Midnight Monday brought the end of Obamacare’s first open enrollment period, a deadline marked the next day by President Obama’s Rose Garden announcement touting 7.1 million insurance sign-ups to date. “The milestone,” as The New York Times reported, “may be more significant politically than for what it says about the law’s potential impact on the American healthcare system.” A review of press coverage around Monday’s “milestone” identifies challenges for the law itself, for Americans who signed up for insurance, and for reporters continuing to work the story.
Although several news outlets discussed Obamacare’s starring role in the coming midterm election battles—The Washington Post, for example—many also picked up other angles, such as the issue of how to measure the success of the law (something I’ve written about). Pro Publica’s Charlie Ornstein examined various ways to judge success, like assessing whether states met Department of Health and Human Services enrollment estimates (made last fall). Ornstein’s piece concluded with comments from Kaiser Family Foundation president Drew Altman questioning whether the public will wait for all the facts before making up its mind. Altman also figured prominently in a New York Times piece on Friday. “The whole narrative about Obamacare—‘Will they get to six million? What is the percentage of young adults going to be?’—has almost nothing to do with whether the law is working or not, whether the premiums are affordable or not, whether people think they are getting a good deal or not,” Altman told the Times. The question of whether enough young “invincibles” signed up to balance the insurance claims of older and sicker enrollees (if not, the law has provided for such a contingency) has indeed become somewhat of a media obsession.
Another common question in coverage: Will those big bad insurance companies raise their rates for the next round of open enrollment, which begins in November? Bloomberg reported, “Already, Indianapolis-based WellPoint Inc., the largest exchange insurer, has warned it may propose ‘double-digit’ premium increases for the next enrollment period.” Chad Terhune, the insurance reporter for the Los Angeles Times, broadened the insurance angle and WellPoint’s warning, sharing with his readers how actuaries at California Blue Shield make judgments about premium rates.
A few outlets looked at obstacles the newly insured will face. A story by Tony Pugh of McClatchy’s Washington Bureau featured a recently released study in the health policy journal Health Affairs which noted that about half of those with subsidized coverage from the exchanges and about half of new Medicaid recipients are likely to lose coverage within a year for a variety of reasons (divorce, births, deaths, changes in family income). That makes it tough for people to have continuity of medical care, one of the often-stated sub-goals of Obamacare. Last week we suggested reporters use the Health Affairs study as a starting point for further reporting.
Monday, PBS NewsHour took a look at the affordability question that has plagued the ACA’s rollout for months. One guest, Mary Agnes Carey from Kaiser Health News, raised the issue, saying people will have to decide if the coverage is affordable. Said Carey: “Some of these policies have fairly high co-pays, out-of-pockets costs, deductibles, and so on…Do people sign up for a premium and they decide, gosh, they just can’t cut it? Maybe the subsidies don’t help them enough. Maybe they do.” It would have been helpful for host Judy Woodruff to distinguish for her audience the difference between affordable premiums and affordable medical care which, for many families, will be a function of how much cost-sharing the policy requires. Reporters tend to interchange the two concepts, which makes it hard for people to understand the point being made.