Obamacare's last gasp: Get Twitch gamers on board

For a group of people so fixated on not dying, gamers don't talk much about health care. Amy and Ryan Green are an exception.

"The Affordable Care Act was something that we were able to use when we got hit by a financial truck," Ryan Green said of his family's experience navigating insurance with a terminally ill son while launching their own independent video game studio. The result was "That Dragon, Cancer," a game that made waves last year for evoking the powerlessness of fighting and losing to the disease.

Experiences like that of the Greens, and the fact that young people are less likely to be insured, were why US President Barack Obama threw a gaming marathon for more than 200 video game pros and superfans at the White House in December. Just across the driveway from the West Wing, the four-plus-hour mix of gameplay and interviews streamed live to anyone from via Amazon's Twitch video service.

The unorthodox event, held in the waning weeks of his administration, represented a last-ditch effort to raise awareness for the Affordable Care Act and shore up enrollment. Incoming President Donald Trump and Congress have already vowed to dismantle that pillar of Obama's legacy, so the White House turned to this geeky group for some mutual back-scratching. The more citizens rely on the ACA, or Obamacare, the harder it may be for foes to nuke it, or so the thinking goes.

"The gaming community tends to be young," Katie Hill, White House assistant press secretary, said. "It tends to skew a little bit more male than female, which is the same as the remaining uninsured."

The administration first targeted "low-hanging fruit," people it knew were still insured, as it moved through open enrollment periods following the October 2013 launch of Healthcare.gov, she said. As the number of uninsured Americans fell by 20 million, that fruit became trickier to pick.

"We had to be a bit more creative in how we reach them," she said.

A two-player game

Events like the Twitch marathon are a White House strategy of "meeting people where they are," according to Hill. One of the best-known examples is Obama's appearance on Zach Galifianakis's digital talk-show satire, " Between Two Ferns," in which the president plugged Healthcare.gov and said Galifianakis' stance on "same-sex divorce" was why the comedian shouldn't be president. The sketch won an Emmy and has 41 million views on FunnyOrDie and another 20 million on YouTube.

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With Twitch and gamers, the White House was attracted to a platform where a lot of young people spend a ton of time. Twitch users on average spend more than 100 minutes daily watching other people play video games or broadcasting themselves.

Twitch, meanwhile, wanted to raise awareness about a subject that could impact the people who've built their livelihoods there.

"[What] people might not realize is that both Twitch partners and e-sports athletes, a lot of time they own their own business," said Brian Petrocelli, a Twitch product marketing manager who helped organize the event. "This is a burden that they carry, and we want to make sure that we hosted a conversation with our community about the options that are available to them."

Twitch's forays into political streaming started last year, when it live-streamed the Republican and Democratic national conventions. Those streams hit peaks of 30,000 viewers watching at the same time for the RNC and more than 48,000 for the DNC.

Playing fiddle as the ship goes down?

Inside the South Court Auditorium itself, big Twitch broadcasters -- people more likely to spend all day wearing pajama pants while they stream for hours from a webcam -- gussied up in suits, button-up shirts and dresses. Green hair and hoodies peppered the crowd, too.

As gamers at the White House played Street Fighter V and Trials Fusion, commenters in the chatroom alongside Twitch's live stream shouted out high praise and snark. ("The green player definitely needs health care, dies so much.")

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Gaming was interspersed with interviews with people like the Greens, Twitch broadcasters, Obama administration officials like Chief Technology Officer Megan Smith and e-sports stars like Justin Wong. When nongaming personalities took center stage, the live-stream audience's impatience sometimes surged.

"This game is boring," one commenter complained as Juliet Johnson, an official from the Centers for Medicare & Medicaid Services, walked through the enrollment process on Healthcare.gov.

But discussions with people like the Greens hit a sweet spot, straddling the gaming world and health-care policy without straining.

The " Get Covered" White House gaming marathon hit a peak of about 10,000 concurrent viewers, but Twitch emphasized that more than 143,000 individuals total tuned into the broadcast while it was live.

The Department of Health and Human Services didn't provide details about the event's direct effect on signups. But the department reported enrollment rose by 400,000 from a year earlier to 6.4 million by the Dec. 19 deadline, and Obama said that Dec. 15, three days after the event, was the single busiest day ever for Healthcare.gov.

But the possibility the next administration could repeal the ACA reared its head too. Amy Green noted that before the ACA, her son's insurance plan set a $2 million lifetime benefit cap. In a year, Joel's treatment had blown through half of that.

"Paying for private health insurance, when you are not employed by a company, was...a huge financial undertaking," she said. When the ACA began granting the Greens subsidies, she said, "it made it so much more affordable."

"We're scared that the new administration could take away those benefits," her husband, Ryan, added. "That's how we survive."

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