Town hall crowds want clarity on GOP health plans. Can reporters provide it?

Rep. Greg Walden, chairman of the House Energy and Commerce Committee

FOR THIS MONTH’S CONGRESSIONAL RECESS, Rep. Greg Walden returned to his far-flung district and hosted six town hall meetings, attended by thousands of his constituents—many of them seeking clarity on the future of GOP-led efforts to repeal and replace the Affordable Care Act. Walden, the lone Republican who represents Oregon in Congress, currently heads the powerful and media-savvy House Energy and Commerce Committee—where, Willamette Week wrote, “the American Health Care Act, the GOP replacement for ACA, began its short journey.”

In the weeks before House Speaker Paul Ryan pulled the American Health Care Act, there was spin aplenty from the press office of the Energy and Commerce Committee’s press office. The committee sent out numerous press releases aimed at building momentum for passage, and arguing that the GOP’s mission was “rescuing the American people from Obamacare’s collapse and rebuilding our broken health care system.” Those releases were laced with Republicans’ main talking points: protecting patients with pre-existing conditions, lowering costs for families, letting young adults stay on their family policies, and more choice for patients. Some also addressed Medicaid changes, which were wrapped in friendly, reasonable-sounding language.

Walden sent out his own news releases, which reinforced points made in the Committee’s press announcements. In a March 9 statement, he was specific about the changes his committee planned for Medicaid: “We responsibly unwind the Obamacare Medicaid expansion while treating those covered under the expansion today fairly. We refocus Medicaid’s limited resources to the patients most in need.” After Ryan pulled the AHCA, the Willamette Week observed that Walden “may now have questions to answer at home.”

Finely crafted press messages about health care policy from congressional PR shops may not cut it anymore. The voting public craves honesty and clarity.

 

AT HIS TOWN HALL MEETINGS, Walden leaned on the same carefully crafted talking points. That approach may have backfired: News coverage of the town halls (“Walden hears ‘Do your job,'” “Vocal crowd in Bend gives Walden an earful,” “Rep. Walden finds tough crowd at Hood River town hall”) seethed with angry words from attendees who didn’t buy their congressman’s spin.

Joshua Cook, who works in an emergency room on the Oregon coast, traveled to Bend and asked Walden why he wanted to change healthcare. Cook unfurled an American flag and said, “Americans want health care, and it has to be for everybody.” Walden ducked the charge, responding there were pieces of the Affordable Care Act he wanted to keep in place. “I never want to go back to the days that you can’t afford or can’t get insurance because you have a pre-existing condition,” he said.

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When a young woman asked Walden why he wanted to do away with the Affordable Care Act, Walden noted all the elements he wanted to keep. From Oregon Public Broadcasting’s coverage:

Walden pointed out all of the elements of the ACA that he supported retaining, such as protections for people with preexisting conditions and allowing young people to remain on their parent’s plan until the age of 26. But Walden said the health care system under Obama had major problems. ‘I want to fix it, so it will work,’ he said.

If Walden explained how such fixes would come together, then the story from Oregon Public Broadcasting didn’t say. Revisions to Medicare are not part of the ACA repeal-and-replace discussions, but Walden brought them up—perhaps to reassure seniors and to make a positive point about the existing health law without discussing what the GOP has in mind for Medicare. The ACA was “able to close the so-called doughnut hole,” he told a crowd at the town hall event in The Dalles. “We leave that closed.” He added, “That’s important for seniors.”

Press reports indicate Walden did not talk much about Medicaid, which covers about one quarter of Oregon’s population. The GOP’s proposals to change the program’s financing, cut the number of people currently receiving benefits, and impose work requirements to get benefits could affect many of the 11 million people who gained coverage under the ACA’s Medicaid expansion. As CJR wrote recently, the AHCA would effectively erase the gains in insurance coverage achieved under the ACA.

Many town hall attendees seemed anxious over the potential loss of coverage, and raised their concerns over and over. As Walden pivoted to pre-scripted messages, some in his audience caught on, got frustrated, and told reporters they were dissatisfied with what they heard.

An attendee at a Prineville town hall told KTVZ-TV, which serves the Eugene area, that Walden “walked around the question[s].” He offered no details on specific changes Republicans would make to the healthcare law, but instead told the group, “The treatment we want for the people in need is with hope it will actually help them.” By then the crowd, according to the station, “had become disgruntled.”

Many among the thousands of attendees at a Bend town hall were also unhappy with Walden’s responses. “Supposedly the health care bill is being re-written, but I don’t really hear what that is like,” one attendee said. “It seems like at this point it’s just taking people’s health care away, and that there’s no replacement.”

The Bulletin, a Central Oregon newspaper covering the Bend town hall, seized on the same frustration:

“Janice Schock, a longtime Bend resident who has supported Walden, said she was disappointed he hadn’t more directly addressed her question about how, as chairman of the House Energy and Commerce Committee, he would handle renewed efforts to repeal Obamacare. Schock told Walden that while it was fine to ‘tinker,’ getting rid of affordable care was wrong.”

Schock wasn’t the only Walden supporter who wanted more substantive responses. “We want to hear the truth,” about what the Republicans plan to do with healthcare, said 69-year-old Joanne Manciu, who lives in The Dalles. “We get so much heat from the left that seems absolutely outrageous. What do they actually have planned and how does it work?”

Walden offered little clarity on the GOP’s bill, which he called a “work in progress” that needed “to be improved,” according to a local CBS affiliate. He told attendees that he never wanted to return to the days when people with pre-existing conditions were denied coverage.

For the Medford town hall, the Mail Tribune ran down the social media responses to Walden’s comments, and interviewed attendees for their thoughts on the congressman’s answers. “He continually went back to these stock answers that make him look good,” said one, “but clearly what he believes is not what most of the people in this room believes.”

Congressional recess comes to a close on Friday, but there will be more town halls this summer, and the need for clarity on the future of healthcare will still be critical

 

IF THERE’S SOMETHING TO PRAISE in coverage of Walden’s half-dozen town halls, then it’s this: Finely crafted press messages about health care policy from congressional PR shops may not cut it anymore. The voting public craves honesty and clarity. They want to know more and, in these instances, their elected representative didn’t tell them enough.

But neither did the news media. Many of the town hall reports stuck to the same old formula for covering such events. They offered good descriptions of angry and frustrated attendees, and then they fell into “he said,” “she said” reporting that pitted Walden supporters against Walden opponents.

News outlets didn’t get into much substance about the GOP plan to replace Obamacare. There were plenty of opportunities for a few sentences to clarify issues raised at the town halls for those reading or listening to coverage at home. The Dalles Chronicle, for example, reported Walden saying, “Nothing we’re doing in the health law that’s being debated right now adversely affected Medicare.” Instead of piling on more quotes from Walden, the Chronicle might have explained that Republicans do have plans to continue Medicare privatization and then described what those plans could do.

Congressional recess comes to a close on Friday, but there will be more town halls this summer, and the need for clarity on the future of healthcare will still be critical. Local news outlets successfully sounded the alarm over the AHCA last month. Now they should reconsider how they will cover the next round of GOP-crafted policy proposals, to provide their audiences with the information they can’t get at town halls.

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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.