The New Hampshire Union Leader promoted a plan that would use Medicaid expansion funds available under the Affordable Care Act (ACA) not to expand Medicaid to cover more of New Hampshire's poorest residents, but to subsidize private insurance plans. However, under this plan, people would potentially pay higher premiums for their private plans or be left without health insurance.
In a November 17 editorial, the Union Leader advocated for using Medicaid expansion funds to extend New Hampshire's practice of providing subsidies for private insurance policies and mocked legislators who warned that this approach could leave consumers vulnerable to price hikes due to lack of marketplace competition:
That is why Senate President Chuck Morse's plan to use Medicaid dollars to subsidize private insurance for qualified Granite Staters is such a great proposal. He called the Democrats' bluff. Now they are throwing up every objection that they can, even ones that undermine the party's position on Obamacare.
State Senate Republicans had proposed moving newly Medicaid-eligible Granite Staters into subsidized private insurance plans purchased on Obamacare's state insurance exchange, and doing that by 2015. Last week Democrats hilariously complained that this was "unworkable" (Gov. Maggie Hassan's word) because there is no competition on New Hampshire's exchange, which is serviced by only Anthem and Delta Dental.
By pushing for Morse's proposal, the Union Leader failed to take into account two major impediments to the Senate plan. First, a special waiver must be proposed by the state and approved by the federal government before Medicaid funds can be used for private insurance. Knowing this could be a lengthy process, other states that have taken this route have already submitted proposals for approval. The Senate plan backed by the Union Leader forecasts only one year for federal approval, and would end expansion efforts if the plan had not been approved by the end of that year. A different proposal by the House also recommends using Medicaid expansion funds to offer private insurance subsidies, but that plan does not foresee moving people to private plans for at least three years.
The second problem with the Senate plan is the lack of competition in the state exchange marketplace. With only one provider on the marketplace so far, New Hampshire's exchange is not competitive enough to make the Senate private subsidy plan viable, nor does it have the time to grow competition before the Senate plan would be implemented. According to the Boston Globe:
Insurance Commissioner Roger Sevigny cautioned the Senate panel that its timeline is ambitious. Sevigny said he has not heard of any companies preparing to enter the marketplace as the Senate plan envisions in 2015 to join the lone provider, Anthem Blue Cross and Blue Shield.
The House plan rejected by the editorial is deemed more practical, because it would only shift Medicaid funds to private insurance if three providers are competing on the exchanges. According to Forbes, competition is vital to keeping prices low and quality of care high:
In the future, to stay competitive, insurers will need to increase value for their customers. They'll do so by including in their networks only those physicians and hospitals that provide higher quality at a lower cost. This will require providers to improve the processes and outcomes of the care they deliver.
This shift in competition will begin a virtuous cycle. The lower cost, higher-quality insurance plans will attract more people. A growing membership base will give them greater leverage to demand increased efficiency, higher quality and superior outcomes from doctors and hospitals in their networks. This, in turn, will result in further market-share growth as more consumers see the value.
As the Concord Monitor further explained:
Implementing Obamacare and expanding access to Medicaid, let alone doing so under an as-yet unwritten plan that requires federal approval, is enormously complicated. Almost every part of every endeavor is in flux. So without getting into the deep weeds, the sticking point is this: The governor and the House want the people newly eligible for Medicaid to be able to obtain coverage under the standard Medicaid programs now being overseen by three managed care companies until at least 2017 before shifting them to private plans with what amounts to a voucher to subsidize the cost. The added time could allow players other than Anthem, the only insurer signed up to participate in the health care exchange marketplace, to join, thus increasing competition and lowering costs.
Almost all of Ohio's leading newspapers ignored a new poll showing that Ohioans overwhelmingly support action on immigration reform, even as House Speaker John Boehner (R-OH) announced a decision on November 13 that effectively reduced any chances at reform this year.
A poll conducted by Harper Polling on behalf of three pro-reform organizations -- including one that counts News Corp (Fox News' parent company) president Rupert Murdoch as a co-chairman, and another that exclusively supports GOP candidates -- found that 74 percent of Ohio residents surveyed feel the immigration system is broken and that another 72 percent support an immigration proposal with a path to citizenship. The poll also found that 68 percent of respondents support a plan that would grant legal status to undocumented immigrants and citizenship to those who were brought to the country illegally as children.
On November 13, the Cleveland Plain Dealer was the only major daily Ohio newspaper to report these findings, despite Boehner's pronouncement that day that he would refuse to allow negotiations between the House and the Senate on an immigration reform bill. As the Washington Post noted, the decision dealt "a significant blow to the prospects of comprehensive immigration reform by this Congress."
MediaTrackers Ohio attempted to distort local media coverage of the Affordable Care Act (ACA) by using badly flawed comparisons to claim the ACA's exchanges will lead to "sticker shock" for Ohio residents. MediaTrackers' analysis applies to a small slice of Ohio consumers and doesn't take into account important parts of the law.
Local media looking at MediaTrackers' effort should note several omissions in their reports:
As part of its analysis, MediaTrackers published several articles comparing the costs of insurance premiums for plans on Ohio's federally run ACA exchange to quotes for plans at eHealth.com, an online marketplace that allows people to shop for insurance. MediaTrackers looked at costs for 27-year-old women and men and 50-year-old women and men. In all the scenarios, MediaTrackers compared "Obamacare 'Gold' plans from [the Department of Health and Human Services] and existing policies with similar deductibles listed at eHealth."
As The New York Times explained, all health insurance plans starting on January 1 must include essential benefits from 10 health categories meaning consumers are not forced to purchase insurance through the exchanges in order to qualify under the ACA and can purchase private insurance if it is cheaper for them.
However, even using MediaTrackers' scenario, it is misleading to present today's plans and the new ACA-compliant plans as equal. Replicating MediaTrackers' scant methodology as closely as possible, the cheapest current plans do not have several of the health benefits required under the ACA. For example, picking the cheapest plan on eHealth.com in Columbus, Ohio, with a $1,500 deductible will allow a 27-year-old man to pay around $100 per month, but it will not include mental health, substance abuse, oral, or vision care -- all benefits required under the ACA.
The Las Vegas Review-Journal promoted several myths about the Affordable Care Act (ACA) including that men will have excessive coverage, that young people will not sign up for insurance on the exchanges, and that heavy Medicaid enrollment will jeopardize the exchanges.
Several local media outlets published editorials and opinion pieces highlighting and praising CBS' faulty 60 Minutes Benghazi report. Now that CBS has apologized and withdrawn its report, will local media follow suit?
On October 27, CBS' 60 Minutes aired a report highlighting comments from security officer Dylan Davies, who went by the pseudonym "Morgan Jones" and said that he was an eyewitness to the September 12, 2012, attack on the U.S. diplomatic facilities in Benghazi, Libya. After several inconsistencies surfaced in Davies' statements about the evening, CBS pulled its report, apologized to viewers, and said it would "correct the record" on the next edition of 60 Minutes.
Immediately following the 60 Minutes report, various local media outlets across the country published editorial and opinion pieces hyping the report and heralding it as evidence that President Obama and his administration were lying about the attacks. At least six local media outlets, including The Columbus Dispatch, The New Hampshire Union Leader, The Pittsburgh Post-Gazette, The Washington Times, The Charleston Post and Courier, and The Boston Herald, all hyped the CBS report with one outlet calling it a "damning report" while another said the administration's "coverup [is] being exposed." Pittsburgh Press writer Jack Kelly published a piece in the Post-Gazette claiming the report was "noteworthy for the new information provided -- in particular the interviews with 'Morgan Jones' and [Lt.] Col. [Andrew] Wood."
The 60 Minutes report reinvigorated the widely debunked myth that there are "lingering questions" about the Benghazi attack and continued to push a right-wing media narrative that the Obama administration has engaged in a cover-up in response to the attacks. The pervasiveness of the myth even hit Congress as Sen. Lindsey Graham (R-SC) threatened to hold up presidential nominations until questions surrounding Benghazi were answered.
Now that CBS has retracted its report, will local media outlets who also injected this misleading myth into their opinion pages do the same, or will they continue to rely on debunked information that misleads their readers?
The New Hampshire Union Leader argued against a proposal to expand Medicaid in the state and instead advocated for using the federal expansion funds to enact a voucher system. However, numerous studies have found that traditional Medicaid provides more coverage for less cost.
In a November 6 editorial discussing a state initiative to expand eligibility for Medicaid, the Union Leader claimed that Medicaid offered few health benefits and denounced the low reimbursement rates for doctors. The editorial went on to suggest that Medicaid expansion dollars should fund a voucher system:
Studies of Medicaid enrollees show that the program improves health care access, but not measurable health outcomes. And because it pays doctors and hospitals a fraction of what it actually costs for treatment, it does not solve the problem of cost-shifting. Nonetheless, there is pressure to expand eligibility from the state's current 63 percent of the federal poverty level to the Obamacare-demanded 138 percent.
[Sen. Chuck] Morse [(R)] and [Sen. Jeb] Bradley [(R)] have proposed a better way. Rather than throw people onto Medicaid, they would use Medicaid funding to enhance the state's premium support program. Low-income families would get better-quality private insurance, which pays full hospital and doctor reimbursement rates. And unlike straight Medicaid expansion, eligible people who are already privately insured would not be lured onto Medicaid.
Contrary to the Union-Leader's assertion that Medicaid doesn't show "measurable health outcomes," a study of Oregon's 2008 Medicaid expansion published in the New England Journal of Medicine found that while certain health outcomes were not achieved -- such as lowering cholesterol and hypertension -- expansion had other benefits such as lowering rates of depression and increasing the rate of diabetes detection and treatment.
Moreover, the American College of Obstetricians and Gynecologists has argued that expanding Medicaid is a key strategy to improving women's health, as Medicaid "is the largest payer of pregnancy services, financing between an estimated 40% and 50% of all births in the United States, and family planning services, accounting for 75% of all public expenditures."
Reimbursement rates under Medicaid expansion will increase as a result of the ACA, a fact the Union Leader failed to mention. As part of the law, provisions were included to raise rates so that doctors are more likely to accept new Medicaid patients. Rates will increase across the country by an average of 73 percent according to the Kaiser Family Foundation, and in New Hampshire, rates are expected to increase 50-99 percent:
In lieu of support for Medicaid expansion, the editorial advocated for a plan proposed by state Sens. Morse (R-Salem) and Bradley (R-Wolfeboro) that would use Medicaid expansion funds to further expand the state's voucher program. Yet, as Kaiser Health News explained, it is inherently cheaper to enroll more people in Medicaid than to give them subsidies for private insurance. Since HHS requires voucher programs like Morse-Bradley's to provide Medicaid-level benefits, the voucher program would promote more expensive plans but offer identical benefits to Medicaid. Furthermore, according to a study appearing in the Journal of General Internal Medicine, Medicaid offers better protection against underinsurance -- measured as out-of-pocket health care cost over 5% of income -- than basic minimum plans that low-income individuals can afford on the private market:
Greater than one-third of low-income adults nationally were underinsured. Medicaid recipients were less likely to be underinsured than privately insured adults, indicating potential benefits of expanded Medicaid under health care reform. Nonetheless, more than one-quarter of Medicaid recipients were underinsured, highlighting the importance of addressing cost-related barriers to care even among those with public coverage.
The New Hampshire Union Leader hyped a report on insurers discontinuing policies to accuse President Obama of lying about existing health coverage, despite evidence which shows that health care coverage isn't being canceled as the Union Leader suggested and the decision to transition beneficiaries was made by insurance companies, not the president.
The October 29 editorial relied on a NBC report that said the administration was aware of the fact many in the individual market would not be able to keep their plans, and asserted the president was "lying" when he said "if you liked your health insurance, you could keep it":
When President Obama said in 2009 that if you liked your health insurance, you could keep it, he was lying. This was no secret. It was pointed out repeatedly at the time. U.S. Rep. Tom Price, R-Ga., an orthopedic surgeon and professor of medicine, did a whole Republican weekly radio broadcast on it back then.
Price and others pointed out that Obamacare created strong incentives for insurers to cancel people's coverage. That is exactly what has happened -- just as the Obama administration knew it would.
As NBC News reported on Tuesday, "the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them."
First, the idea that consumers are having their policies cancelled is misleading. As the Center on Health Insurance Reforms (CHIR) explained, an insurance company discontinuing a policy is not anything new and the term "policy cancellation" is a "misnomer." These plans are not being cancelled, rather insurance companies are "exercising [the] option to discontinue the policy at the end of the contract year."
Currently, insurance companies generally have year-long contracts with consumers. At the end of the contract, companies can decide to no longer offer a specific policy -- which has nothing to do with the ACA. As CHIR further explains, under the Health Insurance Portability and Accountability Act (HIPAA), individual policies are "guaranteed renewable" but insurance companies can "increase premiums, increase cost-sharing, and/or reduce the scope of benefits covered." The ACA allows companies to continue offering plans that do not meet minimum standards -- known as "grandfathered" plans -- if they were created before March 23, 2010. Yet, as ThinkProgress reported, given the naturally high turnover rate among individuals enrolled in the individual marketplace, it is highly unlikely individuals would be enrolled in the same plans from 2010 in 2014.
As Sarah Kliff at The Washington Post explained, the number of grandfathered plans has steadily reduced since ACA's passage because insurance companies view them as a "dead end." She explained: "They can't enroll new subscribers and are really constrained in their ability to tweak the benefit package or cost-sharing structure," so many companies have instead made the business decision to drop the plans instead of retaining that coverage for their consumers.
Therefore, the Union Leader's accusation that the president lied about people being able to keep their coverage ignores the fact that under the law, people who liked their insurance could keep it, so long as their insurance company decided to retain that policy. Understanding changes in the insurance marketplace, the administration did predict that insurance companies would likely drop grandfathered plans. However, the changes to insurance plans are actually much better for consumers, as they will now have access to more complete coverage and access to tax credits that could result in lower premiums.
Prior to the ACA, private health insurance was referred to as "Swiss cheese" coverage because insurers could create policies with policy holes that would never pass employee benefit standards. These inferior insurance plans have failed customers in the past and helped inspire the minimum benefit coverage under the ACA, including a prohibition against increased premiums due to illness and the ability to get insurance even with a pre-existing condition. According to the CHIR:
For most people shopping on the marketplace, the policies available there will be a better value than anything they have been able to buy on the individual market. First, they will no longer have to worry that if they get sick, their insurer will jack up their premium - that's prohibited under the ACA. Second, many will be eligible for premium tax credits to make their plan more affordable. And, as noted above, all the plans will meet minimum standards for benefits and cost-sharing - no more swiss cheese coverage.
As the Department of Health and Human Services explained in a release, six out of 10 Americans who enroll in coverage on the exchanges could find plans that cost less than $100 per month, all that include the 10 essential health benefits mandated by law.
The New Hampshire Union Leader promoted a CBS report that rehashed a long-answered "question" on the attacks on the U.S. mission in Benghazi, Libya, claiming the Obama administration knew the facility was a target and chose to ignore warnings, despite evidence and testimony to the contrary.
The October 28 editorial applauded a 60 Minutes report for "expos[ing] the coverup" and echoed its claim that the administration had been "warned repeatedly" that the Benghazi mission would be attacked:
This past Sunday, "60 Minutes" aired a report on Benghazi that was a year in the making. It showed, among other things, that the security contractor hired to run the mission's unarmed guard team had warned repeatedly that the mission would fall to an attack because the armed Libyan guards could not be trusted. A Green Beret commander based in Tripoli had warned Washington that al-Qaida was preparing to attack Americans in Benghazi and the only option was "leave Benghazi or you will be killed." Those warnings were ignored.
The White House said for as long as a week after the attack that there was no evidence it had been premeditated. But numerous people on the ground at the time knew it was a planned al-Qaida attack and told Washington that.
However, the State Department's investigative review body, the Accountability Review Board, found no clear evidence of intelligence that could have been used to prevent the attack:
The Board found that intelligence provided no immediate, specific tactical warning of the September 11attacks. Known gaps existed in the intelligence community's understanding of extremist militias in Libya and the potential threat they posed to U.S. interests, although some threats were known to exist.
Then-Secretary of Defense Leon Panetta corroborated the findings of the State Department in Senate testimony. Appearing before the Armed Services Committee in February, Panetta explained that the lack of "specific intelligence" made crafting a timely response impossible:
In response to a question from Sen. Kelly Ayotte, R-New Hampshire, Defense Secretary Leon Panetta said he was aware of a cable sent in August by Ambassador Stevens that said security in Benghazi was not adequate.
"Unfortunately, there was no specific intelligence or indications of an imminent attack on that -- U.S. facilities in Benghazi," Panetta said. "And frankly without an adequate warning, there was not enough time given the speed of the attack for armed military assets to respond."
He also noted that the National Counterterrorism Center had identified some 281 threats to U.S. diplomats, diplomatic facilities, embassies, ambassadors and consulates during the six months before the attack in Benghazi.
The Richmond Times-Dispatch penned a misleading editorial to attack the Affordable Care Act (ACA) by incorrectly claiming income-based tax credits would not be verified, that caps on co-payments have been eliminated, and that the ACA will leave future Americans uninsured.
The October 23 editorial used the slow start of the exchange websites as a launching point to discount the entire law and its provisions as a failure. The editorial pushed several claims about the law including that it drops proof-of-eligibility requirements and it will leave millions of people uninsured in the next decade (emphasis added):
[The ACA] has failed so miserably that President Obama took to the airwaves to emphasize what a wonderful success it was, despite the website issues for which he offered "no excuses" -- and took no responsibility.
Besides, he said, "the Affordable Care Act is not just a website. It's much more." Indeed it is -- and there have been many more problems than just online technical roadblocks. The administration has delayed the employer insurance mandate for a year. It has dropped proof-of-eligibility requirements for exchange subsidies. And it has jettisoned caps on out-of-pocket expenses such as copayments and deductibles. Democrats and Republicans agree that the tax on medical devices should be repealed.
The ACA is not just a website -- and the glitches are not just web-related. Even if the law works exactly according to plan, a decade from now 31 million Americans will remain uninsured, according to the Congressional Budget Office. If that is success, be afraid of what failure could look like.
The Times-Dispatch's claim that the administration had "dropped proof-of-eligibility requirements" for individuals applying for tax credits to use towards the price of health care coverage bought on the exchanges is patently untrue. In fact, a strengthened income verification measure was part of the minimal concessions given to the Republicans to reopen the government after they held the entire law hostage leading to the government shutdown.
Furthermore, according to CNN Money the current verification methods will allow the IRS to recoup any over-payments from falsified information, meaning "anyone who might get a bigger subsidy than they are eligible for will have to pay back the difference to the IRS." According to CNN Money:
The final calculation of a subsidy's size will be done after the fact by the IRS.
"Your actual tax credit will be calculated based on your actual income that next April [when you file your federal tax return]," [Kaiser Family Foundation Senior Vice President Larry] Levitt explained.
Bottom line: Anyone who might get a bigger subsidy than they're eligible for will have to pay back the difference to the IRS.
And they may owe a penalty, too, since they must attest when applying for subsidies that they are not filing false information.
"If you report your income incorrectly, it will catch up with you because there's a reconciliation of these tax subsidies on your tax return. Come tax time you could see an enormous bill," said Linda Blumberg, a senior fellow at the Urban Institute's Health Policy Center.
The Times-Dispatch editorial also claimed that the administration had "jettisoned" out-of-pocket caps or limits placed on deductibles and co-payments. The editorial frames this as a permanent provision to the ACA. However, in reality, there has been a one-year delay in the implementation of the caps to better allow insurance companies to coordinate and fine tune logistical details so that caps can be calculated accurately. According to The New York Times:
The health law, signed more than three years ago by Mr. Obama, clearly established a single overall limit on out-of-pocket costs for each individual or family. But federal officials said that many insurers and employers needed more time to comply because they used separate companies to help administer major medical coverage and drug benefits, with separate limits on out-of-pocket costs.
In many cases, the companies have separate computer systems that cannot communicate with one another.
A senior administration official, speaking on condition of anonymity to discuss internal deliberations, said: "We knew this was an important issue. We had to balance the interests of consumers with the concerns of health plan sponsors and carriers, which told us that their computer systems were not set up to aggregate all of a person's out-of-pocket costs. They asked for more time to comply."
Caps on out-of-pocket spending remain an important part of the ACA and will save American families billions of dollars each year. In 2011 alone it was estimated that families spent $24.7 billion more than the ACA's cap threshold.
Finally, the Times-Dispatch made the inaccurate claim that the ACA, by design, will leave 31 million Americans uninsured. The editorial states that these individuals would remain uninsured "even if the law works exactly according to plan," suggesting the health care reform measure never intended this group to gain coverage. This analysis is flawed for two reasons. First, the law assumed states would participate in the Medicaid program given the low cost and high benefit structure of expansion, which, due to Republican obstructionism has not happened, potentially leaving 6 to 7 million people uninsured. However, a second flaw in their argument is that many of the remaining uninsured people are undocumented immigrants who were barred from gaining coverage thanks to strong Republican opposition and the lack of Republican support on current immigration reform measures.
Right-wing media misinformer Watchdog.org is pushing fabricated myths about the Affordable Care Act (ACA) into the media discussion, stoking fears the program will lead to higher premium costs and create incentives for people to avoid marriage. In reality, tax credits have kept premiums affordable for young people and have not created fiscal deterrents to marriage.
The Las Vegas Review-Journal penned an editorial attacking the Affordable Care Act (ACA) over high premium prices, but failed to provide more than a pair of anecdotes that misrepresented Nevada's uninsured population to support its claims.
The October 8 editorial promoted the idea that people will turn against the ACA as they learn the price of coverage under the exchanges, and according to the Review-Journal, the only thing preventing that scenario are technical glitches that have slowed the process:
It wasn't part of the Obama administration's shutdown theatrics, but healthcare.gov had to close for the weekend, and it was closed again early Tuesday. The website was taken offline because of myriad glitches that have plagued the national health insurance exchange (and state exchanges across the country) since the Oct. 1 rollout.
The technical problems are significant because huge numbers of people are being prevented from learning how much their newly mandatory health insurance will cost. Once potential enrollees can review exchange plans, their premiums and deductibles, there will be yet another uproar -- one with the potential to force changes to Obamacare or at least delay enforcement of its individual mandate.
The Review-Journal went on to give two examples of Californians over the age of 50 who claim to have been quoted at higher premium prices than they had paid in the past. Because the editorial did not include any information about the pair's previous insurance situation, tobacco use, or any other indicators, however, it is hard to verify or explain why these individuals were quoted at higher premiums. But this lack of information did not stop the Review-Journal from extrapolating their experience onto a wider population and predicting a delay to individuals' requirement to have insurance, an action that would gut the law and cripple insurers' ability to cover those with pre-existing conditions.
The editorial also highlighted the rates these individuals will pay without mentioning that older populations can only be charged up to three times what young and healthy adults can be charged. According to the Congressional Research Service, 49 percent of Nevada's uninsured are between the ages of 19 to 21, as compared to 26.4 percent for ages 21 to 64, and 1.9 percent for ages 65 and over. Using two older buyers as a sample of Nevada's insurance-buying population gives a misleading picture of prices and experiences.
Furthermore, the piece made no mention of the federal tax credits that will help make coverage affordable for many young Americans. Nationally, tax credits will allow 6.4 million people to purchase insurance for less than $100 each month. Including the subsidized prices for plans bought on the exchanges is critical to understanding the actual cost of insurance because the law "provides sliding-scale subsides to help people with incomes up to four times the federal poverty level." As the Kaiser Family Foundation explained in a primer on the makeup of the uninsured:
Most people without health coverage are in working families and have low incomes. Adults make up a disproportionate share of the uninsured population because they are less likely than children to be eligible for Medicaid. While a plurality of uninsured people are White non-Hispanic, racial/ethnic minorities are at especially high risk of being uninsured.
Health insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy people are. The consequences of reduced access to care over time can be serious, including preventable hospitalizations, poor overall health, disability, and premature death.
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.
Watchdog.org's Florida bureau concluded young Americans would rather pay a penalty than pay insurance premiums based on a backward reading of a poll conducted by Reuters, choosing to instead rely on the experiences of its "small sampling" of young people.
The October 4 post attempted to prove that young Americans would prefer paying a penalty for not having insurance under the Affordable Care Act (ACA) rather than paying insurance premiums for coverage. The post relied on a survey of an undisclosed amount of young people, and chose to report three negative responses as evidence of youth resistance to the ACA (emphasis added):
Obamacare "only works ... if young people show up."
That's from former President Bill Clinton in a recent MSNBC interview.
It's why Obamacare supporters and government agencies are trying everything from sports advertising to video contests to get young people in the game.
But will those millions of Millennials show up and sign up for health insurance under the Affordable Care Act?
A recent Reuters poll found Obamacare may not attract enough young people to keep costs low for others. And according to our small sampling, the answer would be no.
The poll reported by Reuters and cited by Watchdog appeared in an article titled, "Insight: Poll shows healthy young adults may keep Obamacare afloat," and contradicts much of what Watchdog claims (emphasis added):
A new Reuters/Ipsos poll of 1,053 uninsured Americans, and detailed interviews with 51 of the respondents, shows that Kormick is not an outlier: Obamacare may attract enough of the young healthy adults it needs to buy insurance to offset the costs of covering sicker Americans and keep the system afloat financially.
"Contrary to commonly held beliefs, young adults do want affordable health coverage," said Dr David Blumenthal, president of the Commonwealth Fund, a nonprofit that studies healthcare systems.
The young demographic is so pivotal to the success of Obamacare that one of the law's fiercest opponents, the libertarian group FreedomWorks, is running a campaign on social and traditional media aimed at persuading Americans in their 20s not to buy insurance on the exchanges.
Instead of accurately reporting the results of the Reuters survey, Watchdog continued to make its case by citing interviews with three members of the target age group. Despite being an inefficient sample size to draw conclusions, the three selected were poorly chosen to answer the questions of whether they would join the exchanges, as two of the responders reported they already had health insurance through an employer or parent.
Conservative groups have targeted young people as a key demographic in shaping the success or failure of the ACA. As noted by Reuters, FreedomWorks -- a Tea-Party affiliated non-profit that is partially funded by tobacco giant Philip Morris - has been a major contributor to the anti-insurance campaign. Watchdog is affiliated with FreedomWorks through its parent organization, the Franklin Center.
Watchdog, along with other Franklin Center affiliates, continue to target state media and promote conservative ideology. When it comes to reporting on the ACA, Watchdog has a track record of misinformation and manipulation.
The Las Vegas Review-Journal's Sherman Frederick once again lobbed false attacks at the Affordable Care Act (ACA), claiming the ACA will fund abortions. But Frederick's claim is based on a misreading of regulations.
Frederick's October 3 post accused the Office of Personnel Management (OPM) of allowing members of Congress and staffers to use subsidies to purchase plans on the exchanges that cover abortion:
The current law of the land strictly forbids federal money being used to fund abortions.
But this Monday the Office of Personnel Management ruled that members of Congress and their staffs will be able to buy health care plans that pay for abortions, even though the premiums are funded by taxpayer dollars.
Many believe that violates the law. But President Obama and most Democrats don't see it that way and are determined to stick by that ruling.
Congressional staffers were forced off of the Federal Employee Health Benefits Program and onto the exchanges during partisan deliberations over the ACA. This would have resulted in a large pay cut for staffers as they would have been forced to pay the full cost for coverage on the exchanges. To compromise, staffers will receive a premium contribution from the federal government to use towards a plan of their choice on the exchanges.
Frederick argued that the OPM will allow members and staff to choose plans that include abortion services, and since the government will partially pay for that coverage, the administration violated the Hyde Amendment preventing federal dollars from paying for abortions. However, the ruling Frederick referred to said OPM "can and will" take steps to ensure that abortion services "are accounted for and paid for by the individual rather than from the government contribution" (emphasis added):
Current law prohibits the use of Federal funds to pay for abortions, except in the case of rape, incest, or when the life of the woman is endangered, and the Smith Amendment in particular makes no funds available "to pay for abortions or administrative expenses in connections with health plans under the FEHBP which provides any benefits or coverage for abortions." Neither the proposed nor final regulation alters these prohibitions. Under OPM's final rule, no Federal 8 funds, including administrative funds, will be used to cover abortions or administer plans that cover abortions. Unlike the health plans for which OPM contracts pursuant to 5 U.S.C. 8902, 8903 and 8903a, OPM does not administer the terms of the health benefits plans offered on an Exchange. Consequently, while plans with such coverage may be offered on an Exchange, OPM can and will take appropriate administrative steps to ensure that the cost of any such coverage purchased by a Member of Congress or a congressional staffer from a designated SHOP is accounted for and paid by the individual rather than from the Government contribution, consistent with the general prohibition on Federal funds being used for this purpose.
Frederick conceded that the OPM ruling has "significant nuances" and linked to a Washington Times article that clearly debunked his argument. Still Frederick persisted by promising the OPM ruling will bring a "much bigger controversy" and headlined his post, "Yes, taxpayers, you will pay for abortions under Obamacare."
Conservative media have long pushed the myth that the ACA will fund abortions, and Sherman Frederick is no exception. His latest article continued his personal crusade against the ACA and expanding health care to millions of Americans.
The Union Leader published a misleading op-ed written by Greg Moore, state director of the Koch-funded Americans for Prosperity (AFP), which promoted tired conservative myths surrounding Medicaid expansion in New Hampshire.
Moore's op-ed in the September 30 Union Leader attempted to discredit Medicaid expansion currently being debated by a panel of state lawmakers who are expected to make a final recommendation by October 15. The piece pushed previously debunked claims that Medicaid expansion would force people off private health care and onto Medicaid, would create long wait times to see doctors, and that the government will be unable to pay for expansion:
According to a report commissioned for the state Department of Health and Human Services by the Lewin Group, expansion would result in 20,500 people being dropped from their high-quality private health insurance into a substandard Medicaid program.
With expansion, we will also need to be prepared to wait longer to see our doctors. A study of Oregon's expansion published in May's New England Journal of Medicine showed that under Medicaid, with its lack of deductibles and minimalist co-payments, health care utilization of those covered exploded. With a major new demand in doctors' time and no new supply of doctors, it means that under expansion doctors will be stretched thin and we should all be prepared to wait more to get an appointment or a referral.
Then there's the question of money. Obamacare supporters claim that the federal government will pay for the entirety of expansion for three years and the vast majority as far as the eye can see, and that the federal government will "always" keep its promise.
With a nation that's $17 trillion in debt, it's just a matter of time until the federal government steps away from the high cost of expansion, which starts at more than $350 million each year in New Hampshire and then grows. If state taxpayers have to pick that up, it's hello to a state income tax.
Moore's first point concerning the 20,500 people expected to move from private health care to Medicaid, according to the Lewin Group study, fails to explain the whole story. While denying Medicaid expansion would keep the estimated 20,500 on private insurance, it would also deny 58,000 people any sort of coverage. According to the Lewin Group, failing to expand Medicaid would also result in a need to provide higher uncompensated care:
Although health systems would see more of an improvement in their bottom line, they would need to provide a greater volume of uncompensated care without the Medicaid expansion.
Uncompensated care costs hospitals millions of dollars each year, and with recent cuts to state reimbursement, this could cancel out savings that hospital systems see from denying Medicaid expansion. According to New Hampshire Public Radio:
"Uncompensated care cost our members a little over $300 million this past year," Steve Ahnen, president of the New Hampshire Hospital Association, says, "and obviously the state did not pay out anywhere close to that to hospitals."
Furthermore, the Lewin Group study estimated health systems -- which include hospitals, physician groups, skilled nursing facilities, freestanding surgical centers, and home health agencies - would "see an increase in net income of about $113.1 million" under expansion.
Moore's second point dismissed benefits of giving the uninsured access to health care, claiming that when Oregon expanded care to those in need, "health care utilization of those covered exploded." He continued, making the case that the newly covered would create backlogs in the health care system that would mean limited access to doctors. However, according to The Washington Post, a survey in Michigan found that doctors were willing to take on more patients in the event of Medicaid expansion. Furthermore, New Hampshire has more doctors per capita than Michigan, meaning there are more doctors available for each person.
Finally, Moore suggests that the federal government may not be able to pay for its share of the Medicaid expansion, thus shifting costs to the state; however, this myth has been previously debunked. According to The Washington Post, "there just isn't a history of the federal government 'dumping' new spending on the state."
Moore's organization, Americans for Prosperity, is a notorious media manipulator that is funded by the conservative billionaire Koch brothers. The Union Leader's op-ed page continues a pattern of support for AFP by repeatedly publishing its misleading talking points.