The Fox-led campaign to pressure GOP governors to decline the Affordable Care Act's Medicaid expansion has left 5.7 million people uninsured who could have gained coverage under the law.
In 2012, the Supreme Court ruled that states could decide whether to expand Medicaid eligibility to all adults living below 133 percent of the federal poverty line, under a provision of the ACA which would provide federal funding for the expansion.
Immediately following the ruling, Fox News began a campaign to convince Republican governors to turn down the funding and refuse to expand the program. On July 2, 2012, Fox & Friends praised Florida governor Rick Scott for turning down Medicaid expansion. The same day, then-Fox News contributor Sarah Palin appeared on On the Record and said she "would like to see governors be tough and opt out" of the expansion":
PALIN: Many, many states are not going to be able to afford expansion of Medicaid and these exchanges that are going to try to be forced down states' throats through "ObamaCare." I would like to see governors be tough and opt out of this and exert our 10th Amendment rights and tell President Obama, who does not understand the Constitution -- he even being a constitutional lecturer and supposed scholar in our Constitution, not understanding and probably never reading or absorbing the 10th Amendment to understand that states have rights.
Fox continued to demagogue the program long after the Supreme Court's decision, misleading on its costs, falsely claiming it would bankrupt states, and ultimately blaming the ACA for the coverage gap that resulted from the very expansion refusal it advocated.
The decision not to expand Medicaid is not without consequences. The Kaiser Family Foundation found that 19 states are not moving forward with expansion, while five more are engaging in debate, but have not made a decision. Today, the White House revealed the human costs of the campaign to demonize Medicaid: (emphasis added)
In the five years since President Obama's health care reform plan -- which became the Affordable Care Act (ACA) -- was first introduced, the right-wing media has waged a continuous campaign to attack the law through misinformation, deception, and outright lies.
Fox News attacked a provision of the Affordable Care Act (ACA) that allows certain inmates to be enrolled in Medicaid as "ridiculous and unfair to every taxpayer." But according to health care and correctional experts, increasing access to health services reduces both the costs associated with incarceration and decreases inmates' chances of being incarcerated again.
Fox News' Dana Perino falsely claimed that the Affordable Care Act would be responsible for deepening income inequality in the United States and would hurt low-income families.
The co-hosts of Fox News' The Five attacked the ACA on the last day of open enrollment in the law's health care exchanges. Amid reports that a last-minute surge had brought enrollment over 6 million people, Perino declared that the law "exacerbates income inequality" and will "end up hurting low-income people":
PERINO: My big concern from the beginning on this, on the bigger picture Tom that you were talking about, is actually how it exacerbates income inequality. And it actually will end up hurting low-income people a lot more because as we've seen in the last few weeks you have more and more doctors deciding not to take insurance at all and not to take Medicaid patients, and they're not going to be told that they have to.
Perino's claim is absurd for a number of reasons. A January 2014 study by the Brookings Institution found that the Affordable Care Act will boost the incomes of Americans in the second-lowest income decile by more than 5 percent and those in the bottom income decile by more than 7 percent:
Perino's suggestion that the ACA will cause doctors to refuse Medicaid patients is also dubious. The ACA expands Medicaid eligibility for adults with incomes at or below 138 percent of the federal poverty level. The Urban Institute and Robert Wood Johnson foundation estimated that the expanded eligibility meant that about 15.1 million uninsured adults could gain coverage. The ACA also increases certain payments to health care providers, a change that Wonkblog pointed out could "entice more providers to participate":
That could mean that the states with the highest likelihood of expanding Medicaid might be those with the lower reimbursement rates - and fewer doctors willing to accept these patients by proxy. That could prove true in a state like California, where 1.8 million residents are expected to gain coverage - but fewer than 60 percent of providers accept new patients in the program.
It could also speak to the importance of some of the payment increases in the Affordable Care Act. The law increases Medicaid reimbursements for primary care doctors to match those of Medicare providers. That means that everyone on the right side of this chart will move over to the left. And that could entice more providers to participate. Decker estimates using this data set that it would raise the Medicaid participation rate to 78.6 percent, an 8.6 percent increase from where it stood in 2011.
Fox News is helping promote Sen. Tom Coburn's misleading report on health care spending, which attacked the Affordable Care Act by cherry-picking data on the rise of spending in health care systems.
The Oklahoma Republican released a report this week titled "The History of Federal Health Care Spending," which attempted to rebut projections that the ACA will reduce the deficit and lower health care costs by presenting data on the cost growth of other federal programs like Medicaid and Medicare. The report argued that that "the government's spending on health care programs usually outpaces economic growth" and that "compared with initial government estimates and outlays, most programs have experienced exponential growth."
On Fox News' America's Newsroom, co-host Bill Hemmer said the report revealed "stunning numbers," while Fox contributor Charles Gasparino endorsed the report's suggestion that the growth in government health care programs contradicted positive projections of the ACA's impact, claiming "when government is this much enmeshed in a program like this, it always leads to disaster":
But Fox's hype ignores the crucial flaw in Coburn's report -- it omits crucial context about why the programs' costs have increased and how they perform at controlling costs when compared to private health insurance.
While it's true that spending on programs such as Medicaid and Medicare have increased over the last 50 years, the cause of those rising costs are not a result of government involvement, but due to the fact that overall spending on health care has increased exponentially. A 2010 report in Health Affairs which tracked Medicare spending over roughly 20 years found that much of the growth "is attributable to rising spending on chronic conditions -- specifically diabetes and hypertension, both of which rose considerably in treated prevalence over the past two decades."
Notably, the Kaiser Family Foundation found that "Since Medicare's inception, however, growth in annual spending per beneficiary has been approximately one percentage point lower than private health insurance spending":
Fox News disingenuously blamed the Affordable Care Act (ACA) for a "coverage gap" that could leave 5 million low income Americans without health insurance. In doing so, Fox absolved the sins of the Republican governors whose refusal to expand Medicaid is responsible for the gap and will cost states money.
The ACA allows states to expand Medicaid programs to provide coverage for people whose income falls below 138 percent of the federal poverty level. Initially, the federal government covers the full cost of new enrollees for the first three years. However, many states have refused to expand their Medicaid coverage under the law, "thanks largely to hostility to the law among GOP governors," according to The Washington Post's Greg Sargent.
On the February 10 edition of Fox's America's News HQ, host Bill Hemmer condemned the coverage gap as "another problem growing out of Obamacare." Fox business host Melissa Francis explained that 5 million Americans fall into a gap where they earn too little for federal subsidies but too much for Medicaid benefits and argued that many states did not expand Medicaid benefits under the ACA because they can't afford it:
FRANCIS: The Kaiser Foundation studies this and they say there's about 5 million people between the ages of 18 and 64 who fall into this gap. And it all comes from that Supreme Court decision that said that we couldn't force states to expand Medicaid. Now places like Alabama where this one gentleman who is the example lives, they have said that they can't cover more people with their state program because they simply can't afford it. So that's how these people got left out in the middle but there is a lot of them, 5 million.
FRANCIS: The states, though, are pushing back and saying look, we didn't expand Medicaid because we can't afford it, and even though the federal government will pay for it for 3 years, after that it's on us and we just simply can't afford this. So it's going to be a really tough problem to fix.
New research reveals that the Affordable Care Act has a relatively strong effect on reducing income inequality and economic insecurity for low-income Americans. However, given past coverage of the law, this fact is likely to go underreported in media.
A new study from the non-partisan Brookings Institution projects the Affordable Care Act (ACA, or "Obamacare") to positively impact low-income Americans. The research, performed by economists Henry Aaron and Gary Burtless, reviews a comprehensive income measure combining wages, the value of employer-provided health insurance, and the value of government-subsidized coverage. The authors project that the ACA will increase incomes in the bottom-fifth of the population by almost 6 percent, while increasing incomes in the bottom-tenth of the population by more than 7 percent.
Additionally, the authors found that positive "benefits of the ACA to low-income families would have been greater if the enacted version of the law had been put into effect." According to the study, the Supreme Court's landmark 2012 decision upholding the law, but allowing states to opt-out of expanding Medicaid to low-income residents, has dampened the effectiveness of health care reform -- preventing nearly 6 percent of the American population in the lowest 20 percent of income earners from accessing free health coverage through Medicaid. If not for the Supreme Court's decision, and corresponding "state inaction," the relatively strong impact of the ACA in reducing inequality for low-income Americans would have been greater.
The study concludes that, while the ACA does not positively impact the income of all Americans, the "small proportional drops in income" correspond with "larger proportional gains" for the poorest quarter of the working population. The graph below shows the average expected impact of the ACA on after-tax adjusted incomes for each tenth of the wage spectrum. The results show that corresponding positive impacts at the bottom of the income bracket more than make up for marginal decreases at higher income levels.
Previous Media Matters research has exposed how the media almost never mentions the positive impact of health insurance access on reducing economic inequality and strengthening economic security. Instead, media outlets opted to focus on the difficult rollout of Obamacare health care exchanges -- notably Healthcare.gov. The lack of discussion regarding the positive impact of the ACA on reducing economic inequality is particularly pervasive among right-wing media, where policy proposals aimed at reducing inequality are treated as trivial and unimportant.
Image via southerntabitha using a creative commons license
Right-wing media have spent the last few years baselessly dismissing the decades-long push to alleviate poverty as not worth the fight, despite evidence showing that government efforts to reduce poverty have been successful.
On January 8, 1964, President Lyndon B. Johnson used his State of the Union address to enumerate proposals that would come to be known as the War on Poverty. Many of the proposals and policy prescriptions outlined in the president's speech were eventually signed into law.
Recent research from the Columbia Population Research Center at Columbia University reveals the extent to which anti-poverty programs since the 1960s have alleviated poverty for millions of Americans. The study, titled "Trends in Poverty with an Anchored Supplemental Poverty Measure," uses a uniform measure of poverty (supplemental poverty measure or SPM) to show a dramatic drop-off in poverty rates from 1967 to 2011. From the study (emphasis added):
The OPM shows the overall poverty rates to be nearly the same in 1967 and 2011 -- at 14% and 15% respectively. But our counterfactual estimates using the anchored SPM show that without taxes and other government programs, poverty would have been roughly flat at 27-29%, while with government benefits poverty has fallen from 26% to 16% -- a 40% reduction. Government programs today are cutting poverty nearly in half (from 29% to 16%) while in 1967 they only cut poverty by about one percentage point.
Today, despite mounting evidence of their success, the corresponding anti-poverty programs created during the War on Poverty face incessant and withering criticism from conservative politicians and their right-wing media allies. Conservative media voices regularly repeat the claim that anti-poverty programs are useless, or that after 50 years they are no longer working. In fact, as recently as January 7, Fox News host Martha MacCallum cast doubt on whether or not lowering the poverty rate over the past five decades was worth the effort, but the following graph from The New York Times' Economix blog shows just how effective these programs have been:
Source: The New York Times, Economix Blog, "The War On Poverty at 50"
In addition to questioning the general efficacy of anti-poverty relief efforts, right-wing media voices have targeted specific Johnson-era programs and initiatives like Social Security, Medicare and Medicaid, expanded food stamps and welfare, and an increased minimum wage in their coordinated attempt to undermine the social safety net, effectively stymying the purpose of the War on Poverty.
Much of the Affordable Care Act (the ACA, also known as Obamacare), went into effect on January 1, 2014. Major evening news broadcasts focused on different aspects of the law's effects and the extent to which the law will benefit consumers.
Fox Business host David Asman baselessly speculated that health care reform's Medicaid expansion could bankrupt states, a prediction at odds with economic experts who have declared the expansion "a very favorable financial deal for states."
The Affordable Care Act allows states to expand Medicaid programs to provide coverage for people whose income falls below 138 percent of the federal poverty level. Initially, the federal government covers the full cost of new enrollees. After 2016, the federal government will continue to pay 90 percent of the program's cost.
On the December 11 edition of Fox News' America's News HQ, Asman warned that new Medicaid enrollees who became eligible for coverage due to the Affordable Care Act's would be covered at "an extraordinary extra cost to taxpayers." Asman went so far as to claim the cost could bankrupt states:
ASMAN: States are spending 30 - 40 percent of their entire budget on Medicaid. And as these more people sign on to Medicaid because of Obamacare, they're going to not only cost us taxpayers more money on the federal level, but they may make some states go bankrupt, because they won't be able to keep up with all those extra Medicaid patients.
Expanding Medicaid would not only not bankrupt states, according to the Center on Budget and Policy Priorities (CBPP), it "will add very little to what states would have spent on Medicaid without health reform." CBPP found that "Expanding Medicaid is thus a very favorable financial deal for states":
Fox News claimed the Obamacare rollout has "clearly" been worse for the American people than the government shutdown, because the shutdown's "biggest inconvenience" was a few closed national parks and memorials -- ignoring the shutdown's cuts to domestic violence centers, women and children's food and health care, stalled scientific research, and severe economic losses.
On the November 11 edition of Fox News' Fox & Friends, co-host Steve Doocy and Fox legal analyst Andrew Napolitano held a "pop quiz" to determine "[w]hich was more harmful to your personal freedoms," Obamacare or the government shutdown? Both decided that there was no contest: Doocy proclaimed that Obamacare was "clearly" worse than the "slimdown," and Napolitano agreed that it was "[n]ot even a close call." As evidence, Napolitano pointed out that "the biggest inconvenience" of the government shutdown was "a couple hundred well-intended people trying to get into national parks and monuments and the government had closed them." In contrast, he claimed that Obamacare hurts people by forcing them to buy expensive "high end, one-size-fits-all" health insurance policies.
Fox's faulty comparison ignored the significant impacts of the government shutdown, which harmed the economy and slashed funding to necessary programs for low-income Americans.
Because of the shutdown, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a program that helps provide health care for at-risk babies and "helps new mothers feed themselves and their babies properly," saw its funding slashed, and states that were unable to lend the program local funds were forced to stop accepting enrollees. The shutdown also cut federal funding to at least 2,000 shelters for victims of domestic abuse, workplace safety inspections were halted, federal workers stopped inspecting toxic waste sites, and the CDC stopped monitoring the spread of the flu. National Geographic further reported that the shutdown caused long-term setbacks in scientific research, and The Washington Post detailed how the shutdown's fallout cost low-income workers their economic stability.
The shutdown also did lasting damage to the U.S. economy. Moody's Analytics estimated that the shutdown "cut real GDP by $20 billion, shaving half a percentage point off growth in the fourth quarter," according to a Congressional Research Service (CRS) report. CRS also noted that "JP Morgan Chase's chief economist was quoted as estimating that the shutdown reduced fourth quarter growth by 0.5 percentage points, with half the reduction attributable to lower government spending and half to 'spillover effects and lost activity' in the rest of the economy." The shutdown also eroded consumer confidence and may have derailed our gradual economic recovery, and economists argue that the shutdown will have lingering effects on the labor market and overall economy for several months.
Napolitano's argument that "5,500,000 innocent Americans were told they don't - they won't have health insurance on January 1st" is also inaccurate. Fox has repeatedly worked to hide the fact that rather than losing coverage outright, most of these consumers are simply being offered new, often better, options because policies will be required to include basic standards of care. Moreover, the rollout of the Affordable Care Act, though rocky, has successfully allowed hundreds of thousands of Americans to sign up for Medicaid.
Fox News overstated the costs of Medicaid expansion for states by ignoring research and evidence showing that expanding Medicaid actually saves money for many states because of the high share of the cost being picked up by the federal government in the Affordable Care Act (ACA) and the reductions in money spent by states on uncompensated care.
Fox News obscured Republicans' role in creating a Medicaid coverage gap in the administration's health care expansion to hype one woman's coverage loss as an example of Obama's broken promises.
Fox host Elisabeth Hasselbeck welcomed guest Tammy Fiechtner onto the November 1 Fox & Friends to discuss a letter she received from her insurer explaining that she's being automatically moved to a new insurance plan. Hasselbeck hyped "what's being called the Obamacare coverage gap," saying, despite the letter, that she "hasn't gotten a new plan. In fact, she doesn't have coverage at all." Fiechtner's comments shed more light on her predicament; the new plan she was being moved to had a similar premium, but a higher deductible. Fiechtner then explained that after exploring her options, she found that she would have qualified for Medicaid coverage under the Affordable Care Act (ACA)'s expansion of the program, but her Republican-led home state of Nebraska chose not to accept the Medicaid expansion (emphasis added):
FIECHTNER: When we went on the website, we found out that we didn't qualify for Obamacare because of how our business structure works. So, we were told that we had to go on Medicaid, which I don't understand why I have to be on Medicaid, but that's where they directed us to. Nebraska did not expand Medicaid, so there will be no help for people like ourselves. So we now are forced to buy a new plan all on own and face these expenses by ourselves.
As The New York Times reported, the ACA was "written to require all Americans to have health coverage" and "about 30 million uninsured Americans were to have become eligible for financial help" through subsidies for lower-income earners and the Medicaid expansion. According to the Times, the Supreme Court's 2012 decision to allow states to opt out of the Medicaid expansion left millions of low-income consumers without financial help in acquiring insurance:
But the Supreme Court's ruling on the health care law last year, while upholding it, allowed states to choose whether to expand Medicaid. Those that opted not to leave about eight million uninsured people who live in poverty ($19,530 for a family of three) without any assistance at all.
Hasselbeck's attempt to lay the blame for Fiechtner's situation on President Obama papers over Republicans' role in sabotaging access to affordable health insurance. As Politico reported in a November 1 story headlined "The Obamacare sabotage campaign," there is "a strong factual basis" for the charge that "calculated sabotage by Republicans at every step" has undermined key points of the law -- including the Medicaid expansion -- and has seriously damaged the overall rollout (emphasis added):
In the week following the end of the 16-day government shutdown, major print media outlets shifted their attention to upcoming bipartisan budget negotiations. This coverage of budget priorities was far more likely to mention the need for deficit and debt reduction than economic growth and job creation, despite economists warning that growth is the more pressing concern.
The Wall Street Journal attacked the Affordable Care Act's (ACA) Medicaid expansion by claiming that Medicaid beneficiaries would have better health outcomes with no insurance at all. But the Journal's analysis relies on an inaccurate reading of an Oregon health care study and ignores that Medicaid has been shown to lower rates of depression, reduce financial strain, and benefits low-income children, mothers, and veterans.