Health Care Reform

Issues ››› Health Care Reform
  • A Comprehensive Guide To The Right-Wing Media Myths And Facts About Trump’s Potential Health Care Policies

    ››› ››› CAT DUFFY

    Right-wing media have helped promote piecemeal Republican proposals to replace the Affordable Care Act (ACA), propagating a series of myths about the efficacy of health savings accounts, the benefits of allowing insurers to sell across state lines, how high-risk pools operate, and what converting Medicaid into so-called “block grants” would mean for beneficiaries. Health care experts have resoundingly rejected these proposals as alternatives to the ACA, as they all would result in higher costs and less coverage for Americans.

  • PolitiFact’s Month-Old Rating Of Baldwin Statement Relies Too Heavily On GOP Talking Points 

    ››› ››› CAT DUFFY

    PolitiFact Wisconsin rated Sen. Tammy Baldwin’s (D-WI) month-old claim that the GOP is “organizing to take people’s health care away” mostly false, claiming that while the Congressional Budget Office (CBO) found that “repeal of the Affordable Care Act (ACA) could result in millions of people losing their health insurance,” the office did not consider the impact of an expected GOP replacement plan. In reality, the GOP has yet to produce a consensus replacement plan, thus giving the CBO nothing to rate, and all existing plans that Republicans have put forward would strip coverage from millions. 

  • 5 Questions CNN Should Ask During The Sanders-Cruz Obamacare Debate

    Blog ››› ››› CAT DUFFY

    Moderators Jake Tapper and Dana Bash should utilize the February 7 CNN debate between Sens. Bernie Sanders (I-VT) and Ted Cruz (R-TX) on “the future of Obamacare” to ask targeted questions about the GOP’s plans to replace the Affordable Care Act (ACA) and how that will affect the American health care system. As CNN’s town hall with House Speaker Paul Ryan (R-WI) demonstrated, these forums can serve as opportunities to fact-check misinformation, but they can also fail to substantively engage on specific policy issues. Moderators should be prepared to pose specific questions to Cruz, the representative for “the viewpoint of President Trump and the Republican party,” on distinct policies proposed by the GOP to repeal and replace the ACA.

    While there is no shortage of important questions about the negative impacts of repealing the ACA on Medicare, job growth, LGBTQ equality, the budget deficit, and mental health care services, moderators must prioritize the subjects they can address in the time allotted. Here are five of the most important questions that CNN should ask Cruz in tonight’s debate.

    1. Will The GOP Replacement Cover As Many People As The ACA, Which Has Reduced The Number Of Uninsured Americans By More Than 20 Million People? 

    Implementation of the ACA has resulted in a record low number of uninsured Americans -- merely 8.6 percent in June 2016, down from over 16 percent in 2010. Numerous reports have noted that Republican politicians continue to obfuscate about whether their replacement for the ACA would cover as many people as Obamacare does, likely because none of their proposed policies would. Vox’s Sarah Kliff analyzed the existing replacement plans and found that all of them would reduce coverage, with the number of people impacted ranging by between 3 million and 21 million people.

    Given that Cruz himself dodged this question during a 2016 Republican presidential primary debate, this new venue provides a unique opportunity to press the senator on whether the Republican replacement will maintain existing coverage levels.

    2. Will The Replacement Plan Rescind ACA Provisions That Pertain To Women’s Health, Like The Contraception Mandate, The Prohibition On Gender Rating, And The Sex Discrimination Ban? 

    Congressional Republicans, including President Donald Trump’s nominee to lead the Department of Health and Human Services, Tom Price (R-GA), have publicly opposed some ACA provisions regarding women’s health care. As CBS News noted, the debate over the ACA resurrects the risk of “a return to higher premiums for women” and “gaps in coverage for birth control and breast pumps.” The ACA also banned discriminatory practices, like sex discrimination and gender rating, while significantly reducing out-of-pocket costs for women’s birth control.

    Tapper and Bash should ask about the future of women’s health care, making sure to reference the specific gains made by the ACA to prevent generic answers that dodge the question.

    3. Can You Guarantee That Medicaid Block Grants Won’t Result In Benefit Cuts For Recipients?

    One of the leading GOP proposals for reforming the health care system revolves around changing Medicaid’s funding structure to a block grant system, which caps the amount of funding a state receives from the federal government. While conservatives typically discuss block grant proposals in terms of allowing states to “innovate,” in reality, most block grant proposals shift Medicaid costs to the states, which would cause chaos on state budgets and force draconian cuts in services covered by Medicaid.

    Under the ACA, the Medicaid expansion extended health insurance to millions of low-income Americans, making a discussion of proposed changes a necessity during the debate.

    4. How Is It Possible For An ACA Replacement To Keep Popular Parts Of The Law, Like The Ban On Denying Coverage To Those With Pre-Existing Conditions, While Also Eliminating The Individual Mandate? 

    Numerous conservatives, including Trump, have pledged to keep certain parts of the ACA, like the ban on denying coverage to people with pre-existing conditions and the provision that allows young adults to remain on their parents’ insurance until age 26. But they simultaneously promise to get rid of other provisions, like the individual mandate and the varied taxes, which provide the revenue to fund the popular parts of the law.

    As New York Times columnist Nicholas Kristof wrote, it’s “impossible” to keep certain popular provisions “while eliminating unpopular parts,” because the “good and the bad depend on each other.” This tension is a central fault line in discussions about the ACA and should be a central theme in CNN’s town hall.

    5. Given The Terrible Track Record Of High-Risk Pools, Would Resurrecting Such A System Simply Repeat The Mistakes Of The Past? 

    One of the few specific health care policies Republicans have championed in pushing to repeal and replace the ACA involves the resurrection of high-risk pools. Despite conservative attempts to repackage high-risk pools as a new idea, they have a long history of problems, as they typically are chronically underfunded, are prohibitively expensive for customers, and provide inadequate coverage. As the Los Angeles Times’ Michael Hiltzik noted, 35 states used high-risk pools prior to the implementation of the ACA’s protections for people with pre-existing conditions, and the experience was “almost universally grim.”

    Moderators should ask about high-risk pools, because they would degrade access to health care to those who are most vulnerable and need care the most.

  • Media Shouldn’t Fall For GOP’s Sham Plan To “Repair” The ACA

    Blog ››› ››› CAT DUFFY

    The GOP has shifted from its message of “repealing and replacing” Obamacare to “repairing” the law. Media must press conservatives on what their so-called “repairs” to the Affordable Care Act (ACA) might look like, especially in the likely event that “repairing” the ACA is really just repealing it with no replacement.

    Republicans reportedly started transitioning away from their pledge to “repeal and replace” Obamacare, focusing on a more appealing call to “repair” the health care law. Frank Luntz, a GOP consultant known for repackaging conservative misinformation to advance a Republican agenda, encouraged conservatives to pledge to “repair” the ACA because that word “‘captures exactly what the large majority of the American people want.’” As lawmakers like Sen. Lamar Alexander (R-TN) have adopted the “repair” buzzword, others, like Speaker of the House Paul Ryan (R-WI), continue to obfuscate, claiming, “if we’re going to repair the U.S. health care system, … you must repeal and replace Obamacare,” indicating that GOP disarray over the ACA extends to its messaging strategies.

    The GOP’s pledge to “repeal and replace” the law has largely backfired. After seven years, Republicans still have no replacement for the law. The GOP still can’t agree on the timing or the substance of any replacement plan. Most of its “replacement” plans are fact sheets rather than legislative language, and all of them would reduce coverage for millions of Americans.

    The continued fight over the potential replacement has also inadvertently highlighted the tangible gains achieved by the ACA and made the public acutely aware of the negative impacts of repeal. New polling finds the ACA is increasingly popular, especially as news outlets highlight stories of individuals who would be impacted by repeal.

    As Slate’s Jim Newell explained, the semantic change alone “does not signal a new course in the repeal-and-replace progress.” But, even if the GOP does decide to abandon its promise to repeal the ACA and instead focus on “repairing" the law, it remains vitally important for news outlets to force conservative politicians to clarify which portions of the ACA they intend to repair and how. Media have largely failed at questioning potential replacement plans for the law. And as top GOP lawmakers continue to falsely repeat right-wing media myths about the alleged “collapse” of the ACA, media must fact-check the GOP’s messaging strategies and interrogate its plans for repealing or repairing the law. If the GOP actually intends to make “repairs” to the ACA, those repairs may just be another messaging strategy for its plans to scale back services, gut Medicaid, and give a tax-break to the wealthy.

    With millions of lives at stake, news outlets must aggressively question GOP lawmakers about what portions of the ACA they intend to repair and force lawmakers to clarify that repairing the ACA is not simply a buzzword phrase for repealing the law with no replacement.

  • WV’s Register-Herald Shows The Right Way To Report On The Impact Of Obamacare Repeal

    Blog ››› ››› CAT DUFFY

    While much of the media coverage of the debate over the repeal of the Affordable Care Act (ACA) has missed the boat, West Virginia’s Register-Herald published an in-depth article on the implications of the repeal of the health law, providing a model of the best practices all other media outlets should emulate moving forward.

    Media coverage of the future of the ACA thus far has largely failed to inform the public about the negative impacts of repeal. A Media Matters study of pre-election coverage showed that broadcast and cable news reporters largely failed to ask substantive questions about what a replacement plan from President Donald Trump’s administration might look like, despite his repeated pledges to “repeal and replace” the ACA. Outlets repeatedly wrote articles with headlines that uncritically repeated Trump’s false statements on the ACA, while others have failed to aggressively fact-check Republican politicians who spread misinformation about the law. Media Matters studies of state newspaper coverage revealed severe flaws in local coverage as well, as the papers largely failed to report the potential impact of repeal on vulnerable communities like women, minority, and low-income areas.

    West Virginia’s Register-Herald broke this trend with its recent reporting on the ACA, illustrating the best practices other outlets should follow in their coverage of the law’s future.

    1. Discuss The Substantive Impact Of Repeal And Impact Of Potential Replacement Plans

    The January 26 article outlined the specific impacts repealing the law would have on West Virginia and the nation as a whole and detailed how a repeal would negatively affect the uninsured rate, the state’s budget, consumer protections, and Medicaid:

    [N]ot only 184,000 West Virginians would lose health insurance, but the state's weak economy could falter with the loss of billions of dollars of federal funds.

    An estimated 16,000 jobs would be lost by 2019 and nearly $350 million would be lost in tax revenue over five years. The Urban Institute estimates West Virginia would lose $14 billion in federal funds between 2019-2028, including $12 billion supporting Medicaid/CHIP.

    Another study conducted by WalletHub shows West Virginia will be the state second most impacted in the nation by the repeal.

    "The ACA is much more than a lifeline for hundreds of thousands of West Virginians who have gained health coverage and important patient protections," said WVCBP Executive Director Ted Boettner, who authored the report. "It has been a billion dollar investment in our people that has lead to thousands of new jobs during a time when our state's communities are struggling."

    The article also discussed potential policies that have been proposed as a part of a replacement package and the impact those policies would have on the state of health care, like the Republican-backed proposal to convert Medicaid to block grants, which could have significant negative consequences for recipients. This substantive discussion of the impact of potential plans to repeal and replace the ACA transcends the typical media focus on sound bites, providing an essential step toward more productive overall coverage of a complex policy area.

    2. Cite Experts, Not Pundits

    The article cited numerous experts, like the West Virginia Center on Budget and Policy, and studies from major medical journals like The New England Journal of Medicine, instead of political pundits, to explain the debate. This increases the quality of coverage because it means the focus of the interview or article revolves around a substantive discussion of the policies in question, rather than the political optics that pundits prefer to discuss. This is particularly important when discussing confusing policies like health care, where misinformation or political spin can permeate public conceptions about complex issues.

    3. Put A Human Face On The Impact of Repeal

    The Register-Herald paired its substantive policy discussion with interviews with West Virginia residents who would be directly affected by repealing the ACA to present the human impact of the health care debate:

    Zachary was 23 years old when he was diagnosed with thyroid cancer — a rare diagnosis for a young man. He's had multiple surgeries along with radioactive iodine ablation treatment, but each summer for the past three years, his cancer has returned.

    Zachary, now 26 years old, fears he will not be able to utilize the final months of his health coverage under his parents' plan if the ACA is repealed.

    "He's scared out of his mind," Vaughan-Meadors said. "He thinks he's going to get dropped tomorrow. We understand as adults it doesn't happen that quickly, but as a young person, you don't cope well with cancer to begin with."

    Using personal testimonies humanizes the discussion of the ACA and puts a face on the impact of the repeal in a way the repetition of insurance statistics cannot. While human interest pieces should not crowd out detailed policy reporting, The Register-Herald shows it is possible to succeed in doing both.

  • NBC News Latino Debunks Conservative Falsehood That “The Number Of Uninsured Hispanics” Grew Under ACA 

    Other Publications Uncritically Ran With The American Action Network’s False Claims

    Blog ››› ››› MEDIA MATTERS STAFF

    Unlike other media outlets that uncritically parroted the conservative American Action Network’s false claims about Latino coverage under the Affordable Care Act (ACA), NBC News Latino showed evidence disproving the political group’s false statement that “the number of uninsured Hispanics has grown” under the ACA. This statement was based on the group’s misinterpretation of a report that actually found that more Hispanics have gained health insurance under the ACA.

    In an effort to boost the Republican effort to repeal the ACA, the American Action Network -- a conservative political group affiliated with the Congressional Leadership Fund super PAC -- announced that in addition to English-language television ads, it would also be launching Spanish-language television ads to garner opposition to the ACA among Hispanics. In the press release, AAN executive director Corry Bliss falsely asserted that “Obamacare supporters claimed this law helps Hispanics, yet the number of uninsured Hispanics has grown.” In reality, the ACA has expanded minority access to free preventive care, improved the overall quality of care in minority communities, and reduced the number of uninsured persons of color.

    The Washington Post repeated Bliss’ claim uncritically, noting that “AAN cited a study last year by the nonpartisan Commonwealth Fund … that found that the share of Latinos without health-care coverage grew from 29 percent in 2013 to 40 percent in 2016, higher than other racial or ethnic groups.” The Hill also echoed AAN’s misinterpretation of the Commonwealth Fund report.

    On the other hand, NBC Latino accurately interpreted the report and corrected AAN’s misleading statement by explaining that “American Action Network's press release points to an NBC Latino story that cites a Commonwealth Fund report that found that the share, though not the number, of uninsured Hispanics grew.” That means that even though Hispanics make up a larger share of the uninsured, the number of Hispanics who gained health insurance under the ACA grew, albeit slower than other groups. The article pointed out that Republican states that “opted to not expand Medicaid under Obamacare” have large Latino populations, which, among other reasons, explained why Latinos’ uninsured rate decreased more slowly than other groups’ rates. From the January 18 NBC News Latino report:

    In a news release, Bliss asserted that "the number of uninsured Hispanics has grown."

    In fact, the number of Hispanics without health care has dropped, meaning the percentage of Hispanics without insurance has gone down.

    [...]

    American Action Network's press release points to a an NBC Latino story that cites a Commonwealth Fund report that found that the share, though not the number, of uninsured Hispanics grew. Latinos are 40 percent of all uninsured, including whites and blacks, a share that grew from 29 percent in part because Hispanics gained coverage at a slower rate than whites.

    The report cites several reasons why Latinos are a growing share of the uninsured, among them:

    - Many uninsured Latinos live in states such as Texas and Florida that opted to not expand Medicaid under Obamacare.

    -- There is a disproportionate share of Latinos who are poorer or lower income but not eligible for Medicaid either because their state didn't expand the program or they are not aware of eligibility.

    -- There are Latinos who are legal residents and their state restricts access of legal immigrants who have not had legal residency for at least five years, as the Affordable Care Act allows. (The uninsured rate among U.S. born Latinos is about 12 percent but for foreign born Latinos, it is 39 percent.)

    -- Many Latinos are immigrants who don't have legal status and therefore are not eligible for Obamacare. Immigrants who benefit from the Deferred Action for Childhood Arrivals, DACA, program also are not eligible for Obamacare. (Attempts to extend Obamacare to immigrants without legal status drew heavy Republican opposition while the law was being debated.)

    -- There are Latinos who qualify for coverage under Obamacare but won't sign up out of fear that their family members who lack legal status may be found out by the government and detained and deported. The fear of turning over information to the government has increased with the election of Donald Trump.

    These are factors that would have to be addressed in order to make a dent in the number of Hispanics who are uninsured.

  • CNN Paul Ryan Town Hall Illustrates Need For Aggressive Fact-Checking On Obamacare

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    During CNN’s town hall with Speaker of the House Paul Ryan (R-WI), Jake Tapper showed the value of fact-checking conservative misinformation on health care policy -- even in a conversational setting -- by providing strong pushback about funding for Planned Parenthood. But there were several other moments during the event when Ryan pushed false information about the Affordable Care Act (ACA) that Tapper could have fact-checked. Going forward, more media outlets should adopt an aggressive approach to addressing conservative misinformation on health care policy, given the severe consequences of ACA repeal.

    During the town hall discussion of the fight over the ACA, the final question on health care came from an audience member asking where the millions of women who use Planned Parenthood to access women’s health care services will go if the Republican Congress defunds the network. When Ryan falsely tried to claim that providing federal funds to Planned Parenthood “commit[s] people’s taxpayer dollars to fund” abortion, Tapper correctly noted that the Hyde Amendment bans taxpayer money from funding abortions.

    Tapper also noted the hypocrisy in Ryan’s earlier statements emphasizing the necessity of choice in health care policies, asking, “You believe in providing more choice for people when it comes to health insurance, except for Planned Parenthood?”

    But there were also many other opportunities for Tapper to fact-check Ryan as he used the town hall to reiterate stock talking points and push false narratives about the ACA. When asked whether “the government should guarantee health care” for Americans, Ryan falsely claimed that the ACA is failing and that premium spikes were proof that “the law is collapsing.” In reality, during the most recent open enrollment period, more people signed up on the ACA insurance marketplaces than during the previous year, contradicting the conservative claim that people are fleeing the market. Ryan’s claims about premium hikes omit the crucial context that subsidies rise in proportion to premium hikes, mitigating the impact for the majority of enrollees. While the ACA clearly has problems, claims that the law is “collapsing” or in a “death spiral” are clearly false and should be rebutted as such.

    When an audience member who survived cancer asked Ryan how the GOP’s plans would impact individuals with pre-existing conditions, Ryan claimed that “state high-risk pools are a smarter way of guaranteeing coverage for people with pre-existing conditions.” While high-risk pools sound like a good idea in theory, they have a long history of problems, as they are typically chronically underfunded, are prohibitively expensive for customers, and provide inadequate coverage. Similarly, Ryan’s claims about the benefits of refundable tax credits and health savings accounts should prompt substantive follow-up questions, as legitimate critiques raise questions about their effectiveness in reducing costs and maintaining coverage.

    While Tapper illustrated the value of fact-checking conservative misinformation during the discussion on Planned Parenthood, he ought to have also provided substantive follow-up questions and pushback on some of Ryan’s policy claims. Going forward, media outlets should use any interview, in any format, to hold conservative politicians’ feet to the fire on the issue of the ACA -- to prevent the further spread of false narratives and to investigate the efficacy of proposed GOP policies. The lack of consensus on what a replacement plan might look like, combined with the massive impact repeal will have on the millions who have obtained insurance through the Affordable Care Act, makes it especially vital for the media to ask substantive questions about conservative claims on health care policy.

  • Miami Herald Outshines Other Major Florida Newspapers On ACA Coverage (But The Bar Is Low) 

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    Republicans are pushing forward with a repeal of the Affordable Care Act (ACA), and Florida is one of the states that stands to lose the most if health care reform is rolled back. Yet over the past two months, the top Florida newspapers -- the Miami Herald, the Sun Sentinel, the Tampa Bay Times, and the Orlando Sentinel -- have largely failed to convey the impact of repeal on many of the state’s vulnerable residents. While there were coverage flaws across the board, the Miami Herald outshone the other major newspapers.

  • Trump's Press Conference Shows Media Must Scrutinize HHS Nominee Tom Price

    Blog ››› ››› CAT DUFFY

    President-elect Donald Trump dodged a question during his January 11 press conference about how he plans to repeal and replace the Affordable Care Act (ACA) and whether or not the replacement plan would insure as many people, but he did indicate the attack on health care reform will be led by his nominee to run the Department of Health and Human Services (HHS), Rep. Tom Price (R-GA). In light of Trump’s delegation to Price, the media must do a better job of scrutinizing the devastating consequences of Price’s proposals than they have in the past

    A Media Matters study of pre-election coverage found that prime-time cable and broadcast news failed to ask substantive questions about what Trump’s replacement for the ACA would look like. This cannot be the standard going forward.

    On January 11, Trump held his first press conference in nearly six months and took questions on a variety of issues. A reporter asked Trump a two-part question about the future of Obamacare, first, asking for specifics on the timeline for the repeal and replacement of the ACA, and second, questioning whether or not Trump’s replacement would “guarantee coverage” for those who gained insurance under health care reform. During his three-minute answer, Trump provided no specifics on what policies the replacement package might include and dodged the question of whether or not it would maintain current levels of insurance coverage, instead insisting:

    DONALD TRUMP: We're going to be submitting as soon as our secretary is approved, almost simultaneously, shortly thereafter, a plan. It‘ll be repeal and replace. It will be essentially simultaneously.

    Trump’s answer, while not containing any policy specifics, did reveal two key things about the upcoming ACA fight.

    First, Trump’s reluctance to answer whether or not his replacement will cover as many individuals as the ACA does is a trend, not an anomaly. As Vox senior editor Sarah Kliff and other reporters have noted, Republicans continue to dodge and obfuscate when pressed for details on how their ACA replacement will maintain the coverage expansions achieved since 2010. According to a December 15 article in The New York Times, a Republican congressional aide promised that the GOP plans would guarantee “universal access” of health care and coverage but provided no details about how this would improve on existing law.

    Second, Trump’s claim that his administration would submit a plan “as soon as [his] secretary is approved,” seems to indicate that his replacement package would closely resemble the legislation authored by his HHS nominee, Tom Price. Price’s bill, the “Empowering Patients First Act,” is the most developed health care replacement of all the Republican plans. (After dozens of symbolic votes to repeal the ACA and six years of campaigning against the law, Price is the only congressional Republican to actually put a replacement plan together in legislative language.)

    Price’s plan would gut access to health insurance in the U.S. and eliminate the essential health benefits package -- allowing insurers to determine whether or not things like maternity care should be covered. This dismantling of health care reform would benefit younger, healthier individuals while sending costs skyrocketing for older or sicker individuals. The plan would reinstate high-risk pools, endangering health care access for individuals with pre-existing conditions an ACA provision conservatives claim to want to preserve. Price’s bill would also rescind the ACA’s Medicaid expansion entirely and convert the program to a block grant, blocking access to care for many low-income communities. Additionally, as the HHS secretary, Price could unilaterally reverse the contraception mandate, a benefit he has dismissed because he claims he has yet to meet “one woman” who had trouble accessing birth control before the ACA. If enacted, Price’s “Empowering Patients First Act” would roll back the gains the Affordable Care Act has achieved, leaving millions more Americans uninsured -- as would most of the variants of “Trumpcare.”

    Given that the incoming president suggested during his press conference that he will leave stewardship of repealing and replacing the ACA to his HHS secretary, journalists need to actively scrutinize Price’s record and his proposals for the future of American health care.

    During the January 11 press conference, reporters asked just one question about the ACA, with zero attempts at a follow up, despite the fact that Trump functionally avoided the original question. The initial reporting on Price’s nomination whitewashed his history of opposition to reproductive health care, and largely failed to contextualize the potential impact of his proposed policies on the American health care system. Since Trump hinted at the major role Price might play in the upcoming ACA fight, it is incumbent on reporters to step up beyond their pre-election coverage and take the current job of vetting Price seriously, making clear the disastrous effects his proposals could have on the American health care system.

  • STUDY: Major Wisconsin Newspapers Failed To Contextualize The Impact Of ACA Repeal

    ››› ››› CAT DUFFY

    Republicans are pushing forward with a repeal of the Affordable Care Act (ACA), with Speaker of the House Paul Ryan (R-WI) leading the charge. The top Wisconsin newspapers have largely failed to convey the impact of repeal on Wisconsin residents on a variety of crucial metrics, with little to no mention of the impact on women and minority communities and insufficient contextualization of the potentially devastating changes to Medicare and Medicaid.