Mitt’s Health Plan, Debunked

Why isn’t the press paying attention?

Mitt Romney’s win in a couple of primaries gives the media another chance to look seriously at his Massachusetts health plan. Romney continues to trot out his health care bona fides every chance he gets, even at his victory celebration in Michigan. There he told a cheering crowd that, “You got out and told America what they needed to hear. You said that we would fight to get health care for all Americans”—implying, of course, that he was the man who would do just that.

About the time Romney was winning in Michigan and Nevada, Physicians for a National Health Program (PNHP), a group of some 14,000 doctors who support a single-payer system, gave reporters an opening to examine what kind of health plan he really got for everyone in Massachusetts. PNHP, which was founded in 1986, issued a press release featuring a letter signed by more than 250 Massachusetts doctors who pointed out what they called “disturbing early outcomes of Massachusetts’ widely-heralded approach to health care reform.” The plan, an individual mandate approach, requires residents to buy private insurance or face a tax penalty if they don’t. The poorest people get tax subsidies to help pay premiums. The doctors’ letter, suggesting a fiscal disaster in the making, noted that:

• A little more than one-third of the uninsured had gained coverage, and most of them are very poor people enrolled in Medicaid and other free plans. They were previously eligible for free care funded by the state but now face copayments under Romney’s plan.

• Only about 7 percent of the uninsured who had incomes too high to qualify for tax subsidies had enrolled, suggesting that the premiums were still too steep to buy their own coverage.

• The state’s cost for the subsidies is running $147 million over budget, and assessments on employers who are required to pay $295 each year for each uncovered worker are 80 percent below projections.

Clearly, the docs’ letter gave reporters leads for further investigation. Ida Hellander, PNHP’s executive director, told me that reporters seemed interested but so far the release had not generated any coverage to speak of. Of the 2,000 outlets that received the letter, only, a site affiliated with the Seacoast Media Group, and a blog, printed the letter. “We’re telling the press the reason this is so relevant is that all three Democratic candidates are proposing variations of the Massachusetts plan,” Hellander said. The letter is also relevant in California where the state senate is holding hearings this week on a similar plan supported by Governor Arnold Schwarzenegger and passed by the state assembly at the end of last year.

The lack of interest in reporting bad news about Massachusetts may be the health-policy equivalent of the new-drug stories that the press loves to write. These stories tout the wondrous benefits of new drugs and skip the negative side effects or the lack of evidence that they actually work, or bury these points deep down in the story. The Massachusetts law hailed by the media when it passed in 2006 may suffer the same fate as Vioxx, a popular and heavily promoted drug later shown to harm patients who took it. If the doctors are right, some people in Massachusetts may already be learning the same lesson.

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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.