The insurers got a safeguard in the bill. They can charge older people three times more than a younger one for the same coverage in the same geographic area—a kind of proxy for medical underwriting, which will be prohibited. Why not level with readers and tell them just how much more they may pay? The more details the better, especially since most people don’t know much about the law.
The Vague: An early piece from McClatchy’s Washington bureau is an example of a less-than-helpful consumer story. It consisted of a bunch of points, staccato style. “Would require most employers to provide coverage or face penalties.” But what penalties? Are they the same for big and small businesses? Which ones get a tax credit? “Would provide subsidies for families earning up to 400 percent of poverty level, currently about $88,000 a year, to purchase health insurance.” But how much of a subsidy? What will families still pay out-of-pocket? Can they still afford coverage? You get the picture. Not a lot of meat here.
The Speculative: The Christian Science Monitor gave it the old college try with its “Health care reform bill 101” series, a brief overview of different aspects of the law. One story concerned the rules for preexisting conditions:
Insurers will no longer be able to exclude children with preexisting conditions from being covered by their family policy. For current policies, that means insurers will have to rescind preexisting-condition exclusions.
I wondered about the latter phrase, and wanted to know the source. It may be true, but that statement cried out for attribution. So I contacted a top official at one of the state insurance departments, who knows her stuff. “The law does not say the carrier has to let your kid in; there’s nothing specific about that,” she said. “I think the reporter was reading something into some of the talking points.” She explained that the Secretary of Health and Human Services may have the authority to do that, when all the rules and regs are written: “A lot of the details and interpretation will be left to HHS.”
And that’s precisely the point. Much of the law and how it will work will be determined by regulations written by the federal and state agencies. And here is where the press comes in. Even as the health story shifts to the legal challenges to the bill and the politics of the midterm elections, reporters must stay on top of the “what’s-in-it-for me” story. All those pesky, regulatory details, where the special interest lobbyists have a big say, can determine whether the law fails or succeeds—and what happens to consumers as a result.