THE BETTER CARE RECONCILIATION ACT—the Senate GOP’s version of the American Health Care Act—may be the most anticipated and least understood piece of legislation put forth by Republican lawmakers under the Trump Administration. Editorial boards around the country have criticized the secrecy surrounding the bill’s conception—as “detestable” and “unhealthy” and “too much.” Newsrooms have an obligation to decry efforts by politicians to obscure major policy matters. But there is a risk that countless American communities may see their own unique health care problems as secondary to the political drama surrounding the health care plan.
CJR recently invited contributions from journalists whose work remains focused on the healthcare challenges specific to their communities. We asked each reporter the same question: “As the nation anticipates passage of the American Health Care Act, what are the health stories that are most urgent for journalists to tell in your region?” The first dispatch, from The Post and Courier‘s Lauren Sausser, is below. As the Senate moves towards a vote on the Better Care Reconciliation Act, we’ll publish more dispatches to encourage journalists to cover the changing health care landscape from the ground up.—Brendan Fitzgerald, editor, United States Project
LAST MONTH, CNN PUBLISHED a story that showed how local newspapers across the country treated breaking news about the so-called “Comey memo”—a subject also recently parsed by CJR. Most featured the story on their front pages. Some—including The Post and Courier, the Charleston, South Carolina paper where I work—gave it top billing. The article pointed out that “the Comey memo news was, generally speaking, big-ish news in swing states—though, in most places, nowhere near as big news as it was in the Times and the Post.”
The Post and Courier has similarly covered the American Health Care Act—now the Better Care Reconciliation Act—as an important legislative debate, and written several articles about it for the front page. But the AHCA is far from the only health care story we’re reporting.
In South Carolina, we’ve covered decisions by some immigrants to opt their children out of health care benefits for fear of deportation. We’ve reported on a proposed measure that could divert liver donations from the state. Since January, we’ve published articles about child sexual abuse, antibiotic resistance, teen suicide rates, lead poisoning, neonatal abstinence syndrome, Medicare reform, and a gynecologist from South Carolina who operated on slaves in the 19th century without anesthesia.
We’re also focused on the Affordable Care Act—legislation whose impact still demands coverage, even as it is threatened with repeal. In one recent article, we developed a series of maps that show how most insurance companies have stopped selling ACA policies in South Carolina. The lack of competition in our marketplace is particularly worrisome for nearly 200,000 customers in the state who depend on the ACA for coverage.
The looming passage of the Better Care Reconciliation Act is vitally important to our readers. But as local health reporters anticipate (and report on) those potential policy changes, they should also prioritize other equally important issues, such as the opioid epidemic and the existing insurance coverage gap.
If Congress reforms the Medicaid program, that decision could impact South Carolina’s higher-than-average infant mortality rate, the number of low-income patients who qualify for behavioral health services, and more.
I MET A MAN LAST YEAR named Jim Connor, who was diagnosed with cancer and fell into that ACA coverage gap. He’d waited months to see a doctor because he was uninsured. A local hospital eventually covered the cost of his treatment, but charity care came too late, and Connor died in September.
It’s impossible to say that a Medicaid card would have saved Jim’s life. But it would have helped him see a doctor when he started losing weight.
— The Post and Courier (@postandcourier) October 16, 2016
Medicaid covers more than 1 million South Carolinians, most of them children. That number represents 21 percent of the state’s total population. (Another 136,000 adults would qualify for Medicaid under the ACA if conservative South Carolina leaders opted into the expansion.) If Congress reforms the Medicaid program, as many Republican lawmakers would like, that decision could impact everything from South Carolina’s higher-than-average infant mortality rate to the number of low-income patients who qualify for behavioral health services.
South Carolina’s former Medicaid director recently detailed the impact of proposed federal cuts to the program. Such cuts would likely force the state agency to reduce the number of people who qualify for Medicaid, and reduce the amount of money the state spends on each patient. The state agency could cut spending, the director said, by scaling back benefits or reducing provider rates.
THIS IS SPECULATIVE, OF COURSE. The Better Care Reconciliation Act isn’t public policy yet, and we’ll continue covering its legislative journey. But the law will eventually have real life-or-death consequences for some South Carolina patients. Those are stories we’ll certainly write about.
I’d recommend other reporters do the same. But in South Carolina, and in many other states, there are very few reporters left at local newspapers who cover health care exclusively. That resource challenge is compounded by the difficulty of a topic that general assignment reporters cover only occasionally.
Still, there are patients, doctors, nurses, nursing home providers, hospital administrators, caregivers and Medicaid beneficiaries in almost every corner of the country who have much to say about the health care system. For me, covering their stories has always been a good starting point.