From the March 15 edition of Fox News' Fox & Friends Saturday:
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The Columbus Dispatch has pushed several myths about what health care enrollment numbers mean for the Affordable Care Act (ACA) marketplace, falsely claiming that not enough young or previously uninsured people have signed up and that people who have signed up for but haven't paid for an insurance plan will doom the law.
Right-wing media are newly outraged over the Affordable Care Act's "hardship" exemption, a provision of the original law that pardons qualifying persons from the individual mandate to purchase health insurance coverage.
One conspiracy theory, favored by the editorial board of The Wall Street Journal and conservative blogs like The Daily Caller, is that the Obama administration 'secretly' changed the ACA last week by "quietly" adding a hardship exemption. Others like FoxNews.com suggested that the administration added the hardship exemption -- "a mega-exemption" -- to the law just three months ago. But the one thing all right-wing media agree on is that the hardship exemption "might be the death knell" for the individual mandate, as Fox put it. According to the Journal:
[L]ast week the Administration quietly excused millions of people from the requirement to purchase health insurance or else pay a tax penalty.
This latest political reconstruction has received zero media notice, and the Health and Human Services Department didn't think the details were worth discussing in a conference call, press materials or fact sheet. Instead, the mandate suspension was buried in an unrelated rule that was meant to preserve some health plans that don't comply with ObamaCare benefit and redistribution mandates. Our sources only noticed the change this week.
That seven-page technical bulletin includes a paragraph and footnote that casually mention that a rule in a separate December 2013 bulletin would be extended for two more years, until 2016. Lo and behold, it turns out this second rule, which was supposed to last for only a year, allows Americans whose coverage was cancelled to opt out of the mandate altogether.
But what right-wing media are missing in their most recent set of attacks against the ACA is that the hardship exemption has been a part of the ACA from the law's inception, and their attacks against the law's "new," "mega-exemption" guidelines are actually based on three-month old HHS guidance that was laid out under routine rule-making authority. As Jason Linkis of Huffington Post and Brian Beutler of Salon detailed, not only is the original provision old news, so too is the new hardship category that right-wing media like the WSJ editorial board suddenly discovered even though multiple outlets covered the change in December.
The hardship exemption was written into the ACA at the law's outset, with the intention of exempting certain individuals from the shared responsibility payment -- the "individual mandate." As the law was written, exemptions and exclusions from this penalty would be granted to a range of groups in addition to those experiencing hardship and an inability to find an affordable plan, including undocumented immigrants, members of health care sharing ministries, and Native Americans. A 2010 report from the Urban Institute examining the impact of the main provisions of the Affordable Care Act noted at the time that the ACA allows "financial hardship exemptions to be granted. The requirements for these are left to the discretion of the Secretary of the Department of Health and Human Services." A Congressional Research Service report called the ACA a "particularly noteworthy example of congressional delegation of rulemaking authority to federal agencies," and "indicates that PPACA gives federal agencies substantial responsibility and authority to 'fill in the details' of the legislation through subsequent regulations."
The Pittsburgh Tribune-Review cherry-picked data surrounding the Affordable Care Act's (ACA) effect on health care premiums for small businesses, failing to explain that a small rise in prices for some will allow a more fair premium rating policy for all and could save small businesses money in the long term.
The March 11 editorial references a misleading Investor's Business Daily editorial which cites a Center for Medicare & Medicaid Services (CMS) claim that a number of small businesses will see health care premium increases as a result of the ACA by 2016:
The latest ObamaCare fabrication, exposed by the health system's own numbers cruncher, is that government-directed medical care somehow will reduce small-business premiums by 4 percent -- and by as much as 25 percent in 2016.
But the dream proffered back in 2009 by President Obama has become today's nightmare, as detailed by the actuary for the Centers for Medicare & Medicaid Services: 65 percent of small businesses offering insurance will see their rates go up.
And that will affect about 11 million workers, according to Investor's Business Daily.
Although the actuary's report doesn't say how much rates will rise, studies cited by Investor's Business Daily peg the hike between 12 percent and 20 percent. Which businesses are likely to see their rates inflate? Why, those that employ younger -- and healthier -- workers, who under ObamaCare inevitably must pay more to keep the scheme afloat.
However the CMS report cited by the Tribune-Review and Investors Business Daily provides a narrow look at how small businesses are affected by the ACA by leaving out other factors which could relate to premium prices. In addition, CMS also admits "there is a large degree of uncertainty associated with this estimate" (emphasis added):
This analysis focuses on the number of people with health insurance coverage through their employer whose premium rates are expected to increase or decrease as a result of the guaranteed issue, guaranteed renewability, and premium rating provisions of the ACA only. Other factors affecting rates such as changes in product design, provider networks, or competition are not considered. In addition, other provisions of the ACA, including the coverage expansions, the extension of dependent coverage to age 26, the individual mandate, and the employer mandate will impact the availability of coverage, the take-up of that coverage, and the premium rates charged to those who currently have employer-sponsored insurance, but those impacts are not included in this estimate. We prepared a more complete report on the financial effects of the ACA in 2010.11 As mentioned previously, the effect on large employers is expected to be negligible, therefore our evaluation examines the impact on employees of fully-insured small firms.
There is a rather large degree of uncertainty associated with this estimate. The impact could vary significantly depending on the mix of firms that decide to offer health insurance coverage. In reality, the employer's decisions to offer coverage will be based on far more factors than the three that are focused on in this report so understanding the effects of just these provisions will always be challenging.
From the March 11 edition of Fox News' The O'Reilly Factor:
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Fox News displayed a striking double standard on politicians appearing on comedy shows, questioning the appropriateness of President Obama's comedic interview, and ten minutes later praising Sen. John McCain's (R-AZ) Letterman appearance
On America's Newsroom, Fox co-hosts Bill Hemmer and Martha MacCallum questioned the appropriateness of Obama's interview with comedian Zach Galfianakis on his Funny or Die show "Between Two Ferns." Ten minutes later, the same Fox hosts lauded McCain's appearance on the Late Show with David Letterman, laughing at a joke he had made and declaring that McCain had "knocked it out of the park":
Fox News promised to stay in touch with the cancer patient at the center of one of right-wing activists' favorite Obamacare horror stories. But now that new reports show it is actually an Obamacare success story, as the woman who worried the Affordable Care Act was "unaffordable" will now save approximately $1,000 a year under the new law, will Fox make good on its promise?
Desperate to find Obamacare horror stories, right-wing media have repeatedly hyped the story of Michigan resident Julie Boonstra, who is suffering from leukemia and saw her existing insurance plan canceled after it failed to meet the ACA's new guidelines, which force insurers to provide more comprehensive coverage than in the past. Right-wing media, conservative candidates, and ads by Koch-funded special interest groups held Boonstra up as an exemplar of health care reform victims after she claimed her new plan was too expensive.
The one problem? This right-wing bubble's characterization didn't hold up under scrutiny -- as Washington Post's fact checker Glenn Kessler noted on February 20, Boonstra's monthly premiums were "cut in half" on her new plan, and eventually she would reach the law's new caps and no longer have to pay anything.
But Fox News was undeterred by the holes in the story. From February 20 - March 4, the network hosted Boonstra at least three times, painting her as under attack by the Obama administration for speaking out against the ACA.
On the March 4 edition of Fox's The Kelly File, host Martha MacCallum praised Boonstra as a "fighter" for pushing back against those questioning whether she was worse off under the ACA, encouraging her to continue her "fight on both fronts." MacCallum promised to speak with Boonstra again:
MACCALLUM: You're become, sort of, a face for other people who are also getting letters, who are also getting thrown off their plans. Do you feel a responsibility now given the stories that they share with you?
MACCALLUM: Julie, thank you. You're a fighter. Continue your fight on both fronts. And we look forward to speaking with you again.
Right-wing media are upset that President Obama sat down for an interview with comedian Zach Galifianakis on "Between Two Ferns."
Fox News contributor Laura Ingraham claimed that undocumented immigrants under the Obama administration's deferred action program would have access to health care benefits under the Affordable Care Act (ACA). In fact, DACA recipients are ineligible to apply for subsidized health insurance.
During a town hall event with Spanish-language media on March 6, President Obama allayed fears within the immigrant community that information gathered about undocumented immigrant family members while signing up for health care would not be used for deportation enforcement. In the process, he stated that only U.S. citizens and those with "legal presence" would be able to apply for subsidized health care, noting that "it's true that the undocumented are not eligible -- that's how the law was written."
On her radio show, Ingraham distorted Obama's comments, claiming that "legal presence" applied to "anyone that he decides to defer immigration action on." She added: "The DREAMers can get Obamacare."
In fact, as the New York Times reported in September 2012, undocumented immigrants with lawful presence under DACA are not eligible for subsidized health care:
The White House has ruled that young immigrants who will be allowed to stay in the United States as part of a new federal policy will not be eligible for health insurance coverage under President Obama's health care overhaul.
The decision -- disclosed last month, to little notice -- has infuriated many advocates for Hispanic Americans and immigrants. They say the restrictions are at odds with Mr. Obama's recent praise of the young immigrants.
In June, the president announced that hundreds of thousands of illegal immigrants who came to the United States as children, attended school here and met other requirements would be allowed to remain in the country without fear of deportation.
Immigrants granted such relief would ordinarily meet the definition of "lawfully present" residents, making them eligible for government subsidies to buy private insurance, a central part of the new health care law. But the administration issued a rule in late August that specifically excluded the young immigrants from the definition of "lawfully present."
At the same time, in a letter to state health officials, the administration said that young immigrants granted a reprieve from deportation "shall not be eligible" for Medicaid or the Children's Health Insurance Program. Administration officials said they viewed the immigration initiative and health coverage as separate matters.
Thanks to a 1995 California law however, about 73,000 DACA recipients who are 21 and under are reportedly eligible for the state-funded Medi-Cal program, which is completely separate from the ACA's Medicaid program.
Fox reported that a new survey found that a small number of previously uninsured people have enrolled for health coverage on the new Affordable Care Act (ACA) online exchanges, but failed to report the cause: that many people who have avoided enrolling because of cost concerns were misinformed about the costs.
On the March 7 edition of Fox News' America's Newsroom, co-host Martha MacCallum hyped new information that she said shows "big problems with Obamacare." MacCallum cited a March 6 McKinsey & Company survey to report that one in 10 previously uninsured individuals who qualify for ACA coverage have signed up through the exchanges.
This framing hides crucial elements of the survey, which highlighted misinformation about the ACA as a key reason that potential beneficiaries chose not to enroll. According to McKinsey, the "most common reason for not enrolling cited by both previously insured and previously uninsured respondents continues to be perceived affordability challenges, "and for most of those respondents, that perception was based on insufficient information. From McKinsey:
Over 80 percent of the respondents who cited affordability as the reason for not enrolling are eligible for subsidies; 66 percent of these consumers were not aware of their subsidy eligibility status or subsidy amount.
Furthermore, the survey showed a positive trend in enrollment numbers, which have "continued to increase, particularly among the previously uninsured."
It's not surprising that Fox hid Mckinsey's findings about the negative impact that misinformation can have on Americans' willingness to enroll in ACA coverage, since the network has consistently worked to stoke fears about the costs of ACA coverage. Meanwhile, this is not the first time the network has shamelessly twisted or cherry-picked a McKinsey survey to baselessly smear Democratic policies.
Speaking at the 2014 Conservative Political Action Conference, conservative columnist Ken Blackwell, who also holds leadership positions at the National Rifle Association (NRA) and Family Research Council (FRC), used health care reform to compare the Obama administration to a "totalitarian" or "authoritarian" regime and conspiratorially claimed that Obamacare was designed to "destroy the family" and "silence the church."
Blackwell, Ohio's former Secretary of State, sits on the NRA's public affairs committee and has served on the organization's board of directors. He is also the Senior Fellow for Family Empowerment at FRC, an organization designated by the Southern Poverty Law Center as an anti-gay hate group.
When asked about the "unintended consequences" of Obamacare during a panel discussion titled "Healthcare After Obamacare: A Practical Guide for Living When No One Has Insurance and America Runs Out of Doctors," Blackwell spoke of a "deliberate strategy by the Obama administration to fundamentally take over that section of our economy" before comparing the current administration to an oppressive regime:
From CPAC 2014:
BLACKWELL: It is really hard for me to talk about unintended consequences around Obamacare because I actually think the consequences that we are experiencing are part of a deliberate strategy by the Obama administration to fundamentally take over that section of our economy.
BLACKWELL: Probably from their stand point, they've assumed -- they have assumed that the American people are asleep at the switch and what CPAC and organizations that are affiliated with this forum know that American people are wide awake and we are brighter than the administration gives us credit for. Look, if you go back over the whole span of human history and you look at authoritarian regimes, totalitarian regimes, or big welfare states had to do a couple of things, they've had to destroy the family and they've had to silence the church.
Conservative radio host Mark Levin is receiving the "inaugural" Andrew Breitbart Defender of the First Amendment Award at noon today at the Conservative Political Action Conference, the annual conference for right-wing activists.
The award, named after the conservative media entrepreneur who passed away in 2012, will be presented by top executives at Breitbart News, the website he founded, and by Citizens United President David Bossie.
Levin has a long history of pushing conservative lies and hateful rhetoric, including recently comparing marriage equality to incest, polygamy, and drug use, comparing supporters of the new health care law to Nazi "brown shirts," claiming "middle class" is a "Marxist term," supporting racial profiling, and likening immigration reform to the "destruction" and "unraveling" of society.
According to Breitbart News, Levin is winning the award because he "fearlessly and passionately stands up for conservatives and everyday Americans whose voices the mainstream press often tries to marginalize or silence."
Fox News launched a new false attack on the Affordable Care Act's risk corridor provision, suggesting that the program which shuffles money between private insurance companies would cost taxpayers $5.5 billion.
On the March 5 edition of Fox's America's News HQ, co-host Greg Jarrett and Fox Business host David Asman promoted the GOP claim that the ACA's risk corridor provision is a "taxpayer funded bailout" for insurance companies, suggesting that an estimated $5.5 billion in payments over the next year contradicted President Obama's promise that there would be no more bailouts and that the ACA would not add to the deficit. Asman further claimed the administration is "calling it a temporary pool of money. Now maybe if you believe that Obamacare wasn't going to cost a dime, you'll buy that explanation. But most of the time when the government sends money in to that degree, into these companies, it doesn't get the money back":
The distortion that risk corridors are an insurance company bailout is a frequent theme on Fox, but this latest narrative is especially misleading. What the Fox hosts failed to acknowledge is that the estimated $5.5 billion payment doesn't come from taxpayers, but from the insurance companies themselves. The risk corridor provision transfers money from insurance companies with healthier risk pools to companies with less healthy risk pools with higher than anticipated costs.
While the federal government may be required to subsidize some of the payment in extreme circumstances, White House officials expect that the entire risk corridor cost over the next year will be borne by the insurance companies themselves. As Bloomberg reported:
From the March 4 edition of Fox News' The O'Reilly Factor:
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The Miami Herald's coverage of the Florida Medicaid debate was significantly more comprehensive than the other four top circulating Florida newspapers, including multiple mentions of the benefits of expansion and the negative impacts the lack of expansion would have on the state and Floridians. However, similar to other top Florida papers, the Herald also largely missed out on discussing the coverage gap, which if not closed could leave hundreds of thousands of Floridians without affordable health coverage.
The Medicaid expansion in Florida, which is part of the Affordable Care Act, would extend the low income health care program to 763,890 people and create an estimated 70,000 new jobs, but the state's failure to expand Medicaid will have major negative economic and health related impacts on the state.
According to a Media Matters analysis of Medicaid expansion mentions from January 1, 2014 through March 4, 2014, the Herald discussed key benefits of expansion or the negative effects associated with not expanding Medicaid 11 times, including 5 mentions of the impact lack of expansion would have on Florida health systems. The next closest paper, the Tampa Bay Times, only had 4 mentions of the benefits of expanding or the negative effects of the failure to expand (click to expand):
This updated analysis mimics the findings of a previous Media Matters analysis of the top four highest circulating papers' coverage of Medicaid issues.
While no single article in the Herald covers all of the topics, the paper offers the most comprehensive analysis of the pros and cons of Medicaid expansion. The paper's focus on these key issues is important as Miami-Dade County has one of the highest uninsured rates in the country at nearly 40 percent of the population.
A January 3 article from The Herald's provides a clear example of what the paper did correctly in reporting the Medicaid debate. Instead of publishing a "he said/she said" back and forth between Florida's politicians or just mentioning the expansion with little context, the article discussed the cost sharing ratio of Medicaid expansion and also provided informative quotes that detailed a baseline number of potential eligible enrollees under expansion:
Though the federal government has promised to pay 100 percent of the cost [of the Medicaid expansion] for the first three years and 90 percent thereafter -- about $50 billion over 10 years -- Florida has not expanded Medicaid eligibility to include those persons and families earning up to 133 percent of the federal poverty level, which was about $15,300 a year for an individual and $31,300 a year for a family of four in 2013.
[Democratic] Rep. [Lori] Berman vowed that her party would make Medicaid expansion a Florida legislative priority in 2014.
She said the effort will include reminders to voters of the stakes involved and the House's Republican leaders responsible for refusing to hear a Senate plan that would have expanded Medicaid eligibility in 2013.
"We need to make sure the people of Florida understand,'' she said, "you've got somewhere in the neighborhood of 840,000 to 1 million people who would be covered'' if Medicaid eligibility were expanded.
Also present in the Herald's reporting is information and analysis on Medicaid expansion's impact on doctors and health systems in the state, which could see funding cuts due to the Florida's reluctance to expand the program.