Ad Campaigns Compete as Health Law Rollout Looms

Stephen Crowley/The New York Times

President Obama, shown at the Business Roundtable last week, is about to lead a campaign in support of his health care law.

WASHINGTON â€" President Obama waged a fierce fight to pass his health care law four years ago. But as his administration prepares to put it in place, he is facing an aggressive Republican campaign to prevent a successful rollout and deny him his most important legacy.

Speaker John A. Boehner and House Republicans celebrated on Friday after voting to eliminate money for the health law.

Starting this week, the White House will kick off a six-month campaign to persuade millions of uninsured Americans to sign up for health coverage as part of insurance marketplaces that open for business on Oct. 1. If too few people enroll, the centerpiece of the president’s Affordable Care Act could collapse.

But instead of offering the kind of grudging cooperation that normally follows even the most bitter of legislative battles, Mr. Obama’s foes have intensified their opposition, trying to deepen the nation’s anger about the health insurance program, which both sides often call Obamacare.

Across the country, Republicans are eager to prevent people from enrolling, fearing that once people begin receiving the benefit they will be loath to give it up. And in Washington, lawmakers have cast the law as the evil villain in a legislative melodrama about the budget that is barreling toward another government shutdown.

One group called Generation Opportunity distributed a Web video last week showing a creepy-looking Uncle Sam peering between a woman’s legs at a gynecologist’s office.

“Don’t let government play doctor,” the video says at the end. “Opt out of Obamacare.”

In the face of the intense opposition, the White House is pushing ahead with a vigorous public relations effort that will begin accelerating Monday, according to top White House aides in charge of the program.

Officials said the rollout would include a presidential event this week in New York with former President Bill Clinton and a health care speech by Mr. Obama on Thursday in Maryland. Michelle Obama will urge mothers and veterans to enroll their families. Vice President Joseph R. Biden Jr. will host a nationwide conference call with nurses to enlist them in the effort to spread the word. Members of the president’s cabinet will fan out across the country, lobbying constituent groups to prod their members into action.

Those efforts will eventually be augmented by a Madison Avenue-style advertising campaign by insurance companies, which officials say are poised to spend $1 billion or more to attract millions of new customers. Some of the ads are likely to be aimed at young people, many of whom are uninsured but healthy â€" and great for the insurance companies’ bottom line.

Liberal advocacy groups have also begun to organize door-to-door canvassing, much as they did on behalf of Mr. Obama’s two presidential campaigns.

The overarching goal is to persuade many of today’s 48 million uninsured to sign up for insurance on the new exchanges created by the law. Crucially, officials need to woo older, sicker people without insurance as well as younger, healthier people, whose payments effectively subsidize those who will end up using more health care. Mr. Obama’s organizing strength among young adults â€" whom he won by a wide margin in 2008 and 2012 â€" may aid the campaign.

“We will have to create buzz and engagement and adjust and reach people in a sustained way from October to the end of March,” said Tara McGuinness, who is leading the health care communications effort inside the White House. “This is about what makes sense for families, what’s affordable for them.”

But even as Mr. Obama’s campaign accelerates, Republicans at all political levels are working against the law.

The Republican National Committee has begun what it calls a monthlong awareness campaign, with a television booking operation to make sure that pundits opposed to the law are always available to counter its boosters. The committee’s effort has already booked local and national politicians on radio programs like “The Hugh Hewitt Show” and cable TV programs like “The Mike Huckabee Show.”

A Republican committee Web site counts down the days, hours, minutes and seconds until what it calls the “Obamacare Train Wreck.”

Other conservative groups are broadcasting television advertisements that urge people not to sign up for coverage under the health care law. Americans for Prosperity began broadcasting an ad last week featuring a cancer survivor who warns about the dangers of the law. It is the latest in a series of commercials featuring women criticizing the law.

“Obamacare is dangerous â€" it can’t be implemented,” Tricia, the cancer survivor, says in the ad. “Your well-being judged by a bureaucrat in D.C. is devastating.”

Republican state and local officials are trying to thwart the administration’s enrollment efforts by imposing restrictions and requirements on volunteers seeking to inform people about how to enroll in coverage plans under the law. The Heritage Action Fund organized a Defund Obamacare bus tour this summer that helped convince House Republicans that no federal budget deal should be made without stripping the money from the health law.

And in Congress, House Republicans are threatening to shut down the government and risk a default unless Congress eliminates all of the financing for the law, effectively killing it.

A version of this article appears in print on September 22, 2013, on page A1 of the New York edition with the headline: REIGNITED BATTLE OVER HEALTH LAW.

The Backlash to the American Invasion of the Booker Prize

LONDON â€" The Americans are coming, and the British literary world is not happy.

Jim Crace, whose novel "Harvest" is shortlisted for the Booker Prize.

Jhumpa Lahiri, whose novel "The Lowland," is shortlisted for the Booker Prize.

The Man Booker Prize, which had been open to English-language novels from Britain and the Commonwealth, has just gone global, producing anxiety about damage to cultural diversity and fears that the American cultural hyperpower that dominates movies and television will crush the small literary novel.

“It’s rather like a British company being taken over by some worldwide conglomerate,” said Melvyn Bragg, an author and television host in Britain.

The Booker Prize for fiction, begun in 1969, was always something that Britain and its former territories could call their own, seen as a bulwark against the spread of the American novel, that globalized product of the world’s richest market.

The award â€" with its publicity, its paycheck and its immediate impact on sales â€" has been an important boost to the careers of Canadians like Michael Ondaatje and Yann Martel, and Indians like Kiran Desai and Aravind Adiga. It has brought attention to novelists previously unknown and unpublished in the United States, and it has been an important encouragement to publishers of quality fiction.

This week, the chairman of the Booker Prize Foundation, Jonathan Taylor, said, “We are abandoning the constraints of geography and national boundaries” to become a truly international prize, as a result of consultations that began in 2011. The change could enhance the Booker’s “prestige and reputation through expansion, rather than by setting up a separate prize” for Americans, he said.

Next year, the prize will be open to any work originally written in English and published in Britain, not just works by citizens of Britain, the Commonwealth, Ireland and Zimbabwe, bringing immediate concerns that American novels will dominate, “simply through an economic superpower exerting its own literary tastes,” the British novelist Philip Hensher, who has been both a Booker finalist and a judge, said in an interview.

More troubling, he said, will be the loss of “new, interesting voices.” American novels are already culturally dominant, he said: “It’s hard to think of American novels that don’t make their way into the larger English world. But I can think of Canadian, Indian, African novels that struggle to find a broader readership.”

Karolina Sutton, a literary agent who works with both American and British authors, said that the winner of the Booker sometimes sees a sales bump of hundreds of thousands of copies, an effect that could multiply if the winner were American.

“I think it’s terrific for American publishers, terrific for American writers, and it’s not bad news for readers,” she said. “It will suddenly become more competitive.”

Criticism of the prize has been a literary sport since its inception, with complaints about the winners, the judges and even the prize dinners. A. L. Kennedy, who was a judge in 1996, famously and ungrammatically said that the winner was determined by “who knows who, who’s sleeping with who, who’s selling drugs to who, who’s married to who, whose turn it is.”

Ms. Kennedy is in favor of the expansion of the Booker, however, noting that other, newer prizes open to any English-language novel published here, like the Folio Prize (£40,000, or about $64,000, which makes its first award next January) and the International Impac Dublin Literary Award (100,000 euros, or about $135,000, and also open to translations) have been “nipping at its heels.” The Man Booker award comes with a prize of £50,000, or about $80,000.

The Booker has also become less literary, some argue, suggesting that since the Man Group, a multinational financial company, took it over in 2002, the renamed Man Booker Prize has become more middlebrow.

Even this year, one of the six finalists, Jhumpa Lahiri’s “Lowland,” has been criticized as an American novel. Born in London, Ms. Lahiri moved to the United States at the age of 2 and generally writes about the experience of exiles living in the United States.

Julie Bosman contributed reporting from New York, and Kimiko de Freytas-Tamura from London.

This article has been revised to reflect the following correction:

Correction: September 21, 2013

An earlier version of this story contained an incorrect figure for the monetary award that accompanies the Man Booker Prize. It is £50,000, or about $80,000.

A version of this article appears in print on September 21, 2013, on page C1 of the New York edition with the headline: The Backlash to the American Invasion of the Booker Prize.