(Bloomberg) -- Call them Doctor Moms. Women make about 80% of the health care decisions for their families, and also utilize more health care than men.

That’s why supporters and opponents of the Affordable Care Act have targeted mothers in a surge of advertising and grassroots organizing as a major piece of Obamacare readies to roll out Oct 1. The push is reminiscent of presidential campaigns, with both sides eager to win over the “soccer mom” and “security mom” vote.

“They’re the No. 1 decision maker,” says Tim Phillips, the president of Americans for Prosperity, an anti-Obamacare organization backed by conservative billionaire energy executives Charles Koch and David Koch. “They’re going to be impacted more than anyone else.”

Total spending on political and advocacy ads should break the $1 billion mark by 2015, according to a July analysis by New York-based Kantar Media CMAG, which tracks advertising. A big chunk of that will go toward the health care debate.

More than $500 million has already been spent on advertising for and against health reform since the first spots aired in 2009, though groups opposing Obamacare have outspent supporters by almost 5 to 1. Many of those ads have been targeted at women.      

“The view is that in the household, the mother is the decision maker about health care,” says Elizabeth Wilner, Kantar’s vice president. “And when it comes to voters in 2014, Republicans want to get that turnout.”

TV ads

One ad from Americans for Prosperity features a woman on a park bench talking about her son’s seizures. She asks “can I really trust the folks in Washington with my family’s health care?” Americans for Prosperity is spending about $1 million on a campaign to help repeal the law.

Chicago-based Organizing for Action, a nonprofit advocacy group founded after President Barack Obama’s 2012 campaign, is also spending about $1 million on TV ads. In a spot that began in July on the Bravo and Lifetime channels and national cable news networks, a concerned mother credits health reform with ending lifetime insurance caps on the care she needed for her daughter. “Before Obamacare, insurance companies could put lifetime caps on your health insurance,” a mother says in the ad.

“Overall, our goal is to make sure the facts about Obamacare get out there. There are people pushing their agendas and misinformation,” Ben Finkenbinder, a spokesman for Organizing for Action.

The marketing blitz from both sides has left some women more confused than informed. Shelley Gross is one of them. From MSNBC to YouTube to Allrecipes.com, Gross and women like her are being targeted by ads designed to sway their opinions. While the self-employed video producer likes that people with pre-existing conditions won’t be denied coverage, she worries health care may become more expensive.

“I’m caught in the middle,” says Gross, 48. “But it matters to me. I’m reading what I can, watching the ads. I’m the one who picks our family’s doctors and health care.”

The Affordable Care Act, the largest regulatory overhaul of health care since the 1960s, aims to reduce medical costs and extend insurance coverage to more than half of the nation’s 50 million uninsured. Those not covered by employer or government health plans will have to secure insurance, which may be subsidized, or pay a penalty. New online marketplaces to buy health plans are scheduled to begin Oct. 1.

Republican opposition

The complexity, reach and cost of the $1.3 trillion overhaul has divided Washington and alienated conservative regions of the country. Since its enactment in 2010 by a Democratic-led Congress, Republicans in the House of Representatives have voted at least 39 times to repeal or reduce funding for all or parts of the law.

A Gallup Poll from July showed 52% of the public disapproves of the law, up from 45% in November 2012. A Kaiser Family Foundation survey shows 42% of Americans couldn’t even say with certainty if the law was still in effect.

To mobilize mothers, the U.S. Department of Health and Human Services is tapping into MomsRising.org, an online and on-the-ground grassroots organization with more than 1 million members. U.S. Health Secretary Kathleen Sebelius has posted on the site about how health reform will benefit women, and in July the agency participated in an online chat with MomsRising.org.

Members of MomRising.org are hosting coffee gatherings to talk about health reform. The conservative group Americans for Prosperity has run opinion articles in newspapers talking about how moms need to know what they’re getting from the law.

Jo Ann Levy, a 59-year-old a substitute teacher and mother of three from Boca Raton, Florida, tends to back the law. She says the ads from both sides only serve to alienate mothers who see the aggressive outreach as politically motivated.

“I start to tune it out,” Levy says. The bottom line for her is this: “For mothers, the fact that children can be on your insurance plan until 26 and that pre- existing conditions can’t be denied is very important.”

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