On Sunday, the Boston Globe published the second installment in its two-part series on “Romneycare,” the Massachusetts health care overhaul passed in 2006. Though not as buzz-worthy as the first part of the series — which tracked the back-room negotiations in which then-governor Mitt Romney came to support the program, and particularly the controversial individual mandate — the article offers a good, if imperfect, example of policy reporting for a general audience.
Most importantly, reporter Brian C. Mooney takes on the responsibility of figuring out for himself — and his readers — whether the program has achieved its goals. His conclusion: “while there have been some stumbles — and some elements of the effort merit a grade of ‘incomplete’ — the overhaul has, after five years, worked as well as or better than expected,” especially in expanding access to health insurance.
Mooney also notes, and specifically rebuts, attacks on the law that “rely on distortions, omissions or flagrant inaccuracies”. For example: Texas governor Rick Perry — a potential rival of Romney’s for the Republican presidential nomination — was “flat-out wrong” when the said the ranks of Massachusetts’s uninsured had not declined since the law was passed. This is good stuff, and the clear language helps make some of the wonky details more digestible.
At the same time, the article pays ample attention to some of the “stumbles” mentioned at the outset; readers who don’t think RomneyCare is sustainable will find plenty of support for their views. While the state’s expenses have been manageable so far, the upward trend in health care costs hasn’t been checked, and federal aid — key to helping the state balance its books so far — is about to drop off. Various revenue sources have generated less money than expected. And the law has done less than it first appears to reduce costly-but-unpaid emergency room care; a strong passage in the story notes how official records on that score leave “a false impression” of progress.
For all those virtues, there are some important nits to pick here. The article devotes lots of space to the grievances of small business owners, the interest group that’s angriest about the law. It’s a meaningful topic, but some of those grafs might have been devoted to the experience of individual patients — and to exploring whether, as Marcy Wheeler asks, improved access to insurance has meant improved access to care.
And near its conclusion, the article gives space to, but doesn’t really address, a provocative critique about the political economy behind RomneyCare:
“I’d give it an ‘A’ for access and an ‘F’ for cost and small business fairness,’’ said Jon B. Hurst, president of the Retailers Association of Massachusetts. “We were supposed to get rid of the free care pool and get all these young folks insured, and that was going to bring costs down.
“Instead, what we did was a wealth shift from consumers and small businesses to big health care in the state, which is not a surprise given who was pushing the bill all along — the biggest hospital chain and the biggest insurer,’’ Hurst said, referring to Partners HealthCare and Blue Cross Blue Shield of Massachusetts.
While Hurst frames this shift as an issue of “small business fairness” — and the Globe adopts that framing — if what he’s saying is true, the impact on consumers is at least as important. Unfortunately, the declarative language on display earlier in the article gives way here to dueling quotes between the critic and a state spokesman. That’s understandable, as the issue in question is a lot more complicated than whether rates of the uninsured have declined; it’s also disappointing.
Even taking those criticisms into account, though, the article offers a judicious, balanced assessment of an important policy change, delivered in plain language. There’s a lot to like here.
Greg Marx is an associate editor at CJR. Follow him on Twitter @gregamarx.