A woman in overalls standing in front of a crop field. A man in a dirty jacket holding a wrench near heavy machinery. A woman in an apron in the aisle of what looks to be a grocery store.
The Minnesota Hospital Association used these photos in its successful ad campaign supporting the state’s provider tax, a highly partisan measure that lawmakers passed in the final days of the 2019 legislative session.
The tax on hospitals and others helps fund a healthcare program for the state’s working poor called MinnesotaCare. It provides coverage with low copays and deductibles to nearly 100,000 low-income residents who don’t qualify for Medicaid but can’t afford private insurance. The 27-year-old tax was scheduled to sunset at the end of 2019, until a last-minute deal prevented its demise.
“We thought if we showed the real faces of Minnesotans who depend on this care and will be affected by the decisions of the Legislature, we can really be an advocate for the hundreds of thousands of Minnesotans who depend on this,” said Nick Marcouiller, digital consultant with Tunheim, the Bloomington, Minn.-based public relations firm the MHA hired for its provider tax campaign.
While Tunheim doesn’t know the insurance status of the people in the photos, they are Minnesotans who gave permission to have their photos used in the campaign, said Sarah Hinde, a senior consultant with Tunheim, which partners with the MHA on an ongoing basis. The idea was to show people working the types of jobs MinnesotaCare beneficiaries are likely to hold.
The campaign, which launched in April, spurred more than 1,500 contacts with legislators from citizens and about 68,000 social media engagements. It earned this year’s Healthcare Marketing Impact Award—Best in Show.
It might sound odd for an industry to campaign for a tax on itself. Wendy Burt, the MHA’s vice president of communications, said her organization’s cost-benefit analysis found having more people covered outweighed the lower reimbursement rates from MinnesotaCare and Medicaid relative to commercial insurance. Tax proceeds also support the state’s Medicaid expansion, which happened in 2013.
Although the MHA wanted to keep the tax, the organization pushed to have it lowered from 2% to 1.5%, which Burt said was to prevent it from generating surpluses that in the past lawmakers diverted for other purposes. Lawmakers ultimately lowered it to 1.8% with no sunset date.
The tax applies to hospitals, other healthcare providers and wholesale drug distributors. Burt said it’s largely baked into the rates health insurers pay for services. Patients may see the tax on their bills from certain providers, like dentists, chiropractors and ophthalmologists, she said.
The campaign featured ads on Facebook, Instagram and YouTube, Twitter posts and even a news conference with Minnesota’s governor that garnered a number of news stories. The digital ads took visitors to a landing page that facilitated emails to legislators.
The centerpiece of the creative strategy was an animated video featuring a woman and MinnesotaCare beneficiary named Ashley who cares for aging parents and works at a restaurant that doesn’t provide health insurance. The video got a lot of traction on Facebook and Twitter from the MHA’s supporters, including from the governor’s office, Burt said. “We set out to try and humanize our argument and to humanize the coverage that is provided to low-income Minnesotans.”
A significant portion of the MHA’s audience is made up healthcare decisionmakers, Marcouiller said. They tend to be women—often mothers—ages 40 to 65.
Tunheim also targeted its ads to Minnesota legislators who hadn’t yet taken a position on the tax, and placed some in Republican districts in an effort to win key Senate votes. The issue was fiercely partisan, but the MHA kept its messaging neutral with respect to political affiliation, Burt said.
The MHA was supported in its effort by a number of hospital CEOs who lent their voices, including leaders of Minneapolis-based Allina Health, Northfield (Minn.) Hospital and Avera Marshall (Minn.) Regional Medical Center. The MHA spent about $33,500 on the campaign, including social and digital ad placements and creating the video, Burt said.
The ads were designed to inspire action. “Our goal with any of these campaigns is to help explain complex health issues to everyday Minnesotans,” Marcouiller said, “and help empower them to feel like they can have a voice in the conversation.”