Local conservative blogs and opinion sections seized on reports of initial technical glitches with the online health care exchanges to broadly slam the Affordable Care Act (ACA), and failed to recognize similar challenges with implementing Medicare Part D.
The online health care exchanges opened on October 1 to assist people in selecting an insurance provider in compliance with the ACA. Since the launch, several local opinion outlets have framed the story to maximize frustrations over technical glitches and paint the federal government as incompetent in preparing for enrollment. These same outlets have been repeatedly critical of the ACA.
For example, the Las Vegas Review-Journal ran an editorial that called the exchange launch "an information-technology disaster." Other outlets have been openly rooting for the exchanges to fail, such as North Carolina's Civitas Institute which called for readers to submit "Obamacare horror stor[ies]." Watchdog.org published a reporter's first-hand "maddening" experience with trying to log onto the New Mexico Health Insurance Exchange.
The user complaints are not completely unwarranted, as very real technical issues attributed to heavy traffic on the sites and software problems have been reported. High demand to access the health care exchanges drove 8.6 million unique victors to HealthCare.gov in the first 72 hours after the exchanges went live.
However, much of the negative local coverage of the rollout fails to take the exchanges in perspective. Few reports question whether it is reasonable to expect such a large and complex undertaking to run smoothly right out of the gate. The 2005 enrollment of millions of seniors in Medicare Part D - the government program to subsidize the cost of prescription drugs for Medicare patients - is the closest way to put the ACA exchanges in perspective.
Las Vegas Review-Journal columnist Sherman Frederick hyped two debunked myths about the Affordable Care Act (ACA), including the false claim that the Cleveland Clinic is cutting costs as a direct result of the ACA and that "skinny networks" will limit access to quality care.
In his September 28 column, Frederick claimed the truth about the ACA was revealed when Eileen Sheil, corporate communications director for the Cleveland Clinic Foundation, said that the clinic would be cutting its budget and making other employment decisions due to the law. The column continued:
Ms. Sheil announced that in order to prepare for Obamacare, the Cleveland Clinic, one of the world's best health care providers, would slash up to 6 percent of its 2014 budget, put some 3,000 employees into early retirement, hold positions vacant longer and, if necessary, lay off employees.
Let that sink in. Just like that, the world-renowned Cleveland Clinic brought to bended knee by Obamacare. If this law can do that to one of our best medical institutions, what's going to happen to the quality of our local hospitals? How will isolated, rural facilities cope?
The problem with Frederick's assertion is that it's not true. The Atlantic reached out to Sheil who "seemed a bit confused by the emphasis on Obamacare in reports" and explained that the clinic had been "working on reducing costs for years" in order to remain viable, and the ACA was just the catalyst to implement those decisions. Fox News' Greta Van Susteren also debunked this myth when she backpedaled on initial Fox reports after speaking with Toby Cosgrove, CEO of the clinic.
Anti-Affordable Care Act (ACA) group Generation Opportunity placed a misinformed op-ed aimed at Millennials in at least a half dozen local papers in an effort to prevent younger Americans from enrolling in the Affordable Care Act 's individual exchanges.
Generation Opportunity's op-ed ran in at least a half-dozen newspapers over the weekend of September 28, including in Nevada's Las Vegas Review-Journal and Florida's Sun-Sentinel. The piece was authored by former unsuccessful Congressional candidate from Pennsylvania and president of Generation Opportunity -- a Koch-brothers backed anti-Affordable Care Act group -- Evan Feinberg. The editorial attempted to frame the ACA as a "bad deal for young people" and urged them to "opt out" by claiming it will cost them a lot of money and that it "relies on a system of generational redistribution":
Apparently they think Millennials are gullible. But no veneer of popularity can mask the exchange system's deep problems. The simple fact is that they are a bad deal for young people. And as a result, it makes more financial sense for Millennials to opt out and purchase a non-Obamacare policy on the private market.
The most obvious problem with the exchange system is how it perversely relies on a system of generational redistribution. Quite simply, the law takes from the young to subsidize the old. That's why the White House is so dead-set on getting young people to sign up -- without our money, the system won't work, and the exchanges will enter what has been called a "death spiral."
Despite conservatives' constant attempt to turn young people away from the ACA, many Millennials are able to understand that having health insurance can save thousands of dollars in cases of serious injury or illness and that gaining coverage through the exchanges, employer benefits, or through private plans also allows them to access affordable prescriptions, and afford preventive care which can help prevent minor issues from becoming major health concerns.
Feinberg clearly recognizes the benefits of health coverage, as he suggests that young people "opt out and purchase a non-Obamacare policy on the private market." However, Feinberg leaves out the important detail that federal tax credits, often referred to as subsidies, are only available through the exchanges and are designed to make coverage affordable. Suggesting young people "opt out" and buy coverage through a private plan adds up to telling Millennials to pay more for private coverage that must meet identical standards as the plans offered on exchanges.
The Las Vegas Review-Journal took a news article from its own newspaper out of context to mislead about insurance coverage and provider networks in Nevada under the Affordable Care Act (ACA).
In a September 19 editorial discussing new coverage options under the ACA, the Review-Journal suggested that people would be forced from their current provider networks onto streamlined "skinny networks," which would offer fewer doctor and hospital choices but would also cut health insurer costs (emphasis added):
President Barack Obama's 2009 guarantee was emphatic. "We will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period."
ObamaCare exchanges roll out in less than two weeks. The Patient Protection and Affordable Care Act -- or at least the portions of it the president deems politically expedient -- takes effect Jan. 1. And many Nevadans are about to learn the value of the president's word -- and get notice worthy of an exclamation-point tirade.
As reported by the Review-Journal's Jennifer Robison on Sept. 12, Nevada's insurers are expected to control the costs of dozens of coverage mandates by slashing the number of doctors and hospitals they contract with, creating what local employee benefits consultants call "skinny networks."
If you like your doctor, and your doctor isn't in your new skinny network, then guess what? You will not be able keep your doctor. Period.
But the editorial is misleading for several reasons. First, the Review-Journal article to which the editorial referred actually indicated that those who already have health coverage through an employer or their own business wouldn't see any coverage changes at all unless they elected to switch (emphasis added):
Whether you'll see a trimmed-down network in 2014 depends on your current coverage. If you have a policy through a big company or a self-insured business, and you don't change plans Jan. 1, your network should stay the same. If you have to change plans, or if you're buying for the first time, you could see thin networks.
For carriers who offer them, skinny networks save money two ways. First, with fewer providers, consumers won't seek as much care. If the closest hospital in your network is 20 minutes away, you're less likely to make an unnecessary trip to the ER, for example. So the networks cut patient-use rates.
They also let insurers carve out the priciest providers. One carrier told Caparso a heart procedure that costs $19,000 at one local hospital runs $43,000 at another. With a skinny network, that carrier can offload the more expensive hospital and cut its reimbursement exposure by more than half.
The editorial also promoted the false claim that insurance rates "have to go up" under the ACA. However, a new report by the Department of Health and Human Services shows that premium prices are expected to be 18 percent lower than previous 2014 projections:
In the eleven states for which data are available, the lowest cost silver plan in the individual market in 2014 is, on average, 18% less expensive than [Assistant Secretary for Planning and Evaluation's] estimate of 2014 individual market premiums derived from CBO publications.
Lastly, the Review-Journal's editorial used common conservative scare tactics to stoke fears about fraud in the federal subsidies for health coverage. In fact, the Congressional Budget Office released a report on September 10 showing that income verification procedures are already in place to ward off potential fraud, and will be ready for the January 1 launch. As CNN reported, those applying for federal financial aid under the exchanges will have their incomes verified against federal records:
Exchanges must still check the applicant's income against a federal database, which will include information from his federal tax returns and a record of Social Security benefits.
The exchanges will be looking for disparities between what the applicant says and what's in the database.
If it looks like someone is understating his income by more than 10%, and the exchange doesn't have other sources to quickly check against, the exchange may choose to rely on what the applicant says.
But in those cases, the exchange must also conduct a random sample of similar applicants to make sure the verification process is working.
The Las Vegas Review-Journal failed to note that the author of a recent op-ed on the fast food worker strike is closely associated with a lobbying group for the fast food industry.
The August 30 op-ed titled, "Minimum wage hike means fewer jobs," was authored by Michael Saltsman, who the paper identified simply as the "research director at the Employment Policies Institute." Saltsman wrote that increasing the minimum wage to $15 an hour, which fast food workers are currently demanding in strikes across the country, would leave employers with no choice but to "provide the same service with fewer employees," a common conservative myth which has been debunked.
The paper did not disclose that the Employment Policies Institute is one of several front groups started by corporate lobbyist Richard Berman. Berman, who has received the nickname "Dr. Evil" for the corporate clients he represents, was featured in an April 2007 CBS report which explained his lobbying efforts:
Rick Berman takes a certain pride, even joy, in the nickname "Dr. Evil." But the people who use it see nothing funny about it--they mean it.
His real name is Rick Berman, a Washington lobbyist and arch-enemy of other lobbyists and do-gooders who would have government control--and even ban-a myriad of products they claim are killing us, products like caffeine, salt, fast food and the oil they fry it in. He's against Mothers Against Drunk Driving, animal rights activists, food watchdog groups and unions of every kind.
A Las Vegas Review-Journal editorial opposing minimum wage laws claimed that minimum wage jobs are only meant to be starting points for young workers who will later seek better paying jobs and that increasing the minimum wage would hurt youth employment, citing a fast food industry lobbyist's think tank to support these claims. In reality, studies show that minimum wage work is not limited to entry-level workers, increases in minimum wage would not hurt youth employment, and Nevada would benefit from an increase in the minimum wage.
The Las Vegas Review-Journal hyped the need for entitlement reform, calling for an increase in eligibility ages for Social Security and Medicare, means-testing or tying benefits to a beneficiary's income, and competition for Medicare. However, the Review-Journal neglected to mention that health care cost growth has been slowing down and that enacting these policy prescriptions would hurt seniors and low-income Americans.
Las Vegas Review Journal contributor Sherman Frederick penned a column claiming that state legislators are pushing a new bill seeking to bolster sex education in Nevada because they believe "Nevada girls are easy."
After discussing one Hispanic legislator's support of comprehensive sex education, which Frederick assumes is just teaching students "how to put a Ziploc bag over a cucumber," Frederick determines that the argument the legislator is making is that Hispanic girls are "really, really easy":
As easy as Nevada girls are, you see, Nevada's Hispanic girls are really, really easy. That comes from the mouth of Sen. Ruben Kihuen, D-Las Vegas. According to him, that's because Hispanic parents never talk to their children about sex. So government must do it.
Lest you think I am making this up, take a look at this excerpt from the Reno Gazette-Journal's Ray Hagar, who interviewed Kihuen about AB230, and Assemblywoman Lucy Flores, D-Las Vegas, who testified in favor of the bill and revealed that she got pregnant as a teen and had it aborted.
Instead, we have AB230. Social conservatives on one side. Liberals on the other. And wanna-be leaders unwittingly (I hope) contending that not only are Nevada girls easy, Nevada's Hispanic girls are really, really easy.
Frederick claimed that the "Nevada girls are easy" quote comes from a news report by Reno Gazette-Journal's Ray Hager. However, Hager said in a tweet "That's Sherm's quote. I, or anyone I've quoted, did not say that": (click to enlarge)
The Las Vegas Review-Journal promoted a plan to create a merit pay system for teachers, but failed to note that merit-based pay schemes have not succeeded and could hurt students in low-income areas.
In the May 1 editorial, the paper claims that criteria such as "teacher experience, credentialing, and graduate degrees do not translate to higher student achievement" and should no longer be the basis for pay increases. Instead, it advocates for a merit pay system, as proposed by former Nevada State Superintendent James Guthrie, which would increase teacher pay based on a testing criteria. The top earners would make $200,000 a year, which, in Guthrie's estimation, would attract some of the nation's top teachers and "rescue Nevada public education."
Teachers are currently paid less than comparable workers and their pay has been declining. However, switching to a merit based system is not a proven solution. A study by the RAND corporation which looked at a merit pay system that gave bonuses to better performing teachers, found that, while students performed better over the course of the study, "students of teachers randomly assigned to the treatment group (eligible for bonuses) did not outperform students whose teachers were assigned to the control group (not eligible for bonuses)." A similar RAND study analyzing New York City's experiment with bonuses for teachers found similar results, causing Education Week's blog to claim that it "put the final nail in the coffin" for the NYC program. According to Education Week, the study confirmed that the bonus incentive wasn't achieving its desired outcome:
Apparently the RAND study, commissioned by New York City's education department, was the final straw. The RAND researchers, like those in the previous studies, found the program did not raise student achievement in mathematics or reading in any grade, nor did it improve teacher job satisfaction. The findings led to the city's decision last week to eliminate the program.
Researchers suggested that the program had not adequately motivated staff to understand the program or buy in to the criteria for the bonuses, and noticed that both participating and control schools already faced intense pressure to improve because of the city's accountability measures.
The Las Vegas Review-Journal penned an editorial attacking minimum wage in Nevada by claiming that raising the minimum wage hurts youth employment, even though studies have found no conclusive correlation between youth unemployment and minimum wage increases.
An editorial by the Las Vegas Review-Journal discussed the recent announcement by Nevada Labor Commissioner Thoran Towler that Nevada's minimum wage won't change from its current level of $8.25 for workers who don't receive health benefits to push the claim that younger, unskilled workers would be harmed by future increases to minimum wage:
Broadcast newsreaders are in the habit of chirping that any hike in the minimum wage means "Nevada's lowest-paid workers got a raise today!" In reality, younger, unskilled workers can expect to be laid off and replaced with robots and computers, while more than half those searching for their first, entry-level job are plumb out of luck.
By delaying teens' first job experiences, where they prove they can show up on time, take direction and interact with customers, this law limits their future earning potential.
How bad are things? Nationwide, a quarter of youths ages 16 to 19 were employed last year. About 61 percent of Americans between ages 20 and 24 were working. Such lows haven't been seen since World War II. According to the Center for Business and Economic Research at the UNLV, Nevada's youth employment rate was a couple of percentage points higher, at 27 percent and 64 percent. Yes, that means only 27 percent of Nevada kids ages 16 to 19 could find work.
Despite the Review-Journal's assertion, studies have found that there is little evidence to support a link between youth unemployment and a higher minimum wage. In fact, as Heidi Shierholz of the Economic Policy Institute pointed out, unemployment overall, not just specifically for teens, is not massively affected by a minimum wage increase:
While it is true that there is some disagreement among economists about whether increasing the minimum wage increases or decreases employment, there is a consensus on the essential point: the impact of a minimum wage raise on jobs, whether positive or negative, is small. The warnings of massive teen job loss due to minimum wage increases simply do not comport with the evidence.
Major newspapers in Pennsylvania, Oklahoma, and Nevada have urged their governors to reject expansion of Medicaid -- the shared state-federal program that provides health care coverage to low income Americans -- under the Affordable Care Act, citing high costs that they claim would add to the states' financial burdens. In fact, a new report by the Kaiser Family Foundation finds that the Medicaid expansion would substantially reduce the number of uninsured at little cost to their state budgets.
As governors continue to decide whether to implement key aspects of the Affordable Care Act, the editorial boards of the Pittsburgh Tribune-Review and the Las Vegas Review-Journal urged the rejection of Medicaid expansion, while the editorial board of The Oklahoman applauded the recent decision by Republican Gov. Mary Fallin to reject the funding.
From the Pittsburgh Tribune-Review:
As stipulated under the Patient Protection and Affordable Care Act, Medicaid eligibility will expand to an additional 800,000 Pennsylvanians -- in effect, placing a quarter of the state's residents on government insurance, according to the Commonwealth Foundation. Never mind that Medicaid currently consumes 30 percent of the state's operating budget.
Once fully realized, ObamaCare will have all the appeal of a perpetual flu.
From the Las Vegas-Review Journal:
The accompanying Medicaid expansion, meanwhile, would throw millions of additional Americans into a system that's already bankrupting state governments and increasing costs in the private market. Geoffrey Lawrence of the Nevada Policy Research Institute, noting last week that Gov. Sandoval is pondering whether to expand Medicaid eligibility in Nevada, said any Medicaid expansion would mean reduced access to care for those currently enrolled.
President Obama won re-election this month, but the states hold the future of ObamaCare in their hands. Knowing the harm the law would do to our citizens, the economy, and the quality of American health care, Gov. Sandoval should join with many of his colleagues and decline to become the enabler of a vastly expensive, European-style medical rationing system that poll after poll has shown most Americans do not want.
From The Oklahoman:
Oklahoma has joined a growing list of states that won't expand Medicaid or implement state-run health exchanges, two key components of Obamacare. Predictably, the political left argues Republicans are being obstructionist. But why would state Republicans rush to implement a bad law to benefit a president who's made clear he would never do the same if the tables were turned?
As of June 2011, Medicaid programs in all 50 states and the District of Columbia provided health care coverage to 52.6 million people. However, as the economy has improved, the rate of growth of enrollment in the program has slowed down. With the passage of the Affordable Care Act, the federal government wants to expand the program in an effort to decrease the number of uninsured by providing coverage to those with an income below 133 percent of the federal poverty level. Previously, qualification for the program varied depending on factors such as age or employment status. Despite the claims from these editorial boards, the Affordable Care Act's Medicaid expansion provision will in fact achieve its goal, at only a slightly higher cost than what those states currently pay for Medicaid.
A recent study published by the Kaiser Family Foundation found that if all states expanded Medicaid it could lead to health care coverage for an additional 21.3 million people nationally with a total cost of around $1 trillion. Yet, the combined costs to states would only be approximately $76 billion as the federal government will cover the other $952 billion.
Specifically, Pennsylvania, Nevada, and Oklahoma would see significant increases in the number of people insured for only small changes to their current spending.
In Pennsylvania, if all states expanded Medicaid, the state would see a 52 percent reduction in uninsured citizens, while spending 1.4 percent more on Medicaid than current expenditures when accounting for the savings in uncompensated care. While Pennsylvania's expansion costs are higher than some other states, healthcare professionals note that this is because Pennsylvania currently has one of the more draconian Medicaid systems in the country. From WHYY in Pennsylvania:
New Jersey is on the opposite end of the spectrum, with projected costs of $1.2 billion with an expansion. And Pennsylvania? Almost $2 billion over 10 years, even after accounting for savings.
"Pennsylvania has not expanded to adults whereas other states have," said Ann Bacharach with the Pennsylvania Health Law Project.
"If you're a single, childless adult, there is not much that the state can offer in terms of coverage," Bacharach said.
So the new enrollees covered by an expansion would add costs, but the federal contribution would not provide the same savings in Pennsylvania as it will in Delaware.
Meanwhile, Nevada would see a 44.8 percent reduction in uninsured citizens for only 2.6 percent more in Medicaid spending if all states expanded Medicaid coverage. As Media Matters has previously noted, the Review-Journal's editorial board has attacked the Medicaid provision of the Affordable Care Act while neglecting to note any of the benefits expanding Medicaid would have on their state.
Lastly, Oklahoma would see a 54.4 percent reduction in uninsured for only 1.9 percent more in Medicaid spending if all states expanded Medicaid coverage. From Tulsa World:
[David Blatt, director of the Oklahoma Policy Institute] said the governor's calculations also leave out savings to the state in areas such as health, mental health and corrections that are currently outside the Medicaid system but could be included with expansion. Savings to those agencies has been estimated at more than $49.4 million a year.
Also missing from the calculation would be tax revenue increases the state would see as a result of the Affordable Care Act, he said.
For example, the state has a small tax on insurance premiums. If thousands of Oklahomans begin purchasing insurance through a federal health insurance exchange, that tax revenue goes up, he said.
If every state adopted the Medicaid expansion provision they would receive $9 in federal money for every $1 they spend to expand the program. As John Holahan, head of the Urban Institute's Health Policy Research Center and the study's author, said, "It's hard to conclude anything other than this is pretty attractive and should be pretty hard for states to walk away from." Unfortunately, the editorial boards of the Tribune-Review, Review-Journal, and The Oklahoman failed to provide that perspective and explain the overall benefit of Medicaid expansion to their readers.
Climate change was almost entirely absent from the political discourse this election season, receiving less than an hour of TV coverage over three months from the major cable and broadcast networks excluding MSNBC. By contrast, those outlets devoted nearly twice as much coverage to Vice President Joe Biden's demeanor during his debate with Rep. Paul Ryan. When climate change was addressed, print and TV media outlets often failed to note the scientific consensus or speak to scientists.
A two-part Media Matters examinantion of the largest newspapers in CO, NH, NV, OH, PA and VA from July 1-August 15 and from August 16-October 31, 2012 revealed a variety of shortcomings in the way clean energy and regulatory issues are covered by those publications.
Nevada media outlets failed to disclose the Big Oil interests behind a group offering cheap gas in the state this week to mislead voters about Obama's energy policies, including the false claim that the administration's energy policies are responsible for high gas prices. The bizarre stunts -- involving a walking, talking, anthropomorphic gas can -- were funded by groups largely financed by the Koch brothers, major conservative political donors who have significant oil interests. These groups are pushing policies that will benefit the Koch empire, not American consumers.
From the Associated Press:
Dozens of people lined up at a Reno gas station Tuesday to buy gasoline for $1.84 a gallon as part of a political event.
The cheap gas was offered by the Gas Can Man, a group funded by a [PAC called] Morning in America, focusing on energy policy. The conservative group Americans for Prosperity also funded the event.
A spokesman for the Gas Can Man told KOLO-TV that the event was supposed to remind voters that gas prices are high.
Spokesman Michael Findlay says that gas was $1.84 a gallon in the month of President Barack Obama's inauguration.
The Las Vegas Sun noted that as "people filled up their tanks, they stood in the shadow of AFP's campaign bus emblazoned with the slogan: Obama's Failing Agenda. One man registered voters." The paper quoted an Americans for Prosperity representative claiming the stunt was an exercise in "citizen education":
For the organizers of the event, the cheap gas offering wasn't a handout for those in need.
"It's citizen education," said Nick Vander Poel, of Americans for Prosperity. "This is issue awareness. We're educating them on the issues."
But the Las Vegas Review-Journal, Las Vegas Sun, and local television stations failed to disclose in their reports that the Gas Can Man and the cheap gas-campaign dubbed the "Million Can March" is funded by oil industry barons pushing policies that, if enacted, would line their own pockets but do nothing to lower the price of gas (the Sun disclosed the Koch ties, but neglected to mention their role in the oil industry).
Two days after the widespread publication of Mitt Romney's controversial declaration that 47 percent of Americans are "dependent on government," the largest newspaper in Nevada, a swing state in the 2012 election the 2012, has thus far failed to cover the story. Additionally, on September 18, the "Swing States Project" at the Columbia Journalism Review noted that another important swing state publication -- New Hampshire's Union Leader -- had also failed to cover the Romney comments.
A story published yesterday by the Columbia Journalism Review pointed out that the New Hampshire Union Leader -- New Hampshire's largest newspaper by circulation according to the Audit Bureau of Circulations -- had failed to cover Mitt Romney's comments that 47 percent of Americans will support Obama "no matter what" and that they are "dependent upon government."
While the Union Leader still has not published a news story on the topic, it did publish an editorial defending Romney's comments explaining that it was obviously a "statement of campaign strategy, not policy." From the editorial:
Naturally, the media portray this as Romney not caring about half the country. Absurd. It was a statement of campaign strategy, not policy, and every single national political reporter knows that.
In contrast to the Union Leader's limited attention to the issue, the Review-Journal -- Nevada's largest newspaper by circulation -- has not published anything on the subject at all, according to a Media Matters search of Nexis records and the Review-Journal website. In fact, despite not mentioning the comments once in its news or opinion sections, the Review-Journal has published two unrelated stories on Mitt Romney since Monday -- including a story discussing a private fundraiser Romney was planning on having in Las Vegas this Friday.
While 41 swing state newspapers made the Romney comments a front page story, the Review-Journal has mentioned it only once in an online-only blog post by opinion columnist and former publisher, Sherman Frederick, who, unsurprisingly, defended Romney for his "admirable truth-telling." Unfortunately, it seems that similar to the Union Leader, over 200,000 print subscribers of the Review-Journal can't count on their hometown paper to report a story with national implications if it doesn't look good for its preferred candidate.