United States Project

How local news sounded the alarm over the GOP’s defeated health plan

March 24, 2017

The GOP’s decision to pull the American Health Care Act, which would have repealed most of the major provisions of Obamacare, reflects in no small measure the groundswell of opposition from local news outlets. The bill would have substantially increased the number of uninsured, including the 13 million or so that gained coverage under Obamacare’s Medicaid expansion, and would have eliminated the ACA’s essential benefits package, which included coverage for maternity care, mental health services, emergency room visits, and prescription drugs.

Editorials and news coverage in numerous American communities responded with a clear message that such measures simply didn’t pass muster for their communities. Many in their audiences agreed: A Quinnipiac Poll released yesterday found that only 17 percent of American voters approved of the Republican’s bill, while 56 percent didn’t. Many editorials found ways to ask the same question—“Is this bill good policy?”—and then answer, conclusively, “No.”

“There are so many things wrong with this plan that it’s hard to know where to begin,” wrote the St. Louis Post Dispatch’s editorial board. The Star-Ledger in New Jersey attacked the GOP’s plan for Medicaid, calling the $880 billion spending reduction over the next decade “a savage cut that will gut the program no matter how they spin it.” The Akron Beacon Journal’s editorial board described the structure of the Obamacare exchanges as “sound enough.” By comparison, the board noted, “Trump, Ryan and the rest are misrepresenting things mostly to justify their ill-conceived intervention.”

The Lincoln Journal Star told readers that the AHCA fell far short of Trump’s pledge “to come up with a new plan that’s going to be better health care for more people at a lesser cost.” The Virginian-Pilot declared the Republican plan would make things worse for low-income Americans who earn too much to qualify for Medicaid but too little to benefit from subsidies. (“There are hundreds of thousands of those folks in Virginia alone,” the paper noted.) Two papers in Florida whose coverage areas are represented by GOP congressmen spared no criticism of the proposals; the Gainsville Sun recommended that Sen. Marco Rubio and Rep. Ted Yoho “reject the plan in favor of something that fixes problems with Obamacare and not make things worse.”

News coverage in many states hinged on similarly blunt statements from sources. The Boston Globe covered a legislative committee meeting where the state’s Secretary of Health and Human Services Secretary, Marylou Sudders, discussed how cutting Medicaid payments would affect Massachusetts residents who relied on Medicaid to pay for nursing home care. (The Ryan plan would force the state to make its requirements to qualify for nursing home assistance even more onerous.) Sudders simply said, “The bill, as currently presented, is not good for us.”

As editorial boards delivered blunt critiques, many newsrooms delivered sharp stories that brought the impact of the Republican health proposal home. In Montana, Lee Enterprises newspapers like the Billings Gazette and The Missoulian published stories that examined how the loss of Medicaid coverage would affect Native Americans; nearly 10,000 of them had signed up for coverage under Montana’s Medicaid expansion. It was “really a game-changer,” said Dr. David Mark, the CEO of Bighorn Valley Health Center in Hardin, Montana. “It’s really allowed people to access care in a whole new way.”

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In Louisiana, the Times-Picayune brought home the point that many older people would pay more for insurance under the AHCA. Last year, Jefferson Parish—a Republican stronghold—had the state’s greatest number of residents enrolled in Obamacare policies. One of every four people enrolled was between 55 and 64 years old, and the Times-Picayune explained how many of those people would receive less in tax credits under the AHCA:

A 60-year-old resident in Jefferson and Orleans parishes who earns $30,000 a year, for example, stands to lose $4,730 a year in tax credits for health coverage under the GOP plan… By contrast, higher-income earners would see their tax credits rise under the GOP plan. A 60-year-old in Jefferson and Orleans parishes who makes $75,000-per-year would see $4,000 more in tax credits under the proposed plan.

Some newsrooms used the opposition from their state’s Republican officials to strengthen their critical coverage. Earlier this week, Michigan Republican Governor Rick Synder sent letters to each member of the state’s congressional delegation. Snyder’s letters all warned that the legislation would reduce federal resources that currently assist 2.4 million Michiganders—nearly one-quarter of the state’s population. For each House member, Snyder provided the number of children, seniors, pregnant women and disabled individuals who are served by traditional Medicare in their districts. “As you know,” the governor said, “these our state’s most vulnerable citizens, friends and neighbors. The proposed AHCA will adversely impact them.”

Michigan’s news outlets used Snyder’s letter to cinch their coverage of the AHCA’s impact. TV stations in Lansing and Kalamazoo carried the story. So did the Detroit Free Press and Mlive.com, which also provided readers with a map and a search tool so they could learn how many people in each of the state’s congressional districts would be affected. At the Detroit News, health reporter Karen Bouffard noted the impact of Medicaid reductions on the state and then pushed beyond the numbers to show how one Detroit mother who frequents a family health center would get less care, if any at all. Bouffard also interviewed the executive director of the Michigan Health Policy Forum, who told her:

“States are going to have less money to treat more people, and once you’re in that situation, there are only a couple things you can do. You can cut the number of eligibles, you can cut the benefits, you can cut provider reimbursements, or you can use state funds to replace where federal funds have fallen short. And none of those options are going to be popular.”

That quote—obtained by a dedicated health reporter at a time when we have far too few—gets at the hard truth of the American Health Care Act debacle, a truth that many local newsrooms seized on, too.

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.