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Extra, Extra: Health Reform Costs Money

Papers emphasize House health bill's cost rather than its content
July 15, 2009

After months of planning, Democrats in the House of Representatives yesterday unveiled their latest proposal for health care reform. But readers of the nation’s major papers this morning might have been left with the impression that they’d been dreaming up ways to hammer rich people and business owners. “Surcharge is Set in a Health Plan; New tax of 1% to 5.4% affecting top filers,” The New York Times headlined its print coverage. (The Web version features a different headline.) “Health-Care Plan Would Add Surtax on Wealthy: House Democrats propose to expand insurance coverage,” reported The Washington Post. The Wall Street Journal offered a variation on the theme: “Small Business Faces Big Bite; House health bill penalizes all but tiniest employers for not providing insurance,” the paper declared.

All those headlines are factually accurate: the House Democrats’ proposal calls for new taxes on the top 1.2 percent of households to cover roughly half of the plan’s cost (which is variously reported at $1.2 trillion or “slightly more than $1 trillion” over a decade). And, because the plan strives to achieve universal coverage in the context of an employer-based system, most businesses must either offer their workers coverage or pay a penalty. And the proposed funding source for any new program does merit significant coverage, both because the press has a role to play in making sure the government pays for its operations, and because the running debate about who bears what costs, and who gets which benefits, is the very essence of politics. The proposed taxes and business fees are an important part of these stories.

But the headlines–and the stories they sit atop–all suggest that the distribution of a program’s costs is actually more important than its contents. The Post and Times stories follow a general pattern: a lede that combines expanded coverage with the proposed tax, a section spelling out the taxes in detail, comments from supporters or opponents, and then, finally, a few paragraphs about how the plan would work. In the Times story, readers learn that the plan would include a “public option” and an individual mandate–two important subjects of debate–in the seventeenth and eighteenth grafs, respectively. The Post piece mentions the individual mandate in the second graf but doesn’t get around to the public option until the fourteenth. The Journal, meanwhile, doesn’t even acknowledge the plan’s projected effect on access to coverage until after the jump. (The front page, though, has space for a quote from a business lobbyist who blasts the proposal.)

The short shrift accorded to the actual program obscures what we’d be getting for all that money. But more important, it keeps readers in the dark about whether, and how, the House plan would achieve the goal of expanding coverage and improving care.

The emphasis is especially odd when you consider that the House’s funding proposal is less likely to become law than other elements of its plan. Today’s stories note that the “tax-the-rich” strategy isn’t likely to advance in the Senate; a Republican senator has already proclaimed it “a dead issue.”

So why did the papers take the angles they did? One explanation might be that the tax proposal crystallized only recently, while the public option, individual mandate, and other features have been in the air for months. That distinction might not mean much to readers who scan the headlines on their way to work, but it probably feels important to reporters who eat, sleep and breathe this stuff. Another is the idea that the surtax’s unfriendly Senate reception and uncertain fate makes it newsworthy–conflict is content, after all.

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But an alternative explanation has to do with audience. The Journal’s coverage is clearly influenced by its broader business orientation; the paper chose the angle it thought would matter most to its readers. Faced with a story that had one meaning for the richest Americans, and another for tens of millions of others, the Post and Times may have done the same.

Greg Marx is an associate editor at CJR. Follow him on Twitter @gregamarx.