No matter how the Supreme Court rules on Obamacare, there's an ad for that

Regardless of how the Supreme Court rules this month — whether the justices repeal the Patient Protection and Affordable Care Act (a.k.a. Obamacare) that 53% of likely voters hate,

Helth insurers have been poreparing for this Thursday

whether they uphold it, or whether they throw out just some parts (such as the individual mandate), health insurers’ advertising departments are ready.

These differing scenarios have “driven some companies to nearly double their research and PR budgets during the past six months,” Ad Age reports. And those budgets were already nothing to, um, sneeze at. Atlantic Information Services notes that the five biggest for-profit health insurers — Aetna, Cigna, Humana, UnitedHealthcare and Wellpoint — “alone spent a collective $366.8 million on advertising in 2011, up 51.6% from 2010.”

Different outcomes, same objective

They’ve used that money to develop different consumer advertising campaigns — one or more for each contingency.

As different as the possible Court outcomes may be, though, the contingency campaigns will have two things in common.

First, they’ll all be complying with the Association of Health Insurance Providers [AHIP] policy of creating a unified message.

Second, the unifying element in all the different messages will be to persuade consumers who didn’t have — and in millions of cases didn’t want — health insurance before Obamacare to start paying for it. This will bring in tons of added premium income, in many cases with little or no payout for benefits.

Contingency #1: Obamacare’s overturned

If the Court declares the whole law unconstitutional, some of these contingency campaigns will target market segments that Obamacare would have mandated coverage for.

One such segment will be young adults up to age 26, who would have been put on their parents’ health policy.

Historically, most 20somethings, when given the freedom, choose to spend their money on other things than health insurance premiums.

And that’s because statistically, they didn’t need to; most are disgustingly healthy.

The fact that trauma is far and away the leading cause of death or hospitalization of young adults bears this out.

So do posts to, some of them from doctors, on the subject:

“The real value of a check-up at this age isn’t so clear. The idea of a ‘complete physical,’ from a cost-benefit perspective, is pointless.”

“[A]nnual physicals in young men who aren’t at high risk for health issues, and who can learn to check their testicles and skin, are probably unnecessary.”

“I’d only recommend an annual checkup before age 30…if there’s a family history (of anything), obesity, or if some strange symptoms crop up (bloody stool, really dark urine, chest pains, strange lumps [anywhere], weird skin changes, &c).”

“[L]ast time I went to my doctor for a “checkup,” he wanted to know what was wrong with me. He didn’t exactly look at me like I had ten heads, but I got the sense that most men in their early to mid 20s don’t go in for checkups…[M]ost men (even with a history or cancer) don’t need to get regular checks until their mid 30s, as long as they check themselves (I monitor my blood pressure, as well as any signs of cancer).”

To a profit-making insurance company, the prospect of signing up literally millions of previous uninsureds, with Mommy and Daddy footing the bill for monthly premiums — and, moreover, little likelihood of paying out much of that money for actual health care — is pure gold.

So, potentially, are golden agers on Medicare Part D who spend between $2,930 and $4,700 a year on prescription drugs and must pay every penny of every prescription that falls into this gap. Some 76% of Part D enrollees never fall into this “donut hole,” but Obamacare closed it anyhow.

So with repeal comes the golden opportunity to sell more seniors on paying more premiums for coverage under which more than three-quarters of the beneficiaries would never need to file a claim.

Contingency #2: Obamacare’s upheld

A decision to uphold the law will create new audience segments for health insurers’ contingency ad campaigns to go after.

One is previously uninsured consumers who will be forced into policies under the individual mandate. One thing these new insureds won’t be forced to do is sign with any specific insurance company, so you can look forward to advertising battling for market share.

As you can for pre-existing condition coverage, “preventive-wellness programs focused on keeping medical costs low,” or buying through state-run exchanges when your employer has canceled a now-exorbitant group plan.

Contingency #3: the Court splits the difference

What exactly the health insurers will advertise depends on which provisions of Obamacare stay and which ones go.

If pre-existing condition coverage becomes one of the casualties, look for advertising about how people without insurance can still get it — most likely in the form of catastrophic insurance which, as its name implies, covers only the direst of conditions.

Insurers will use partial repeal as “an opportunity” to sell new policies with a message that “even though it’s not mandated, we’ll make our products more accessible to you,” Lindsay Resnick, chief marketing officer of health direct marketers KPM Group, told Ad Age.

In either partial or total repeal, former AHIP executive Mike Tuffin predicts “a very intensive targeted effort aimed at policy, stakeholders and opinion leaders” to get the overturned provisions reinstated.

One thing’s for certain

From Richmond, Virginia, to Richmond, California, nobody knows the final outcome. But one thing’s as sure as death and taxes.

One way or another, health insurers are going to find that massive advertising campaigns are just what the doctor ordered.