Wanted: More Skepticism at The New York Times

When the word “nonprofit” has a deeper meaning

On Saturday, The New York Times’s new consumer feature, “Patient Money,” which discusses pocketbook issues relating to health care, tackled the au courant subject of COBRA. Although the media have ignored COBRA for years, it’s suddenly a hot topic—and it should be, since the stimulus package contains an important perk for laid-off workers. Normally they can apply for COBRA, remain on their employers’ insurance policy for eighteen months, and pay the entire premium themselves—which is usually impossible for people without a paycheck. But under the terms of the stimulus package, the federal government will pay 65 percent of the COBRA premiums for up to nine months. In other words, it offers a temporary helping hand.

The Times’s story mentioned COBRA rules and then moved to an anecdote—a single mother who lost her job at an interior design firm and was looking forward to paying only $338 for COBRA premiums, instead of the $966 she would have to pay without the government’s help. The story offered some strategies for unemployed people seeking inexpensive insurance coverage, like staying on COBRA as an individual paying the lower rate and buying a private insurance policy for the rest of the family, or “keeping yourself and your spouse on Cobra or buying private insurance, and enrolling your children in the federally financed CHIP program.” Maybe these strategies will work for some people, if they can afford private policies in the individual market and can meet the insurers’ health requirements. Many can do neither.

Next, readers looking for information and rules in their area were referred to a Web site operated by what the Times called “the nonprofit Foundation for Health Coverage Education.” Then came the suggestion to buy a high-deductible health plan that can be linked to a health savings account, complete with an example of how it might work for a family in Chicago. The story advised that the option might be good for people who expect to have few medical expenses, or a job within the year, or both.

It also mentioned government-sponsored health insurance or services for people whose household income is coming from unemployment insurance, who are single parents, or who have lost a job because an employer moved out of the country. “A lot of people don’t know these programs exist,” said the Foundation’s executive director, Phil Lebherz. Readers were sent to the Foundation’s Web site to take a five-question quiz, in order to find out about the services for which they might qualify.

Either the Times didn’t do its homework on the Foundation, or, if it did, it didn’t tell readers what it learned. The Foundation’s roster of donors listed in its 2007 annual report reads like a Who’s Who for the insurance industry. There’s Anthem Blue Cross Foundation, which, the report said, “fueled the launch” of the group’s U.S. Uninsured Help Line. The Foundation’s Web site identifies Anthem Blue Cross Foundation as a “private, non-profit organization wholly funded by WellPoint, Inc.” Readers might care to know that WellPoint, one of the country’s largest carriers, has staked out a lucrative niche selling bare-bones, high-deductible policies in the individual market, and has been heavily promoting them as cheap alternatives for people without insurance.

Other donors listed include Leonard Schaeffer, the former CEO of WellPoint Health Networks, which later merged with Anthem Blue Cross; Blue Shield of California; the National Association of Health Underwriters, a trade group for agents, brokers, and consultants; several state underwriters associations; Beere & Purves, a large California insurance agency; and associates from Warner Pacific, which bills itself as the top producing general agency for many of the nation’s largest health insurance carriers—including Anthem Blue Cross.

The Foundation’s president, Ankeny Minoux, said that about 67 percent of the people who call are eligible for public programs. The rest are undoubtedly searching for private coverage, and the Foundation seems to be a lead-generating operation for insurance agents. Its tool for helping employers and individuals seeking private coverage tells them to contact the help line for assistance in finding a broker. The matrix of public and private programs for New York, for example, refers people to the New York Association of Health Underwriters. The Web site also says that if callers don’t qualify for public programs, they are referred to brokers within the “Uninsured Help Line database.”

What kind of advice does the help line give? I called and asked for help getting a policy in New York. After disclosing that I take an eye medication, the customer service rep told me “New York doesn’t offer very much,” adding “Your state doesn’t offer anything for people with pre-existing conditions or high risk. Most insurance companies will deny you.” She missed the mark big time. New York is one of the few states that requires all carriers to offer a policy to everyone, regardless of their health status. That means that people with pre-existing conditions can always buy a policy, although there may be a waiting period before expenses associated with the condition are covered. The operator apparently hadn’t checked the Foundation’s matrix for New York, where the correct rules are explained.

There’s a cautionary tale here for all journalists swimming in the health care swamp. The words “nonprofit” as well as “nonpartisan” don’t always legitimize an organization whose officials are eager to be quoted. Too often, some groups that carry those labels are disguised marketing and public relations operations for their funders. It’s always best to check who’s funding the group, what their goals are, and disclose that information to audiences. That’s the step the Times left out.

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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.