Almost lost in the aftermath of last week’s midterm elections was the defeat of California’s Prop 45, a ballot initiative that would have given the state’s insurance commissioner veto power over health insurance rates he deemed excessive for individual and small-business policies. Regulators in 35 other states have that authority, but 60 percent of California voters sided with the insurance industry and its allies in defeating the proposal.
Though ballot initiatives tend to face an uphill battle with skeptical voters, Californians have been sensitive to rate hikes in the not-too-distant past. And in late August, a poll found that nearly 70 percent of registered voters favored the rate regulation measure.
So what changed? A range of influential voices—from the state’s healthcare exchange to the SEIU to Rep. Nancy Pelosi to editorial boards around the state—weighed in against the referendum, arguing that the system was working and change could undermine the ACA in California. But let’s not overlook the more than $55 million the insurance industry and its allies spent on TV commercials, radio ads, and slick mailers, dwarfing the amount spent by proponents.
All that spending made Prop 45 a major theme on the airwaves, via incessant commercials. In terms of time devoted to the issue, coverage by local TV stations couldn’t possibly keep up. But there was some—and two pieces produced by local stations offer an interesting compare and contrast in how to cover issues like these.
In early October, just as the late money from the industry was rolling in, ABC 7 in Los Angeles aired a fairly unremarkable story about a news conference called by Consumer Watchdog, the advocacy group that spearheaded the initiative. But a few weeks later, the station produced this excellent animated primer explaining what a yes or no vote would mean:
As you’d expect from the format, not every wrinkle is addressed. A little more time might have gone to explaining the “no” side’s argument about the interplay between different government offices. Still, the clip broke down a complicated issue clearly and succinctly, and presented the choice in a straightforward way: Yes to add the new regulation, no to leave things as is.
By contrast, this is the segment that ran on Fox 5 News in San Diego just before the election, covering both Prop 45 and a separate ballot measure, Prop 46:
This is succinct, too—but with viewpoints that range from uninformed to ideologically slanted. One woman-on-the-street says, incorrectly, that the measure would put a legislator in charge of making decisions. More problematic was the “political analyst” the station called on to make sense of it all. That’s Richard Rider, head of a local group called San Diego Tax Fighters, who said the proposal was rooted in the theory that “one bureaucrat in California should be setting rates for all the health policies.” He added, “If you check yes, you want the government to run your healthcare. You want a state version of Obamacare.”
It’s clear that he doesn’t like it, but it’s hard to know how to make sense of that last bit. For the record, the ACA does not give the federal government power to set insurance rates. Then there’s the problem that the most prominent “no on 45” voices, like Pelosi, said the measure could undermine Obamacare in the state, the opposite of the concern Rider expressed.
I asked Fox reporter Ashley Jacobs about her choice of experts. She replied that while Rider runs a “tax fighter” blog, “he is knowledgeable on many political topics.” But if those topics include insurance regulation, it didn’t come across here.
Jacobs added: “I was also challenged with the task of fitting both props 45 and 46 into the same story for our viewers a day ahead of elections. As I’m sure you know, in television we’re often limited to a minute and 30 seconds to tell a story. Logistically, I needed someone from each side of the aisle to talk about the props, so I talked with knowledgeable people who could speak about the props, rather than individual experts for each prop.”
That meant getting a liberal and conservative. But while a local lawyer is featured at the end of the segment explaining the other ballot measure, there’s no other “expert” voice, pro or con or neutral, on Prop 45.
The confusion among the public over insurance rates and regulation isn’t likely to go away soon, but sensible local reporting can make a difference. The lessons from these two clips: Play it straight, be clear, and find experts who really know the issue at hand.
And the lesson to editors and news directors: Give your reporters the time they need to do just that.
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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.