Kudos to The Charleston (West Virginia) Gazette

For localizing the health reform story

Before Christmas, Kate Long, the writing coach for The Charleston Gazette, contacted me about the media’s disinterest in the Children’s Health Insurance Program (CHIP), which is in some jeopardy as the reform bill moves toward reconciliation. As Campaign Desk has pointed out, the House wants to eliminate the program and have poor kids go on the same private insurance coverage as their parents; the Senate funds CHIP until 2015.

“The news media has ignored certain things like the children’s health insurance program, as an example,” she said, noting it was strange that the major children’s advocacy organizations weren’t raising a fuss about what could happen under the House bill. “All the public has heard is public option, public option, public option,” Long observed. “People don’t know anything about these bills.”

So Long went out to learn how people in Charleston would fare under reform. The result will be ongoing coverage from the Gazette, she told us. As Campaign Desk readers know, this kind of coverage has been scarce, so we’re pleased to see Long localize the story.

In a piece that ran right after Christmas, Long found Susan Corbin, a clerk at the Stony Creek Country Store near Paw Paw. Corbin said she has tried hard to follow reform’s twists and turns. “I want it, but I’m afraid of it,” she said. “They’re still arguing about it in Washington, and I know it affects me, but I can’t find out what it’s going to be.”

Long reported that the requirement to buy health insurance or pay a fine scared Corbin and her boss. Her piece pointed out that, under the House bill, only businesses with a payroll greater than $500,000 must provide insurance or pay a small fine; under the Senate bill, only firms with fifty or more employees are fined if employees receive government subsidies to buy insurance. “Nobody plans to make small business owners provide insurance,” said a spokesman for an advocacy group West Virginians for Affordable Health Care.

Long described Corbin’s options, such as subsidized insurance in the individual market, and ended by saying that Corbin and her boss “would love to have health insurance, but may pay the penalty instead.” Of course, if that’s the case, they may not have health insurance either, which runs counter to the legislation’s goal of insuring more people.

The Gazette explored some of the problems that would result if people chose to take the penalty rather than buy insurance. The success or failure of the legislation rests on this feature—whether people will buy and what happens to premiums for others when they don’t. For starters, the press can look at what’s happening in Massachusetts, where some insurers have reported that residents are already gaming the system—buying insurance for a few months to pay for some treatments, dropping it when they recover, and taking the penalty. This, of course, raises the price of coverage for everyone, and calls into question whether the individual mandate really will work.

Long continued to probe this theme in another piece the following day—an interview with Richard Sinclair, the president of a company that sells forklifts, cranes, and conveyors. Sinclair provides his 225 workers with insurance. “It’s been important to us to do that,” he says. Sinclair was skeptical of the bills moving through Congress. He said he had compared the amount he pays for health insurance for his workers with the penalties in the bills—a maximum of $750 in the Senate bill—and found it would be “vastly less expensive for me to drop my insurance, pay the penalty, and let my employees choose from what’s on the market. I’m not saying for a moment that I would do that, but I think other companies may.” Sinclair zeroed in on the Massachusetts problem: people would opt out of insurance when they are well and opt back in when they are sick.

Having a business owner make this crucial point was an effective technique. Sinclair’s comments were more engaging than having a policy wonk raise the same concern, which is what too many news outlets have done. Businessmen on Main Street have a huge stake in the outcome of the legislation. We will be watching for more installments in The Gazette’s series, and continue to urge the press to tell how the legislation will affect not only Main Street businesses, but everyone else in town. Remember Long’s observation: “The public doesn’t know anything.”

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.