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Rep. Thomas Massie (R-KY) Highlights Republican Party Civil War Over Health Care
Rep. Thomas Massie (R-KY) doubled down on his characterization of the Republican health care proposal, the American Health Care Act, as “a stinking pile of garbage.” Massie’s criticism underscores the growing “GOP civil war” over repealing Obamacare, similar to the extensive Republican infighting over Donald Trump’s presidential campaign. From the March 9 edition of Fox News’ America’s News Headquarters:
SANDRA SMITH (CO-HOST): So Congressman, let's get to these words that you have used to explain how you think of this Obamacare repeal plan. Let’s see. “It's a stinking pile of garbage.” Why did you choose those words?
REP THOMAS MASSIE (R-KY): Probably because it was off the cuff and it was -- I committed candor. I said what I was thinking. This is a new entitlement program and it's just bad all around. I mean, there are a few good things about it, but we shouldn't replace one entitlement program with another. It's not a Republican conservative bill.
SMITH: OK. So it was an off the cuff remark. Is that something you're walking back at this point, to be clear?
MASSIE: No, it's still a stinking pile of garbage.
SMITH: Congressman, what sort of response are you getting to your Republican colleagues, especially using those kind of words to describe this effort?
MASSIE: Most of them appreciate my frankness. Most, for instance, of the Freedom Caucus. They feel that way, a lot of them haven't spoken that strongly about it. But behind the scenes, they’re -- the speaker's missing at least 40 of the votes that he needs to get to 218, and he can only afford to lose 24 votes. That's a problem in the House. Then in the Senate, it looks like Senator Paul and Senator Lee are strongly against this and other senators for different reasons. It seems dead on arrival in the Senate, but I don't even think it's going to get out of the House.
The hosts of multiple morning news shows allowed the director of the Office of Management and Budget (OMB), Mick Mulvaney, to push falsehoods in his public sales pitch about the newly unveiled Republican health care plan, which would wreak havoc on health care, particularly harming low-income people and women.
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Talking Heads Drown Out Personal Stories Of Americans Threatened By Obamacare Repeal
Cable news outlets dedicated considerable attention to the “Resistance Recess” that swept through congressional town hall meetings over the past week, as tens of thousands of Americans voiced their fear and disapproval of Republican plans to dismantle health care reform, among other issues. Yet evening and prime-time coverage of the grass-roots groundswell largely failed to include perspectives from those attendees opposed to efforts to roll back reforms.
The week of February 18-26 marked the first congressional recess period of 2017 and created an ideal opportunity for American voters concerned with the trajectory of their government to directly petition elected officials face to face. Americans capitalized on this opportunity by flooding in-district town hall events across the country demanding that representatives on both sides of the aisle stand up to President Trump’s radical agenda. Among attendees’ demands was that elected officials present viable solutions to further the cause of health care reform beyond merely “repealing and replacing” the Affordable Care Act (ACA).
Cable news outlets used the town hall turmoil as the basis for 53 evening and prime-time news segments from the start of the recess period through February 27 discussing how the demonstrations might affect the future of health care reform in the United States. Unfortunately, the vast majority of these discussions failed to include input from people voicing disapproval with Republican plans to repeal or significantly alter the ACA at those town halls. Media Matters identified 88 guests during evening and prime-time cable programming related to the town halls -- mostly reporters and political pundits. Only three of the 88 guests were town hall attendees affected by the outcome of this health care debate.
The February 27 edition of MSNBC’s All In did feature an impassioned interview with cancer survivor and Boing Boing editor Xeni Jardin, who, though not identified as a town hall participant, outlined how the ACA granted her access to what would have otherwise been prohibitively expensive life-saving treatments. All three of the actual town hall attendees were featured in two segments aired during the February 22 edition of MSNBC’s For the Record, which featured constituents who attended town halls hosted by Sens. Tom Cotton (R-AR) and Bill Cassidy (R-LA). In the first segment, an Arkansas constituent named Suzie Bell, who co-founded a rural free health clinic, questioned why Cotton wanted to restrict access for the patients she serves. In the next segment, Louisiana constituents Laura Kelley and Shawon Bernard expressed the collective “frustration” of fellow attendees about a laundry list of issues, including the future of the ACA:
MSNBC featured the most guests (46) and the most segments (29) focused on the town halls, but only two segments featured the three aforementioned town hall attendees. CNN featured 30 guests across 18 segments, but no town hall attendees in prime-time. Fox News lagged far behind the competition, featuring just 12 guests during 6 segments discussing the town hall protests and also failed to include any attendees.
CNN's failure to book any town hall attendees during evening or prime-time slots is particularly perplexing given that the network did interview town hall attendees outside of the influential prime-time window. On the February 22 edition of CNN Newsroom, host Brooke Baldwin interviewed Rose Perkins, whose dressing down of Sen. Mitch McConnell (R-KY) at a town hall the day before had already become a viral sensation. Meanwhile, CNN Tonight host Don Lemon interviewed Kati McFarland, a young woman who credits the ACA with keeping her alive despite her chronic, life-threatening illness and whose heartfelt plea to Cotton created an uproar. But the piece didn’t air until 12:19 a.m. on Saturday, February 25. (McFarland was also interviewed by MSNBC’s Ali Velshi during daytime programming on February 23.)
The nationwide coalition of demonstrators, which progressive groups like MoveOn.org have dubbed the “Resistance Recess,” found many Republican members of Congress unprepared to face tough questions. That shouldn’t be surprising, given that many constituents stand to lose their health insurance or see their premiums soar if Trump and the GOP succeed in gutting the ACA. Rather than simply reporting on the abstract optics of these demonstrations, media outlets need to focus on the human beings who dedicated their time to safeguard legislation that benefits millions of Americans every day.
Media Matters conducted a Nexis and SnapStream search of transcripts of cable evening and prime-time (defined as 6 p.m. through 11 p.m.) weekday programs on CNN, Fox News, and MSNBC from February 18 through February 27, 2017. We identified and reviewed all segments that included any of the following keywords: affordable care act or aca or obamacare or healthcare or health care or protester or demonstrator or townhall or town hall.
The following programs were included in the data: The Situation Room, Erin Burnett OutFront, Anderson Cooper 360, CNN Tonight, Special Report, The First 100 Days, Tucker Carlson Tonight, The O'Reilly Factor, Hannity, Hardball, For the Record, All In with Chris Hayes, The Rachel Maddow Show, and The Last Word with Lawrence O'Donnell. For shows that air reruns, only the first airing was included in data retrieval.
Right-wing media have helped promote piecemeal Republican proposals to replace the Affordable Care Act (ACA), propagating a series of myths about the efficacy of health savings accounts, the benefits of allowing insurers to sell across state lines, how high-risk pools operate, and what converting Medicaid into so-called “block grants” would mean for beneficiaries. Health care experts have resoundingly rejected these proposals as alternatives to the ACA, as they all would result in higher costs and less coverage for Americans.
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PolitiFact Wisconsin rated Sen. Tammy Baldwin’s (D-WI) month-old claim that the GOP is “organizing to take people’s health care away” mostly false, claiming that while the Congressional Budget Office (CBO) found that “repeal of the Affordable Care Act (ACA) could result in millions of people losing their health insurance,” the office did not consider the impact of an expected GOP replacement plan. In reality, the GOP has yet to produce a consensus replacement plan, thus giving the CBO nothing to rate, and all existing plans that Republicans have put forward would strip coverage from millions.
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Moderators Jake Tapper and Dana Bash should utilize the February 7 CNN debate between Sens. Bernie Sanders (I-VT) and Ted Cruz (R-TX) on “the future of Obamacare” to ask targeted questions about the GOP’s plans to replace the Affordable Care Act (ACA) and how that will affect the American health care system. As CNN’s town hall with House Speaker Paul Ryan (R-WI) demonstrated, these forums can serve as opportunities to fact-check misinformation, but they can also fail to substantively engage on specific policy issues. Moderators should be prepared to pose specific questions to Cruz, the representative for “the viewpoint of President Trump and the Republican party,” on distinct policies proposed by the GOP to repeal and replace the ACA.
While there is no shortage of important questions about the negative impacts of repealing the ACA on Medicare, job growth, LGBTQ equality, the budget deficit, and mental health care services, moderators must prioritize the subjects they can address in the time allotted. Here are five of the most important questions that CNN should ask Cruz in tonight’s debate.
Implementation of the ACA has resulted in a record low number of uninsured Americans -- merely 8.6 percent in June 2016, down from over 16 percent in 2010. Numerous reports have noted that Republican politicians continue to obfuscate about whether their replacement for the ACA would cover as many people as Obamacare does, likely because none of their proposed policies would. Vox’s Sarah Kliff analyzed the existing replacement plans and found that all of them would reduce coverage, with the number of people impacted ranging by between 3 million and 21 million people.
Given that Cruz himself dodged this question during a 2016 Republican presidential primary debate, this new venue provides a unique opportunity to press the senator on whether the Republican replacement will maintain existing coverage levels.
Congressional Republicans, including President Donald Trump’s nominee to lead the Department of Health and Human Services, Tom Price (R-GA), have publicly opposed some ACA provisions regarding women’s health care. As CBS News noted, the debate over the ACA resurrects the risk of “a return to higher premiums for women” and “gaps in coverage for birth control and breast pumps.” The ACA also banned discriminatory practices, like sex discrimination and gender rating, while significantly reducing out-of-pocket costs for women’s birth control.
Tapper and Bash should ask about the future of women’s health care, making sure to reference the specific gains made by the ACA to prevent generic answers that dodge the question.
One of the leading GOP proposals for reforming the health care system revolves around changing Medicaid’s funding structure to a block grant system, which caps the amount of funding a state receives from the federal government. While conservatives typically discuss block grant proposals in terms of allowing states to “innovate,” in reality, most block grant proposals shift Medicaid costs to the states, which would cause chaos on state budgets and force draconian cuts in services covered by Medicaid.
Under the ACA, the Medicaid expansion extended health insurance to millions of low-income Americans, making a discussion of proposed changes a necessity during the debate.
Numerous conservatives, including Trump, have pledged to keep certain parts of the ACA, like the ban on denying coverage to people with pre-existing conditions and the provision that allows young adults to remain on their parents’ insurance until age 26. But they simultaneously promise to get rid of other provisions, like the individual mandate and the varied taxes, which provide the revenue to fund the popular parts of the law.
As New York Times columnist Nicholas Kristof wrote, it’s “impossible” to keep certain popular provisions “while eliminating unpopular parts,” because the “good and the bad depend on each other.” This tension is a central fault line in discussions about the ACA and should be a central theme in CNN’s town hall.
One of the few specific health care policies Republicans have championed in pushing to repeal and replace the ACA involves the resurrection of high-risk pools. Despite conservative attempts to repackage high-risk pools as a new idea, they have a long history of problems, as they typically are chronically underfunded, are prohibitively expensive for customers, and provide inadequate coverage. As the Los Angeles Times’ Michael Hiltzik noted, 35 states used high-risk pools prior to the implementation of the ACA’s protections for people with pre-existing conditions, and the experience was “almost universally grim.”
Moderators should ask about high-risk pools, because they would degrade access to health care to those who are most vulnerable and need care the most.
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The GOP has shifted from its message of “repealing and replacing” Obamacare to “repairing” the law. Media must press conservatives on what their so-called “repairs” to the Affordable Care Act (ACA) might look like, especially in the likely event that “repairing” the ACA is really just repealing it with no replacement.
Republicans reportedly started transitioning away from their pledge to “repeal and replace” Obamacare, focusing on a more appealing call to “repair” the health care law. Frank Luntz, a GOP consultant known for repackaging conservative misinformation to advance a Republican agenda, encouraged conservatives to pledge to “repair” the ACA because that word “‘captures exactly what the large majority of the American people want.’” As lawmakers like Sen. Lamar Alexander (R-TN) have adopted the “repair” buzzword, others, like Speaker of the House Paul Ryan (R-WI), continue to obfuscate, claiming, “if we’re going to repair the U.S. health care system, … you must repeal and replace Obamacare,” indicating that GOP disarray over the ACA extends to its messaging strategies.
The GOP’s pledge to “repeal and replace” the law has largely backfired. After seven years, Republicans still have no replacement for the law. The GOP still can’t agree on the timing or the substance of any replacement plan. Most of its “replacement” plans are fact sheets rather than legislative language, and all of them would reduce coverage for millions of Americans.
The continued fight over the potential replacement has also inadvertently highlighted the tangible gains achieved by the ACA and made the public acutely aware of the negative impacts of repeal. New polling finds the ACA is increasingly popular, especially as news outlets highlight stories of individuals who would be impacted by repeal.
As Slate’s Jim Newell explained, the semantic change alone “does not signal a new course in the repeal-and-replace progress.” But, even if the GOP does decide to abandon its promise to repeal the ACA and instead focus on “repairing" the law, it remains vitally important for news outlets to force conservative politicians to clarify which portions of the ACA they intend to repair and how. Media have largely failed at questioning potential replacement plans for the law. And as top GOP lawmakers continue to falsely repeat right-wing media myths about the alleged “collapse” of the ACA, media must fact-check the GOP’s messaging strategies and interrogate its plans for repealing or repairing the law. If the GOP actually intends to make “repairs” to the ACA, those repairs may just be another messaging strategy for its plans to scale back services, gut Medicaid, and give a tax-break to the wealthy.
With millions of lives at stake, news outlets must aggressively question GOP lawmakers about what portions of the ACA they intend to repair and force lawmakers to clarify that repairing the ACA is not simply a buzzword phrase for repealing the law with no replacement.
While much of the media coverage of the debate over the repeal of the Affordable Care Act (ACA) has missed the boat, West Virginia’s Register-Herald published an in-depth article on the implications of the repeal of the health law, providing a model of the best practices all other media outlets should emulate moving forward.
Media coverage of the future of the ACA thus far has largely failed to inform the public about the negative impacts of repeal. A Media Matters study of pre-election coverage showed that broadcast and cable news reporters largely failed to ask substantive questions about what a replacement plan from President Donald Trump’s administration might look like, despite his repeated pledges to “repeal and replace” the ACA. Outlets repeatedly wrote articles with headlines that uncritically repeated Trump’s false statements on the ACA, while others have failed to aggressively fact-check Republican politicians who spread misinformation about the law. Media Matters studies of state newspaper coverage revealed severe flaws in local coverage as well, as the papers largely failed to report the potential impact of repeal on vulnerable communities like women, minority, and low-income areas.
West Virginia’s Register-Herald broke this trend with its recent reporting on the ACA, illustrating the best practices other outlets should follow in their coverage of the law’s future.
The January 26 article outlined the specific impacts repealing the law would have on West Virginia and the nation as a whole and detailed how a repeal would negatively affect the uninsured rate, the state’s budget, consumer protections, and Medicaid:
[N]ot only 184,000 West Virginians would lose health insurance, but the state's weak economy could falter with the loss of billions of dollars of federal funds.
An estimated 16,000 jobs would be lost by 2019 and nearly $350 million would be lost in tax revenue over five years. The Urban Institute estimates West Virginia would lose $14 billion in federal funds between 2019-2028, including $12 billion supporting Medicaid/CHIP.
Another study conducted by WalletHub shows West Virginia will be the state second most impacted in the nation by the repeal.
"The ACA is much more than a lifeline for hundreds of thousands of West Virginians who have gained health coverage and important patient protections," said WVCBP Executive Director Ted Boettner, who authored the report. "It has been a billion dollar investment in our people that has lead to thousands of new jobs during a time when our state's communities are struggling."
The article also discussed potential policies that have been proposed as a part of a replacement package and the impact those policies would have on the state of health care, like the Republican-backed proposal to convert Medicaid to block grants, which could have significant negative consequences for recipients. This substantive discussion of the impact of potential plans to repeal and replace the ACA transcends the typical media focus on sound bites, providing an essential step toward more productive overall coverage of a complex policy area.
The article cited numerous experts, like the West Virginia Center on Budget and Policy, and studies from major medical journals like The New England Journal of Medicine, instead of political pundits, to explain the debate. This increases the quality of coverage because it means the focus of the interview or article revolves around a substantive discussion of the policies in question, rather than the political optics that pundits prefer to discuss. This is particularly important when discussing confusing policies like health care, where misinformation or political spin can permeate public conceptions about complex issues.
The Register-Herald paired its substantive policy discussion with interviews with West Virginia residents who would be directly affected by repealing the ACA to present the human impact of the health care debate:
Zachary was 23 years old when he was diagnosed with thyroid cancer — a rare diagnosis for a young man. He's had multiple surgeries along with radioactive iodine ablation treatment, but each summer for the past three years, his cancer has returned.
Zachary, now 26 years old, fears he will not be able to utilize the final months of his health coverage under his parents' plan if the ACA is repealed.
"He's scared out of his mind," Vaughan-Meadors said. "He thinks he's going to get dropped tomorrow. We understand as adults it doesn't happen that quickly, but as a young person, you don't cope well with cancer to begin with."
Using personal testimonies humanizes the discussion of the ACA and puts a face on the impact of the repeal in a way the repetition of insurance statistics cannot. While human interest pieces should not crowd out detailed policy reporting, The Register-Herald shows it is possible to succeed in doing both.
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