Death panels made a comeback at a recent town hall in Pasco County, Florida. On Saturday, Bill Akins, secretary of the county Republican executive committee, and U.S. Rep. Gus Bilirakis, who represents the area, tried to convince attendees that death panels—2009’s “Lie of the Year,” according to PolitiFact—were indeed part of the Affordable Care Act. In the health law, Akins claimed, “There is a provision in there that anyone over the age of 74 has to go before what is effectively a death panel.” CNN reported that Bilirakis nodded. Death panels? That canard is still around?
A 2016 survey by Public Policy Polling found that nearly 30 percent of Americans still believe the Affordable Care Act contains a death panel provision. And that’s not the only enduring misconception about the law: Morning Consult polled nearly 2,000 adults in late January and found that 35 percent either did not know that Obamacare and the Affordable Care Act were the same thing, or else were not certain.
In some ways, those numbers aren’t surprising. Democrats used spin and false promises to sell the law, and Republicans have demonized it ever since, so—perhaps as a consequence—large segments of the public are still confused. Reporters covering the town hall in Pasco County did little to clear up that confusion, and comparable coverage—in Florida or elsewhere—risks perpetuating it.
Seven years ago, Sarah Palin wrote on Facebook that, under the ACA, the government would set up boards to determine whether seniors and the disabled were worthy of care. Former New York lieutenant governor Betsy McGaughey amplified Palin’s falsehood when she told a radio host, “Congress would make it mandatory—absolutely require—that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.” The modest provision written into the health law would have reimbursed doctors under Medicare for offering end-of-life counseling for their patients. Bill drafters struck the provision after the Palin-McCaughey firestorm.
Saturday’s audience pushed back against Akins’ claim. Still, Akins persisted, telling them, “It’s in there folks. You’re wrong. You’re wrong!” One 77-year-old woman shot back, “I think it is unconscionable for this politician to tell me that at 74 I will be facing death panels. There is no such thing as a death panel.”
Bilirakis stepped in to clean up the mess, but instead his comments muddied the waters even more, leaving the 250 attendees with another misrepresentation. Bilirakis said Akins was referring to the Independent Payment Advisory Board (IPAB), a 15-member board set up by the ACA to make recommendations in order to help control Medicare’s spending growth should it exceed targets established in the health law. Changes recommended by the IPAB would be subject to Congressional oversight. Is the IPAB a death panel? Hardly.
The IPAB has never been set up because of strong opposition from healthcare stakeholders who fear their Medicare reimbursements might be cut. Still, CNN noted the Congressman repeatedly cited the IPAB. Town hall attendees probably had no clue what he was talking about. After the meeting Bilirakis told CNN, “The board exists, OK? And I’ve voted to repeal the board.”
Press accounts of the raucous meeting were standard political fare, much of it political filler. The Washington Post framed its story about Akins around what it called “almost daily examples of false, misleading or bigoted stories and memes being shared for his audience” via Akins’ social media accounts. ThinkProgress noted Akins’ lie, and also mentioned Bilirakis, but did not address his misrepresentation and distortion of the IPAB. Instead, the piece mentioned that the Congressman likes to describe himself as a “staunch opponent of Obamacare” and told attendees at the town hall, “People should have the opportunity to tailor their own plan based on their needs.”
Florida Politics reported that the meeting “wasn’t all nastiness,” and that Akins’ counterpart on the county Democratic committee thanked Bilirakis for hosting the town hall when other Republicans were cancelling theirs. Again, no mention of Bilirakis’ misrepresentation. Axios noted in its morning roundup that the IPAB had come up in the Florida town hall and added the law “specifically says the board can’t recommend any healthcare rationing.”
Those outlets, along with CNN, fell short of giving readers a much fuller refutation of “death panels.” Reporters missed the chance to tell readers that, a year ago, the Centers for Medicare & Medicaid Services began giving physicians an $86 payment for up to 30 minutes of end-of-life counseling with individual patients. Doctors can discuss matters including advance directives, health care proxies, and life support measures, but Medicare has set no rules on what they can or must discuss. The rule quietly took effect without the public uproar that accompanied the death panel myth.
Each of those stories also had an opportunity to advance its audience’s understanding of a serious public health issue. A 2015 Kaiser Family Foundation poll showed that more than 80 percent of Americans believe Medicare should cover end-of-life discussions between patients and their doctors, though a much smaller number of respondents said they were actually having them.
Perhaps the return of the “death panels” myth is specific to Pasco County, but it’s likely that reporters covering other counties will encounter other misconceptions, half-truths, and outright lies. When we do, we have two choices: We can do some homework, challenge those falsehoods and help change the discourse around the Affordable Care Act, or we can pass along erroneous statements at the risk of our own credibility.
Photo by Nick YoungsonTrudy 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.