This is the second of a series of occasional “Medicare Uncovered” posts that will look at how the media are covering Medicare, the nation’s vast and publicly accountable health system for the elderly, and a political target in ongoing discussions about the deficit.
In mid-December, Bob Corker, Republican Senator from Tennessee, introduced a bill that would radically change Medicare. Called the Dollar-for-Dollar Act, Corker’s legislation would cut $1 trillion from Social Security, Medicare, and Medicaid in exchange lifting the debt ceiling by $1 trillion. The debt ceiling standoff has been averted for the time being but the bill is still important, because some of its provisions could gain traction in the coming months as Save Medicare Fever spreads among Beltway’s policymakers.
The Corker bill, co-sponsored by Tennessee’s other Republican senator, Lamar Alexander, deserved careful media scrutiny then and still does. So far, there has been almost none. State news outlets might be forgiven, since covering the details of complex proposed legislation is not the way we generally cover our local congressman or congresswoman. We usually ask a few questions, let the politicians give their views, and wrap those views into a story.
But the significance of the economic and safety net issues on the national agenda—which affect almost everyone—demands more than business as usual from the press. How the media have so far covered what Alexander admitted will be painful, “bad medicine for many people,” offers an example of why reporters have to move beyond the borders of their comfort zones. If the medicine will taste so bad, then maybe the media ought to be reporting why, and also explore what, exactly, Corker and Alexander are trying to fix—and if his radical treatment matches the malady, and what other possible treatments are out there.
So far, news outlets in Tennessee, at least, have not imparted a whole lot of information about what Corker wants his 242-page bill to accomplish, and what it would do to healthcare in Tennessee and beyond. (CJR’s own primer on the pending legislation, “Parsing Senator Corker’s big bill,” will run tomorrow.)
Explaining Medicare cuts has added meaning for the people of Tennessee. Thousands of them already know what it’s like to lose health benefits. In 2005, then-Gov. Phil Bredesen, a Democrat, cut them off of TennCare, the state’s highly touted program that had aimed at universal coverage. The program, which had little cost control, became too expensive. Many of those who lost TennCare benefits are now on Medicare, or about to be, and need to know how their health insurance may change again.
The Commercial Appeal offered readers only a tiny taste of Corker’s Medicare plans in November (in a piece also published by the Knoxville News Sentinel), when the senator was pushing them in the context of a fiscal cliff deal and outlining his ideas in a Washington Post op-ed. At the end of its piece, the Appeal noted that Corker called for “gradual age increases within Medicare and Social Security” and increasing Medicare premiums for those making more than $50,000 a year in retirement. Those provisions alone were reason enough to take a second look, but the paper did not explain it adequately.
A month later the Knoxville News Sentinel summarized the Medicare provisions in the Dollar-for-Dollar Act in a one-graph description that was more opaque than illuminating:
Its details include reforming Medicare to include competition from health-care options, gradually raising the eligibility age to 67 by 2027, requiring high-income beneficiaries to pay higher premiums and giving flexibility to the states to manage the program.
But: there already is competition in the program, from Medicare Advantage plans, which are private options; higher-income beneficiaries already pay higher premiums; and Medicare is a federal program, not a state one, so it’s not clear what “giving flexibility” to the states would mean.
All this cried out for more explanation, a point made by a blogger, R. Neal, on the website of KnoxViews (“Progressive citizen media for East Tennessee”). Neal noted that Corker’s plan begins to privatize Medicare, much like the proposals made by vice presidential candidate Paul Ryan would, and he asked in a post, “Maybe a policy expert can explain how ‘Total Health’ [Corker’s program for private plans] is different from the existing Medicare Advantage?”
That’s a good question for The Tennessean, the state’s principal newspaper, which so far hasn’t gotten too deeply into the nitty-gritty of Corker’s bill. In a piece published a few weeks before the fiscal cliff deal, the paper presented a longish account that framed some of Corker’s ideas as a political dogfight—conservative Republican issues versus liberal Democratic ones. The lede:
Advocacy groups and prominent congressional Democrats continue to take aim at Republican Sen. Bob Corker’s proposals to raise eligibility ages for the nation’s two biggest entitlement programs, Social Security and Medicare.