtags served as rallying points for both sides The Obama administration asked people to use the hashtag GetCovered while conservative opponents used the hashtag FullRepeal. During the 5 months of the study, GetCovered was used more than 83,000 times while FullRepeal was used 66,000 times. Obamacare was the most popular hashtag with 1,365,270 mentions over the course of 5 months. ACA was also a popular hashtag with over 200,000 mentions. Obamacare was consistently the most widely used term in the debate Word Cloud widget from the entire 5 month period of monitoring 8