The deeply troubled state of Healthcare.gov has been the big healthcare story of the month. It’s also a lesson in why reporters need to be wary of government spin. In the runup to Obamacare’s big debut on Oct. 1, top federal officials were full of claims about how the site would set a new standard for government service. Coverage that passed along the hype risked being misleading—even deceptive.
That’s a lesson that applies to other elements of the law, too. The public debate over Obamacare has featured lots of oversimplified claims about its benefits against overwrought denunciations of “socialized medicine.” The task for reporters is to get past the spin and hype and explain the real trade-offs the bill makes throughout the insurance system.
The fact that actual prices and policies are becoming available now—at least, if you’re not shopping on Healthcare.gov—makes that task more feasible, and some reporters are beginning to dig deeper. Two fine daily newspaper reporters recently shared their articles, and their observations about reporting on the law, with me. Their comments are instructive for others following the continuing saga of the Affordable Care Act.
Lindy Washburn visits people in a bread line. Even in early October, when problems with the federal website were just becoming apparent, Health and Human Services Secretary Kathleen Sebelius was talking up other “pathways” to get potential customers through the individual market. Washburn, a health reporter for The Record in northern New Jersey, checked out one of those pathways—and what she found hardly matched the hype.
Washburn sent me a note describing what she found when she stood in a bread line near a New Jersey trailer park where representatives of Enroll America, a private group aimed at helping the government enroll seven million Americans by the end of March, were trying to instruct people in the finer points of health insurance. Though the Enroll America workers were pitching Obamacare, they couldn’t actually sign up people, Washburn said. Instead, they were referring them to “navigators” who could help them enroll—in effect, adding another step in a complicated process.
“I could see seeds of resentment building up,” Washburn told me. “There were the old, young, deaf, half-blind, on scooters, undocumented, unwired, Spanish-speaking, angry, grateful, the gamut. I heard a fair amount of anger and skepticism about ‘more government programs’”—a cynicism Washburn believes might have been the result of Hurricane Sandy and Gov. Chris Christie’s missed deadline for housing assistance. The refrain seemed to be, “we’re signing up for this and that and nothing ever happens,” Washburn said. People with kids seemed the most interested in insurance—but the children were probably already eligible for coverage under Medicaid, if the family had known about it. “I was hoping to get somebody to say something about their feelings about limited networks of hospitals in the plans, but that was like advanced calculus for people still in elementary school,” Washburn told me.
“All the buzz is about the website,” she added. But standing with people who need insurance was “such a reality check.” There are only 35 to 40 navigators to help the estimated 900,000 New Jerseyans eligible for coverage on the exchanges. “When you see the intensive effort needed to get everyone enrolled, it makes me wonder how this will work,” Washburn said.
Washburn did write an Oct. 20 piece about those narrow networks, relying more on industry officials than people-on-the-street. The article, “Cheapest Obamacare plans greatly limit choices,” took a careful and comprehensive look at how limited some of the provider networks are in New Jersey, and provided some new insights into the trade-offs exchange shoppers face.
There’s a newcomer in New Jersey, Health Republic —one of the new co-ops that was not cut off at the pass in the New Year’s Eve budget deal—that offers a uniform level of coverage across its entire hospital network, and changes higher premiums in turn. Other insurers, like Horizon Blue Cross Blue Shield, offer lower-cost plans and then funnel patients into just two “preferred” hospitals. If a patient needs to go to another hospital, they can—but they’ll end up paying much of the bill. Despite the potential for large costs down the line, one broker predicted the lower-end policies would be popular. “It’s all about premiums,” he told Washburn. “For the premium dollars it’s going to save, heck, yeah!”