By now, we’re accustomed to tales from the Obamacare trenches—good, bad, and ugly—spun in the media. There was Deborah Cavallaro, the Los Angeles real estate agent, who last fall made the rounds from CBS Channel 2 in LA to NBC Nightly News with her story of dropped coverage. That story didn’t hold up. After Christmas came health blogger Maggie Mahar’s debunking of a Fort Worth Star-Telegram piece about four Obamacare “losers”—one whose story didn’t stand up to scrutiny, Mahar found, and three who were associated with the Tea Party, which the Star-Telegram did not report.
On Monday, Fox News’ Fox & Friends introduced viewers to Rebecca Stewart, a Kentucky woman who has been frustrated by her dealings with the Kentucky insurance exchange and sought help from the White House. Stewart’s tale—centered around her son and whether or not he can continue to see his specialist—was so mixed up, it was hard to tell what her specific problems were. And while Fox & Friends host Elisabeth Hasselbeck did more muddying than clarifying, the segment’s overall message was clear: another Obamacare screw-up. More on that to come.
Before Stewart landed on Fox, she aired her health insurance problems directly to the president during a Google+ Hangout last week. She was concerned whether her 10-year-old son could continue to see his specialist and, in trying to find out, she ran into conflicting answers from insurance companies, the Kentucky insurance exchange, and a hospital she apparently wanted to use. Her plight is hardly unique. It’s that narrow network problem, and shoppers all over the country have had trouble finding out if doctors and hospitals are part of provider networks. These days, insurers are picky about their providers, allowing patients to use only docs and hospitals that have negotiated low rates. That’s the trade-off for lower premiums, a point the president might do well to explain on his next chat. During the Google Hangout, the president promised Stewart the White House would help.
And the White House did, contacting Stewart twice. She wasn’t satisfied, though, and told Fox viewers on Monday, “I think what [the White House was] doing is giving me an answer to call the state of Kentucky and they would set me up with the state and put me in touch.” She added she had been up and down the food chain there; the problem was no one seemed to give her a clear answer about her son’s specialist. Instead of making clear what Stewart’s problem was, Fox host Elisabeth Hasselbeck sowed confusion. Said Hasselbeck:
You said you were happy with your coverage. It had to do with your son and the care that he was getting, which is no longer guaranteed. Let everyone know, because I think, the heart of a mom trying to guarantee her kids get to keep the care they had that they liked, they were promised, is something everyone can relate to.
Huh? Was Hasselbeck implying that the child is “no longer guaranteed” care by his current specialist—which could very well be true—or that the child was “no longer guaranteed” care at all, by any specialist? If the family had a policy—which, apparently they did—the son’s health needs are covered. Under a new policy, the son may have to see a different doctor or use a different hospital. And yes, that annoys lots of people, but it’s not the same thing as having no coverage.
The interview did not get much more edifying as it went along. Stewart struggled to articulate her complaints to a confused-seeming Hasselbeck.
STEWART: Originally I was told by Anthem that I would not be able to cross state lines no matter what insurance I chose, and I was done with children’s hospital. And at that point, I’m considering moving to Ohio, right?
HASSELBECK: Why? Is this for your son, Jack?
STEWART: This is for my son, Jack, yes. And so originally that is what I was told. Digging into this further, I believe I will have an option. I think I will be forced into the exchange and forced to buy Kentucky health cooperative government insurance…That’s my understanding right now.
Say what? Did Anthem tell Stewart she couldn’t use the children’s hospital because it was in Ohio? It was not clear. And if she wanted to use this children’s hospital, could she get out-of-network benefits and pay more out of pocket? Fox’s Hasselbeck did not ask either of these potentially clarifying questions, but rather went straight to her next question: “The president now said, Look things are running ok now, everyone’s happy, it’s almost fixed, you know, we’re still working on it. What’s your message to him this morning?” (As if Fox News’s chyrons hadn’t been answering that question throughout the segment: “MOM WHO LOST HEALTH INSURANCE,” ” ‘WHAT ARE YOU DOING?’ MOM ASKS PRESIDENT ABOUT OBAMACARE PROBLEMS,” “HEALTH CARE HURDLES,” “STILL NOT SOLVED”.) Worst of all, Hasselbeck didn’t respond to Stewart’s confused claim that she would be “forced” to buy “Kentucky health cooperative government insurance.” First, no one can force her to buy a plan from any particular carrier. And second, the Kentucky health co-op is not “government insurance.”
Since Fox didn’t set the record straight, I tried. I rang up John Morrison, the founder and president of the National Alliance of State Health Co-Ops, whose members are the 23 health insurance co-ops set up under Obamacare to provide a member-run alternative to the big commercial carriers. No, the government doesn’t run them. Morrison explained that by 2016 the majority of the board members of these co-ops will be member policyholders. The government gave loans to these co-ops to get them off the ground, Morrison explained, adding the government’s only interest is that they are working well to pay down the loans. “HHS doesn’t participate in management,” says Morrison. “These are private entities with a public loan. The government is the lender, and they keep tabs only to be sure the co-op continues to be a good risk.”
The co-ops are doing well, Morrison says. They account for about 20 percent of the Obamacare marketplace enrollment, although the actual enrollment varies among states. In Kentucky, he said, the co-op is “dominating the market.” There’s a backstory here. The insurance industry never liked the co-ops and managed, in the fiscal cliff deal in early 2013, to kill funding for another 40 co-ops whose applications were in the pipeline. The big insurers worried about competition, Morrison told me at the time.
Maybe there’s also a backstory to Stewart’s mixed up tale. Was Fox sending us a clue that there could be another insurer backlash in the making? Or was the message Fox was sending simply, “HEALTH CARE HURDLES” “STILL NOT SOLVED,” never mind the confused and confusing specifics of Rebecca Stewart’s anecdote, on which Fox shed no light?
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