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Media Need To Stop Falling For The Trump Soundbite Trap
News outlets rushed to report on President Donald Trump’s executive order on the Affordable Care Act (ACA) without knowing what exactly it entailed, resulting in botched headlines that uncritically repeated the false claims made by the Trump Administration.
Late on Friday night, Press Secretary Sean Spicer announced that Trump had signed his first executive order on the ACA claiming that it would “ease the burden of Obamacare as we transition from repeal and replace.” Even before the official text of the executive order was released, reporters rushed to file stories with wildly inaccurate headlines such as Politico’s “Trump signs sweeping order that could gut Obamacare” and The Washington Post’s “Trump signs executive order that could effectively gut Affordable Care Act’s individual mandate.” Others just uncritically repeated Spicer’s framing, like NPR’s headline “Trump Signs Executive Order To 'Ease The Burdens Of Obamacare'.”
In contrast to headlines suggesting an immediate, dramatic change to the ACA, the text of the executive order reveals that it amounts to a symbolic gesture indicating the dedication of the Trump Administration to dismantling the health care law -- a commitment already known, and one that Trump’s appointees could act on even without the order. These inaccurate headlines are the newest episode in a repeated pattern of news organizations failing to report the truth when covering Trump’s false and self-serving talking points.In the health care context, this pattern is particularly problematic given the massive impact of repealing the law and the degree to which Americans are uninformed about health care.
These headlines falsely inflated the actual impact of the executive order even as the substance of many of these articles emphasized that the vague wording of the action cast doubt on its actual effects. For example, that same NPR article noted “it's not clear what kind of relief the executive order envisions.” The flawed Politico article emphasized “the order changes nothing immediately and doesn't spell out exactly what Trump would like his government to do,” an important piece of information that was left out of the article's headline.
Numerous health care policy experts called out the news outlets for their flawed analyses, and underscored that this executive order caused no immediate policy changes and instead reflected “recycled campaign talking points” that amounted to a symbolic gesture until further action is taken. For example, Larry Levitt, vice president at the Kaiser Family Foundation, said “this order doesn’t in and of itself do anything tangible” but it sends “a signal that the Trump Administration is not waiting for Congress” on dismantling the ACA. Tim Jost, health law expert and law professor at Washington and Lee College, emphasized that law “doesn’t allow [Trump] to repeal the Affordable Care Act unilaterally” and noted that no action was likely “until the heads of HHS, Treasury, and probably Labor, as well as the CMS Administration and IRS Commissioner are in place.” Five Thirty Eight’s Anna Maria Barry-Jester explained that the executive action “does very little because it doesn’t grant the administration any powers that it didn’t already have” but that it did telegraph “that change is coming.”
The flawed coverage of Trump’s first executive order is the latest in a trend of inadequate headlines in the coverage of the Republican Party’s moves on the ACA. During an interview with The Washington Post, Trump promised his ACA replacement will guarantee “insurance for everyone,” prompting a spate of headlines that uncritically repeated his vow, despite the fact that he has released no policy details, and all existing GOP replacement ideas would result in millions losing coverage. Similarly, when Trump’s nominee for the Secretary of Health and Human Services, Tom Price, declared that “nobody is interested in pulling the rug out from under anybody,” news outlets made the headline his “vow” to not take away health care coverage, when in reality, Price’s own health care policy proposals would gut coverage and seriously degrade the health care system.
News organizations repeatedly publishing flawed headlines are doing a disservice to their audiences, even if underlying reporting in their articles may accurately contextualize the headlining statements. As The Washington Post reported, “roughly six in 10 people acknowledge that they have done nothing more than read news headlines in the past week,” and “that number is almost certainly higher than that, since plenty of people won't want to admit to just being headline-gazers but, in fact, are.”
The gravity of repealing the ACA and the relative lack of public comprehension of health care policy highlights the need for news outlets to do a better job in crafting their ACA headlines. The repeal of the ACA will result in millions losing health care, allow the return of medical underwriting which discriminates against women for being women and against individuals with pre-existing conditions, and will disproportionately impact the marginalized and vulnerable. ACA repeal affects all Americans, regardless of whether or not they get their insurance through the exchanges.
Additionally, Americans remain confused about what the ACA actually does, as polls show high approval ratings for many individual parts of the ACA while largely disapproving of the law as a whole. A recent NPR poll showed that while most people knew the ACA covered individuals with pre-existing conditions, more than half of the respondents “didn't know that the ACA reduced the number of people who are uninsured to a record low” -- one of the biggest accomplishments of the law. The combination of the enormous impact of repeal combined with the confusion that pervades the health law means that news outlets must be more diligent in crafting headlines for ACA stories, since often that headline will be the only thing the general public reads.
Other Publications Uncritically Ran With The American Action Network’s False Claims
Unlike other media outlets that uncritically parroted the conservative American Action Network’s false claims about Latino coverage under the Affordable Care Act (ACA), NBC News Latino showed evidence disproving the political group’s false statement that “the number of uninsured Hispanics has grown” under the ACA. This statement was based on the group’s misinterpretation of a report that actually found that more Hispanics have gained health insurance under the ACA.
In an effort to boost the Republican effort to repeal the ACA, the American Action Network -- a conservative political group affiliated with the Congressional Leadership Fund super PAC -- announced that in addition to English-language television ads, it would also be launching Spanish-language television ads to garner opposition to the ACA among Hispanics. In the press release, AAN executive director Corry Bliss falsely asserted that “Obamacare supporters claimed this law helps Hispanics, yet the number of uninsured Hispanics has grown.” In reality, the ACA has expanded minority access to free preventive care, improved the overall quality of care in minority communities, and reduced the number of uninsured persons of color.
The Washington Post repeated Bliss’ claim uncritically, noting that “AAN cited a study last year by the nonpartisan Commonwealth Fund … that found that the share of Latinos without health-care coverage grew from 29 percent in 2013 to 40 percent in 2016, higher than other racial or ethnic groups.” The Hill also echoed AAN’s misinterpretation of the Commonwealth Fund report.
On the other hand, NBC Latino accurately interpreted the report and corrected AAN’s misleading statement by explaining that “American Action Network's press release points to an NBC Latino story that cites a Commonwealth Fund report that found that the share, though not the number, of uninsured Hispanics grew.” That means that even though Hispanics make up a larger share of the uninsured, the number of Hispanics who gained health insurance under the ACA grew, albeit slower than other groups. The article pointed out that Republican states that “opted to not expand Medicaid under Obamacare” have large Latino populations, which, among other reasons, explained why Latinos’ uninsured rate decreased more slowly than other groups’ rates. From the January 18 NBC News Latino report:
In a news release, Bliss asserted that "the number of uninsured Hispanics has grown."
In fact, the number of Hispanics without health care has dropped, meaning the percentage of Hispanics without insurance has gone down.
American Action Network's press release points to a an NBC Latino story that cites a Commonwealth Fund report that found that the share, though not the number, of uninsured Hispanics grew. Latinos are 40 percent of all uninsured, including whites and blacks, a share that grew from 29 percent in part because Hispanics gained coverage at a slower rate than whites.
The report cites several reasons why Latinos are a growing share of the uninsured, among them:
- Many uninsured Latinos live in states such as Texas and Florida that opted to not expand Medicaid under Obamacare.
-- There is a disproportionate share of Latinos who are poorer or lower income but not eligible for Medicaid either because their state didn't expand the program or they are not aware of eligibility.
-- There are Latinos who are legal residents and their state restricts access of legal immigrants who have not had legal residency for at least five years, as the Affordable Care Act allows. (The uninsured rate among U.S. born Latinos is about 12 percent but for foreign born Latinos, it is 39 percent.)
-- Many Latinos are immigrants who don't have legal status and therefore are not eligible for Obamacare. Immigrants who benefit from the Deferred Action for Childhood Arrivals, DACA, program also are not eligible for Obamacare. (Attempts to extend Obamacare to immigrants without legal status drew heavy Republican opposition while the law was being debated.)
-- There are Latinos who qualify for coverage under Obamacare but won't sign up out of fear that their family members who lack legal status may be found out by the government and detained and deported. The fear of turning over information to the government has increased with the election of Donald Trump.
These are factors that would have to be addressed in order to make a dent in the number of Hispanics who are uninsured.
Register’s Editorial Board Showed Local Papers What Questions To Ask When Anti-Choice Lawmakers Threaten Access To Essential Care
As conservatives on Capitol Hill threaten to defund Planned Parenthood under dubious pretenses, Iowa’s Des Moines Register is modeling how state papers should handle efforts by local anti-choice lawmakers to do the same.
The Register’s editorial board called on Gov. Terry Branstad (R-IA) to “sit down and write the names of the entities that can provide comprehensive family planning services in Iowa” before following through on his budget plan to eliminate state funding for Planned Parenthood. The paper quoted Branstad saying that his plan “redirects family planning money to organizations that focus on providing health care for women and eliminates taxpayer funding for organizations that perform abortions.”
Branstad’s plan comes from a familiar anti-choice playbook. To justify defunding Planned Parenthood, right-wing media and anti-choice politicians in a number of states have wrongly claimed that the organization uses taxpayer money to subsidize abortion services. Although in reality, the government reimburses Planned Parenthood only for non-abortion services, and that money is provided via Medicaid, lawmakers use this incorrect allegation to demand that funds be shifted to so-called “community health clinics” (CHC). Lawmakers believe these CHCs could absorb patient demand should access to Planned Parenthood be eliminated -- a claim experts call “a gross misrepresentation of what even the best community health centers in the country would be able to do.”
By demanding specifics from conservatives who claim that there are numerous “alternatives” to Planned Parenthood, the Register modeled the kind of reporting local outlets should be doing about threats to defund essential health care in their communities.
Planned Parenthood is an essential care provider for millions of Americans nationally, 60 percent of them low-income patients covered through Medicaid. In Iowa, this process is facilitated through the Iowa Family Planning Network (IFPN) waiver program, which gives patients the option to receive “a form of limited insurance coverage” through Medicaid that covers “basic family planning services.”
As the Register noted, Branstad “must know that many of the more than 30,000 Iowans obtaining services made possible by the waiver receive them from Planned Parenthood,” which means that if he “rejects this particular organization, he should specify exactly who has the statewide ability to take its place.”
There’s ample reason to believe that this task will prove impossible for the long-serving anti-choice governor. As the Register reported, providers have already warned state officials that there “are not enough providers in Iowa to absorb the patients Planned Parenthood of the Heartland currently serves.”
Rather than taking Branstad or other anti-choice lawmakers at their word about the viability of so-called alternatives, the Register performed a critical journalistic function and demanded to know what these facilities were, and whether they have the capacity to meet the medical needs of low-income patients across the state.
Beyond asking Branstad to name specific alternatives to Planned Parenthood, the Register also asked that the list exclude clinics that are “no longer in business” and include only facilities that “actually provide family planning services.”
This may seem like an odd stipulation, but the Register’s specific question about alternative providers’ actual services is exactly the kind of scrutiny local outlets should apply when lawmakers threaten to radically alter the infrastructure of essential health care systems.
Across the country, anti-choice lawmakers have conflated the total number of CHCs with the much smaller number of those facilities that are actually equipped to provide primary care and family planning services. As the Register explained:
Florida lawmakers learned that lesson the hard way. After passing an anti-Planned Parenthood bill last year, they sought to demonstrate there were numerous, alternative providers. Their list became a national joke because it included the names of elementary and middle schools, dental practices and at least one eye clinic.
While Planned Parenthood clinics all offer preventive and basic care services, CHCs can qualify for that classification while providing more limited care -- making direct comparisons between the overall numbers a misleading measure of actual health care provision capacity.
By demanding specific answers about threats to defund Planned Parenthood, The Des Moines Register’s editorial board provided a model for local outlets to critically interrogate claims by lawmakers about so-called alternatives -- questions that are essential when access to health care is on the line.
Trump And Right-Wing Media Are Demanding Greater State Control Over Abortion -- Even If It Causes Harm
Forty-four years ago, Roe v. Wade determined that the constitutionally protected right to privacy ensures an individual’s ability to make personal, medical decisions without interference from politicians -- including the decision to have an abortion.
But now, President-elect Donald Trump and anti-choice politicians who have made careers from promoting scientifically dubious and medically harmful anti-abortion laws want to eliminate Roe’s protections.
During the 2016 presidential campaign, Trump promised to appoint “pro-life justices” who would “automatically” overturn Roe. After the election, Trump told CBS’ Lesley Stahl that he would prefer control over abortion “go back to the states” even it it meant that women would “perhaps have to go … to another state” to obtain necessary reproductive health care.
This may sound like hyperbolic campaign rhetoric, but the threat is very real -- and it’s impossible to overstate how dangerous losing federally protected abortion rights would be.
Right-wing media have consistently argued that greater state control over abortion clinics and providers is necessary to “protect women’s health.” The Supreme Court rejected this allegation in Whole Woman’s Health v. Hellerstedt, which rebuked states for attempting to baselessly regulate abortion clinics under the guise of improving public health and safety.
Legal abortion is one of the safest and most common medical procedures. According to the American College of Obstetricians and Gynecologists, “Where abortion is legal, it is extremely safe. … In contrast, historical and contemporary data show that where abortion is illegal or highly restricted, women resort to unsafe means to end an unwanted pregnancy.”
In contrast, life before Roe v. Wade -- without federally protected abortion rights -- was dangerous and difficult. Women traveled to neighboring states or even other countries to receive an abortion, often alone, in secrecy, with just enough money pooled together from friends or roommates. Some even saw their friends die from what can and should be a safe and simple procedure.
Trump and anti-choice lawmakers seem to think a return to this grim reality would constitute “protecting women.”
Even without attacks on Roe, accessing reproductive health care is already difficult -- especially for marginalized communities. Between rules like the Hyde Amendment, which prohibits federal funding for abortion, and the targeted restriction of clinics meant to increase logistical barriers to abortion access, essential reproductive care is already tenuously out of reach for many.
Conservatives are already putting people’s lives at risk with medically unnecessary laws that restrict abortion access. If they succeed in eliminating the federal and constitutional protections guaranteed by Roe v. Wade, people will get hurt.
Anyone trying to spin that as “protecting women’s health” is lying to you.
During CNN’s town hall with Speaker of the House Paul Ryan (R-WI), Jake Tapper showed the value of fact-checking conservative misinformation on health care policy -- even in a conversational setting -- by providing strong pushback about funding for Planned Parenthood. But there were several other moments during the event when Ryan pushed false information about the Affordable Care Act (ACA) that Tapper could have fact-checked. Going forward, more media outlets should adopt an aggressive approach to addressing conservative misinformation on health care policy, given the severe consequences of ACA repeal.
During the town hall discussion of the fight over the ACA, the final question on health care came from an audience member asking where the millions of women who use Planned Parenthood to access women’s health care services will go if the Republican Congress defunds the network. When Ryan falsely tried to claim that providing federal funds to Planned Parenthood “commit[s] people’s taxpayer dollars to fund” abortion, Tapper correctly noted that the Hyde Amendment bans taxpayer money from funding abortions.
Tapper also noted the hypocrisy in Ryan’s earlier statements emphasizing the necessity of choice in health care policies, asking, “You believe in providing more choice for people when it comes to health insurance, except for Planned Parenthood?”
But there were also many other opportunities for Tapper to fact-check Ryan as he used the town hall to reiterate stock talking points and push false narratives about the ACA. When asked whether “the government should guarantee health care” for Americans, Ryan falsely claimed that the ACA is failing and that premium spikes were proof that “the law is collapsing.” In reality, during the most recent open enrollment period, more people signed up on the ACA insurance marketplaces than during the previous year, contradicting the conservative claim that people are fleeing the market. Ryan’s claims about premium hikes omit the crucial context that subsidies rise in proportion to premium hikes, mitigating the impact for the majority of enrollees. While the ACA clearly has problems, claims that the law is “collapsing” or in a “death spiral” are clearly false and should be rebutted as such.
When an audience member who survived cancer asked Ryan how the GOP’s plans would impact individuals with pre-existing conditions, Ryan claimed that “state high-risk pools are a smarter way of guaranteeing coverage for people with pre-existing conditions.” While high-risk pools sound like a good idea in theory, they have a long history of problems, as they are typically chronically underfunded, are prohibitively expensive for customers, and provide inadequate coverage. Similarly, Ryan’s claims about the benefits of refundable tax credits and health savings accounts should prompt substantive follow-up questions, as legitimate critiques raise questions about their effectiveness in reducing costs and maintaining coverage.
While Tapper illustrated the value of fact-checking conservative misinformation during the discussion on Planned Parenthood, he ought to have also provided substantive follow-up questions and pushback on some of Ryan’s policy claims. Going forward, media outlets should use any interview, in any format, to hold conservative politicians’ feet to the fire on the issue of the ACA -- to prevent the further spread of false narratives and to investigate the efficacy of proposed GOP policies. The lack of consensus on what a replacement plan might look like, combined with the massive impact repeal will have on the millions who have obtained insurance through the Affordable Care Act, makes it especially vital for the media to ask substantive questions about conservative claims on health care policy.
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Republicans are pushing forward with a repeal of the Affordable Care Act (ACA), and Florida is one of the states that stands to lose the most if health care reform is rolled back. Yet over the past two months, the top Florida newspapers -- the Miami Herald, the Sun Sentinel, the Tampa Bay Times, and the Orlando Sentinel -- have largely failed to convey the impact of repeal on many of the state’s vulnerable residents. While there were coverage flaws across the board, the Miami Herald outshone the other major newspapers.
President-elect Donald Trump dodged a question during his January 11 press conference about how he plans to repeal and replace the Affordable Care Act (ACA) and whether or not the replacement plan would insure as many people, but he did indicate the attack on health care reform will be led by his nominee to run the Department of Health and Human Services (HHS), Rep. Tom Price (R-GA). In light of Trump’s delegation to Price, the media must do a better job of scrutinizing the devastating consequences of Price’s proposals than they have in the past
A Media Matters study of pre-election coverage found that prime-time cable and broadcast news failed to ask substantive questions about what Trump’s replacement for the ACA would look like. This cannot be the standard going forward.
On January 11, Trump held his first press conference in nearly six months and took questions on a variety of issues. A reporter asked Trump a two-part question about the future of Obamacare, first, asking for specifics on the timeline for the repeal and replacement of the ACA, and second, questioning whether or not Trump’s replacement would “guarantee coverage” for those who gained insurance under health care reform. During his three-minute answer, Trump provided no specifics on what policies the replacement package might include and dodged the question of whether or not it would maintain current levels of insurance coverage, instead insisting:
DONALD TRUMP: We're going to be submitting as soon as our secretary is approved, almost simultaneously, shortly thereafter, a plan. It‘ll be repeal and replace. It will be essentially simultaneously.
Trump’s answer, while not containing any policy specifics, did reveal two key things about the upcoming ACA fight.
First, Trump’s reluctance to answer whether or not his replacement will cover as many individuals as the ACA does is a trend, not an anomaly. As Vox senior editor Sarah Kliff and other reporters have noted, Republicans continue to dodge and obfuscate when pressed for details on how their ACA replacement will maintain the coverage expansions achieved since 2010. According to a December 15 article in The New York Times, a Republican congressional aide promised that the GOP plans would guarantee “universal access” of health care and coverage but provided no details about how this would improve on existing law.
Second, Trump’s claim that his administration would submit a plan “as soon as [his] secretary is approved,” seems to indicate that his replacement package would closely resemble the legislation authored by his HHS nominee, Tom Price. Price’s bill, the “Empowering Patients First Act,” is the most developed health care replacement of all the Republican plans. (After dozens of symbolic votes to repeal the ACA and six years of campaigning against the law, Price is the only congressional Republican to actually put a replacement plan together in legislative language.)
Price’s plan would gut access to health insurance in the U.S. and eliminate the essential health benefits package -- allowing insurers to determine whether or not things like maternity care should be covered. This dismantling of health care reform would benefit younger, healthier individuals while sending costs skyrocketing for older or sicker individuals. The plan would reinstate high-risk pools, endangering health care access for individuals with pre-existing conditions an ACA provision conservatives claim to want to preserve. Price’s bill would also rescind the ACA’s Medicaid expansion entirely and convert the program to a block grant, blocking access to care for many low-income communities. Additionally, as the HHS secretary, Price could unilaterally reverse the contraception mandate, a benefit he has dismissed because he claims he has yet to meet “one woman” who had trouble accessing birth control before the ACA. If enacted, Price’s “Empowering Patients First Act” would roll back the gains the Affordable Care Act has achieved, leaving millions more Americans uninsured -- as would most of the variants of “Trumpcare.”
Given that the incoming president suggested during his press conference that he will leave stewardship of repealing and replacing the ACA to his HHS secretary, journalists need to actively scrutinize Price’s record and his proposals for the future of American health care.
During the January 11 press conference, reporters asked just one question about the ACA, with zero attempts at a follow up, despite the fact that Trump functionally avoided the original question. The initial reporting on Price’s nomination whitewashed his history of opposition to reproductive health care, and largely failed to contextualize the potential impact of his proposed policies on the American health care system. Since Trump hinted at the major role Price might play in the upcoming ACA fight, it is incumbent on reporters to step up beyond their pre-election coverage and take the current job of vetting Price seriously, making clear the disastrous effects his proposals could have on the American health care system.
Republicans are pushing forward with a repeal of the Affordable Care Act (ACA), with Speaker of the House Paul Ryan (R-WI) leading the charge. The top Wisconsin newspapers have largely failed to convey the impact of repeal on Wisconsin residents on a variety of crucial metrics, with little to no mention of the impact on women and minority communities and insufficient contextualization of the potentially devastating changes to Medicare and Medicaid.
Joy Reid Models Four Must-Do’s When Reporting On Reproductive Rights Topics During The Trump Administration
During the January 8 edition of MSNBC’s AM Joy, host Joy Reid put on a master class in how to cover anti-choice lawmakers’ latest attempts to defund Planned Parenthood.
The Sunday after House Speaker Paul Ryan announced that Republicans would prioritize defunding the essential health care provider, Reid demonstrated four best practices for reporting on reproductive rights topics: hosting diverse guests, discussing the material consequences of policy decisions, including personal testimony in reports, and emphasizing the disparate impact of anti-choice laws on marginalized communities.
Planned Parenthood is an essential health care provider for millions of Americans -- many of them low-income patients reliant on Medicaid to access primary care. To justify defunding Planned Parenthood, right-wing media and anti-choice politicians have falsely claimed that the organization’s primary goal is to coerce women into having abortions using taxpayer money.
In reality, this could not be further from the truth. Due to the Hyde Amendment, the federal government is already barred from funding abortion services. Instead, the government reimburses Planned Parenthood for non-abortion services provided to low-income patients via Medicaid -- just like any other health care provider. Although right-wing media argue that so-called “community health clinics” (CHCs) could absorb this patient demand should Planned Parenthood clinics close, experts agree that CHCs lack the capacity, experience, and resources to replace Planned Parenthood.
In its coverage of the defunding effort, AM Joy set the standard for reporting the consequences of congressional Republicans’ politically motivated attack on health care access -- and other outlets should take note.
During the January 8 segment, Reid hosted two women to discuss the impacts of defunding Planned Parenthood: the organization's president, Cecile Richards, and the executive director of the National Latina Institute for Reproductive Health (NLIRH), Jessica González-Rojas.
In a previous study of prime-time cable news coverage of reproductive rights topics, Media Matters found that networks relied heavily on male panelists to discuss the consequences of policy decisions about abortion and reproductive rights issues. This problem of representation is also more generally borne out across the Sunday political talk shows, which have overwhelmingly relied on guests who are white, conservative, and male.
Hosting diverse guests is essential to providing in-depth, quality coverage of many topics. Non-white and non-male perspectives in newsrooms are often rare, a trend that should incite concern not only about equality but also about coverage accuracy.
AM Joy also focused on the material impacts of defunding Planned Parenthood -- not just the political spectacle of the legislative fight.
At the start of the segment, Reid immediately debunked the pervasive conservative arguments about the consequences of defunding Planned Parenthood:
JOY REID: Let’s be clear about this so-called defunding legislation -- what it would really do. It would prohibit Medicaid recipients from obtaining any kind of services from Planned Parenthood. We're not talking about abortion services because federal law already prohibits those being paid for with federal dollars. We're talking no cancer screenings, no contraception, no STD testing, no medical services as all. The defunding will be packaged with the repeal of the Affordable Care Act, aka Obamacare, which is currently providing health insurance to 22 million people and counting.
Richards and González-Rojas each provided examples of the consequences that defunding Planned Parenthood would have for a number of patients across the country. As Richards explained, “Any senator who votes [to defund] is hurting women in their own home state” because they are “essentially saying to low-income women, 'You can't go to Planned Parenthood for your cancer screenings and birth control.’”
González-Rojas agreed, adding that when Indiana denied Planned Parenthood state Medicaid reimbursements, “we saw an STI outbreak,” and when Texas blocked the reimbursements, “we saw the rates of unintended pregnancy and birth increasing. We heard stories of women splitting birth control pills to make it last longer.”
Throughout the January 8 segment, Reid emphasized personal testimony from herself, Richards, and González-Rojas about relying on Planned Parenthood for essential health care.
Reid noted that Planned Parenthood was “the place where, when I graduated from college and had no money and was broke and had a low-paying job, [I] got all my health care.” Richards echoed the sentiment, explaining that “one in five women in this country go to Planned Parenthood for health care in their lifetime, including me, including you.”
AM Joy also provided a platform to discuss the disparate impact of anti-choice laws, which have a greater impact on marginalized communities than on other groups.
As González-Rojas explained:
JESSICA GONZÁLEZ-ROJAS: I think a good example comes from Texas when we saw the defunding of a lot of the family planning services in Texas. We saw a health crisis happen. We saw health disparities happen. Things like cervical cancer, which is largely preventable, Latinas had huge rates of cervical cancer and that's something that they shouldn't have happen in their life. If they have access to regular screenings, paps, mammograms -- all the services that Planned Parenthood provides -- those types of things would be prevented. So this is a disproportionate impact on communities of color, on immigrant communities, on low-income women and families, young people, so a fight against Planned Parenthood is a fight against our communities.
Because the economics of accessing necessary health care are already so precarious for many communities, networks and outlets should emphasize the disproportionate impact anti-choice laws have on these groups whenever possible.
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The press failed to accurately convey the implications of a potential repeal of the Affordable Care Act (ACA) in the lead-up to the election. Now that Donald Trump is the president-elect, media must improve their health care coverage by contextualizing their stories about a potential ACA repeal and explaining the impact it would have on millions of Americans and the health care system as a whole.
A recent Media Matters study found that in the weeks leading up to the election, television journalists overwhelmingly failed to ask any substantive questions about Trump’s health care policies or the consequences of repealing the ACA. In the two weeks before Election Day, there were only four instances of broadcast or cable news hosts or reporters bringing up a substantive question about Trump’s supposed Obamacare replacement amid 77 segments ostensibly focused on health care. This was not the first time media failed to inform the public about the Republican Party’s extremist health care policy agenda. Another Media Matters study found that evening news shows virtually ignored Speaker of the House Paul Ryan’s resurrection of his Medicare privatization scheme, a proposal that could have dangerous consequences for a program relied on by more than 55 million Americans.
During the campaign, media outlets also lauded Trump for giving a so-called “policy” speech on health care, ignoring that the actual speech contained little to no policy specifics. This lack of attention to detail reflects a broader theme in election coverage, as studies found media overwhelmingly avoided substantive discussion of policy, focusing instead on “scandals” plaguing the Republican and Democratic nominees.
While cable and broadcast news tended to avoid robust discussions of the impact of health care policy, right-wing media filled the void with rampant misinformation. Since the ACA passed in 2010, conservative news outlets have consistently attacked the health law with complete fictions, claiming it will explode the budget, create death panels, bankrupt Medicare, end in a “death spiral,” and facilitate a government takeover of the health care system.
Today, media outlets regularly provide Trump surrogates with free airtime to push misinformation and avoid substantive discussion. In a series of January 3 interviews, Trump senior adviser Kellyanne Conway was given a free pass on health care policy by ABC’s Good Morning America, which neglected to even bring up the looming repeal of Obamacare. NBC’s Today and CNBC’s Squawk Box failed to push Conway with follow-up questions about how exactly the incoming administration plans to maintain popular health care reforms while repealing the law that created them. On MSNBC’s Morning Joe, Conway was allowed to push vague proposals for creating health savings accounts and allowing insurers to sell across state lines (both proposals have been highly criticized). When asked if the replacement plan is “ready to go,” Conway deflected by suggesting that planning could not start until Trump’s nominee for secretary of health and human services, Tom Price, is confirmed. The Morning Joe hosts failed to raise questions about the potential impact of the policies she promoted and allowed her to deflect from questions about the replacement plan to the irrelevant question of cabinet nominations.
Trump and congressional Republicans pledged to make repeal of the ACA one of their top priorities, which means the press must immediately rethink its strategy when covering health care policy and focus on specifics. Media outlets must contextualize the impact of repealing Obamacare in terms of the gains that have already been achieved and how those improvements will be affected or reversed by Republican policies. Health care policy is inherently complex and confusing -- it’s the media’s job to break down the complexity and explain how repealing Obamacare will impact the lives of every American.
The implementation of the ACA resulted in a record low number of uninsured Americans -- 8.6 percent in September 2016, down from 16 percent in 2010. According to estimates from the Department of Health and Human Services, more than 20 million Americans have gained health care coverage as a result of the law.
The ACA’s expansion of Medicaid extended health care coverage to more than 14 million low-income Americans. Studies of the expansion showed that it helped to combat income- and race-based coverage disparities in the insurance market, improved access to coverage for people with disabilities, and significantly improved state budgets in states that accepted federal funds for the expansion.
The implementation of the ACA significantly improved the condition of women’s health care coverage in the U.S. The ACA’s preventive services provision greatly improved access to birth control by eliminating copays -- expanding coverage to millions of women and dramatically reducing out-of-pocket costs. The ACA banned sex discrimination in health care, and put a stop to the widespread practice of “gender rating” in which health insurance companies charged women higher rates for comparable plans made available to men. The law also improved access to maternity care by classifying it as an essential service.
Repeal of the ACA would permit the return of discriminatory practices like gender rating, reducing overall access to health care and significantly increasing out-of-pocket health care costs for women.
The ACA helped the fight in achieving LGBTQ equality by dramatically improving access to health care for LGBTQ patients often targeted by discriminatory practices (like dropping individuals with pre-existing conditions), prohibiting sex discrimination, and guaranteeing protections to married same-sex couples regardless of the state in which they reside. Studies have shown that the ACA has reduced the number of uninsured LGBTQ people and decreased health disparities in the LGBTQ community. The law provided marketplace insurance subsidies to nearly 732,000 individuals, and its expansion of Medicaid was particularly beneficial to LGBTQ youth, who are disproportionately likely to experience poverty and homelessness.
Repeal of the ACA would allow insurance companies to discriminate on the basis of gender, strip coverage for transgender people and transition-related care, and increase the number of uninsured people by repealing the marketplace subsidies and Medicaid expansion.
The ACA has extended the solvency of Medicare by over 10 years, despite false claims to the contrary from right-wing opponents of the program. Discussions of Medicare’s budget outlook typically refer to Medicare’s Hospital Insurance program -- which covers hospital visits, nursing care, and other medical costs. Studies have shown that the ACA has extended the full budgetary solvency of the Hospital Insurance program through 2028, after which “payroll taxes and other revenue will still cover 87 percent of Medicare hospital insurance costs.” In addition to enhancing Medicare’s budget outlook, the ACA improved senior care by reducing prescription costs and extending coverage to key services.
Medicare spending will increase by $350 billion over the next decade if Congress repeals the ACA, accelerating the program’s insolvency. Potential plans to privatize Medicare will gut access to care and cause skyrocketing health care costs for the elderly.
Implementation of the ACA has reduced the budget deficit even more than was originally predicted by the Congressional Budget Office. Studies have shown that since the implementation of the ACA, while premiums have increased steadily, the number of individuals struggling to pay medical bills has steadily declined. While costs overall increase, they have increased by a much smaller margin than they would have if the ACA had not been enacted. Additionally, the ACA helps to combat economic inequality in the U.S., as it increases incomes in low-income households by reducing health care costs through mechanisms like the Medicaid expansion.
The ACA helps to fight the significant health disparities among Americans, expanding minority access to free preventive care, improving the overall quality of care in minority communities, and reducing the number of uninsured persons of color. The ACA invested in community health centers, whose patients are primarily minorities. The ACA provided the foundation for other efforts to combat inequities in the health care system for communities of color, including the HHS Action Plan to Reduce Racial and Ethnic Health Disparities.
The ACA banned health insurance companies from engaging in medical underwriting, most commonly known as discriminating against individuals for pre-existing conditions. If the ACA were repealed, an estimated 50 to 129 million individuals -- or between 19 and 50 percent of non-elderly Americans -- could be denied access to affordable health care coverage for a pre-existing condition. This fundamental reform protects millions of Americans from being needlessly priced out of the insurance market or denied coverage for common conditions like acne or cataracts.
Despite some claims that a Republican-sponsored replacement package could maintain the pre-existing conditions ban, existing potential plans significantly weaken consumer protections and fail to maintain the same level of coverage provided by the ACA.
The ACA substantially increased the number of insured young adults -- by 5.5 million individuals -- by allowing them to remain on their parent’s health insurance plan until the age of 26. Given the high unemployment rate for people ages 18-29, this provision provides a crucial lifeline to that demographic.
While this rule is one of the most popular parts of the ACA, proponents of repeal have yet to explain how they could keep this provision while getting rid of the other parts (like the insurance mandate) that help pay for it.
The ACA greatly expanded coverage of mental health care services by requiring that most plans -- including all plans sold in the HealthCare.gov insurance marketplaces -- cover mental health services, classifying them as essential services. By eliminating medical underwriting and requiring parity between mental and physical health services, the ACA extended coverage to those who were previously refused on the basis of their mental health issues.
While the mental health coverage in the ACA is far from perfect, repeal will undercut the law’s achievements, gut coverage for tens of millions of people with mental illnesses, and roll back other positive gains in related mental health legislation.
In the lead-up to the election, prime-time news shows functionally abdicated any role in questioning what President-elect Donald Trump will offer in place of the Affordable Care Act (ACA) and how it might affect the millions of Americans who gained insurance coverage as a result of the landmark law. Instead of asking pointed questions about Trump’s piecemeal policy proposals, TV personalities focused on negative stories like the 2017 premium hikes and conservative fearmongering about the potential of a so-called “death spiral.” Going forward, media figures must make “What is Trump’s replacement plan?” their first question in any discussion of health care policy and ask necessary follow-ups to pin guests to substantive proposals.
According to a Media Matters analysis of broadcast and cable evening news coverage from October 24 to November 7, TV personalities asked questions about Trump’s potential ACA replacement plans only four times amid 77 total discussions of health care. In total, TV personalities, panelists, and reporters mentioned Trump’s health care plans 13 times, and these mentions occurred exclusively on cable shows, revealing a serious deficit in broadcast coverage of health care in the last weeks of the election. Compounding the problem, nine of the 13 mentions came from either Fox News or a Trump surrogate (like Corey Lewandowski or Kellyanne Conway) on CNN, meaning right-wing media spin dominated the limited substantive discussions of Trump’s plans.
Media figures’ failure to probe politicians and surrogates on Trump’s plans kept important context out of the health care discussion. For example, during a panel segment on CNN Tonight, correspondent Corey Lewandowski insisted that “Trump has laid out a plan” to let individuals “buy health insurance across state lines,” calling it a “simple solution.” CNN host Don Lemon asked no follow-up questions -- problematic given the numerous critiques of the “state lines” proposal -- and instead changed the subject. Hosts must be prepared with the facts on proposed policies and hold guests accountable for explaining the impact of those policies. Permitting conservative talking points to stand unchallenged allows conservative misinformation to fill the void in a confusing policy arena that is poorly understood by the American public.
Coverage of health care in the last two weeks of the election largely focused on the news of double-digit premium increases next year on average for insurance plans sold on Obamacare’s online marketplace at Healthcare.gov. As Trump used this news to make his pledge to “repeal and replace” a focus of his closing campaign, news coverage failed to ask important questions about his idea to keep the popular parts of the ACA -- like prohibiting insurers from discriminating against individuals with pre-existing conditions -- while getting rid of other provisions. Instead, TV personalities focused on the premium hikes and fearmongering about the potential for a “death spiral.” The focus on negative news like premium hikes makes sense -- it was an important story that deserved coverage. But that coverage completely eclipsed almost any substantial discussion of what Trump’s replacement plan might include -- a trend reflected in the broader failure to engage in much of any policy discussion throughout the election.
The overall lack of coverage about the specifics of Trump’s replacement plan represents a fundamental problem in media’s treatment of health care policy and must quickly change now that Trump is the president-elect. A recent study from the Urban Institute showed that 24 million people will lose health care coverage by 2021 if Congress repeals the ACA. Trump’s nominee for secretary of health and human services, Tom Price, is a known foe of the law’s birth control mandate, a regulation that has dramatically reduced out-of-pocket health care costs for women and massively expanded contraceptive coverage. Repeal could also roll back the gains made in reducing the budget deficit, extending the life of Medicare, and lowering health care costs that resulted from the implementation of the ACA.
While no concrete plan for a replacement currently exists -- due to Republican infighting -- repealing Obamacare remains a top priority for the incoming Trump administration. Journalists must start asking questions about what a replacement plan will look like, how it will affect millions of Americans who gained coverage under the ACA, and what its true goals are. Every interview or panel segment about health care must begin with the question, “What is Trump’s replacement plan?” and include aggressive follow-ups about how it would function in order to hold the Trump administration accountable and educate the American public on the future of health care in the United States.
Media Matters conducted a Nexis search of transcripts of weekday network broadcast evening news programs on ABC, CBS, NBC, and PBS and weekday prime-time news programming (defined as 6 p.m. through 11 p.m.) on CNN, Fox News, and MSNBC from October 24, 2016 (the day the Obama administration announced the premium hikes), through November 7, 2016. We identified and reviewed three types of segments -- news reports, panel segments, and interviews. We searched for “Obamacare” or “Affordable Care Act” or “health care” and identified and reviewed all segments in which health care/ACA/Obamacare was the stated topic of discussion, or health care/ACA/Obamacare was discussed by at least two speakers in the segment (e.g., a host asking a single question about the ACA to a guest and the guest responding during a multitopic interview would count).
TBS’ Full Frontal with Samantha Bee drastically outshined nightly broadcast news shows in its coverage of abortion and reproductive rights during the first 11 months of 2016. The weekly comedy program, in just 31 episodes, spent more than twice as much time as any single nightly news show discussing abortion throughout the whole year, and host Samantha Bee’s coverage both delved into policy and debunked abortion myths, unlike the bulk of broadcast coverage. Broadcast news’ lacking coverage of reproductive rights, particularly in a year marked by several newsworthy events around abortion and abortion access, reflected the media’s larger failure to discuss substantive policy issues and left a gap that allowed conservative misinformation to dominate the national dialogue that did take place.
A Media Matters study found that ABC’s World News Tonight, CBS’ Evening News, and NBC’s Nightly News spent a combined total of 46 minutes and 11 seconds discussing abortion and reproductive rights from January 1 to November 30. NBC led the broadcast networks in the time spent covering abortion, with 16 minutes and 23 seconds, while ABC and CBS spent 15 minutes and 52 seconds, and 13 minutes and 56 seconds, respectively, covering issues related to reproductive rights. By contrast, TBS’ Full Frontal with Samantha Bee spent a total of 39 minutes and 43 seconds discussing abortion from when the program premiered in February through November, meaning the weekly comedy program offered more than double the amount of time any one network dedicated to the issue.
Throwing the disparity into even sharper relief, Full Frontal’s almost 40 minutes of abortion coverage took place over the course of 15 segments in just 31 episodes, while the nightly newscasts’ 46 minutes total took place over 37 segments in roughly 1,000 editions combined.
The lack of coverage about abortion on nightly broadcast news shows was totally at odds with the number and scope of major abortion stories in 2016. And a Pew Research Center report on important issues in the 2016 election found that 45 percent of respondents ranked abortion as “very important” in deciding their vote, placing abortion in the top 15 issues of the election cycle. There was no shortage of topics related to abortion and reproductive rights for the newscasts to focus on this year:
States Continued To Gut Abortion Access In New And Inventive Ways. States around the country passed a series of laws aimed at limiting access to abortion. In the first half of 2016, “17 states had passed 46 new abortion restrictions,” according to the Guttmacher Institute. These regulations included a requirement to hold a burial or cremation for any fetal remains (including those from miscarriages), misguided anesthesia requirements for abortions at 20 weeks or later, and even attempts to completely ban abortion.
Whole Woman’s Health Struck Down Unconstitutional Barriers For Abortion Access. The Supreme Court’s decision in Whole Woman’s Health v. Hellerstedt dramatically reshaped the legal landscape of abortion rights by clarifying the “undue burden” standard, which limited the ability of states to regulate (and restrict) a woman’s access to abortion. The decision struck down the Texas anti-choice law HB-2, rejecting the “barely plausible” claims that it increased patient safety, thus issuing a strong rebuke to the “woman-protective anti-abortion” rhetoric that permeated the discussion of HB-2 and other Targeted Regulation of Abortion Providers (TRAP) laws, of which numerous other states also have versions.
Trump’s Anti-Abortion Campaign Rhetoric And His Election Energized Anti-Choice Lawmakers And Anti-Abortion Activists. President-elect Donald Trump’s attacks on reproductive rights throughout the campaign included pledging to overturn Roe v. Wade, calling for women who have abortions to be punished, and pushing anti-choice myths like that of “partial-birth abortion.” Anti-choice lawmakers and activists, energized by Trump’s election, have continued plotting their assault on women’s health. As Politico reported, “Congressional Republicans are aiming to cut off federal funding for Planned Parenthood early next year,” in what would be “the single biggest victory for anti-abortion groups in years.”
The Supreme Court Punted In Zubik v. Burwell, Leaving Contraception Access In Limbo For Many Women. The Supreme Court in June sent Zubik v. Burwell, a consolidated case brought by religious nonprofits challenging the opt-out process of the Affordable Care Act's (ACA) contraception mandate, back to the lower courts in a deadlocked 4-4 decision, urging an appeals court to forge a compromise between the two parties and leaving millions of women without contraception access. As SCOTUSblog’s Lyle Denniston explained, the nondecision created issues around “how soon the government can work out technical arrangements to provide actual access to the contraceptive benefits.”
Congressional Republicans Attempted, But Failed, To Defund Planned Parenthood. Congressional Republicans voted in January to strip $450 million in federal funding from Planned Parenthood, marking “the first time a bill defunding Planned Parenthood has made it to the president's desk in more than 40 years,” according to Mother Jones. President Obama ultimately vetoed the legislation.
Republican Congressional “Witch Hunt” Targeted Women’s Health Care Providers. The House Select Investigative Panel on Infant Lives continued its “witch hunt” against women’s health care providers in 2016, which has been based almost solely on misinformation and has put abortion providers, researchers, and patients at risk of violence. In their report, Republicans on the panel referred Planned Parenthood Gulf Coast to the Texas attorney general’s office, claiming that the group illegally profited from fetal tissue donations. Congressional Democrats on the panel accused the Republicans of using “McCarthy-era tactics” and abusing their power.
A New Report Discovered A Sharp Uptick In Anti-Choice Violence. A report released in April from the National Abortion Federation found “a dramatic increase in hate speech and internet harassment, death threats, attempted murder, and murder” related to abortion. The report called the trend “alarming.”
The lack of reproductive rights coverage on broadcast news reflected the broader pattern of policy discussions being omitted from election coverage. An October study by Tyndall Report found that evening newscasts dedicated a mere 32 minutes to substantive policy coverage throughout the whole year. Another study from Harvard’s Shorenstein Center found that only 10 percent of news coverage during the election focused on the candidates’ policy stances. By contrast, 42 percent of news reports focused on polling and horserace coverage.
The lack of nightly broadcast news coverage on abortion and reproductive rights allowed misinformation about abortion to gain traction in the media and in politics. For example, in the third general election presidential debate, moderator Chris Wallace framed a question about abortion around the myth of partial-birth abortion. Trump echoed the partial-birth abortion myth in his answer, outrageously stating that Democratic nominee Hillary Clinton supported abortion procedures that “rip the baby out of the womb in the ninth month [of pregnancy].” Vice President-elect Mike Pence also invoked the concept of “partial-birth abortion” to attack Clinton during the only vice presidential debate. These mentions marked the only two times abortion was discussed in the general election debates.
While nightly news programs were failing to adequately cover abortion -- and allowing the partial-birth abortion myth to fester -- on Full Frontal, Bee explicitly called out the concept as a myth, exclaiming into a bullhorn, “Partial-birth abortions aren’t a thing.”
Bee emphasized the “nonmedical” term’s origin as a "right-wing construct” made up by the National Right to Life Committee in the 1990s, and she explicitly called out Chris Wallace for “conflat[ing] partial-birth abortion -- which doesn't exist -- with late term abortion, which does, rarely.” Bee also mocked Trump for his comment about babies being ripped from the womb at nine months, pointing out that “removing a baby from a woman's womb in the ninth month isn't an abortion -- it's a birth.” Bee’s coverage of the third presidential debate set a model for media to call out other media figures and politicians who adopt right-wing media fictions, like “partial-birth abortion,” to attack and demonize reproductive rights and the people who support them.
Bee also directly refused false claims that politicians and conservative media pushed in defense of HB-2, which the Supreme Court overturned in Whole Woman’s Health v. Hellerstedt. In oral arguments in the case, Texas Solicitor General Scott Keller falsely claimed that the regulations the law put in place, which included requirements that facilities where women get abortions meet the same standards of ambulatory surgical centers (ASC) and that doctors performing abortions have admitting privileges at a nearby hospital, were medically necessary. Keller also asserted that the law wouldn’t reduce access to abortion services because “the six most populous areas of Texas” would be able to perform “over 9,000 abortions annually.” A report for the University of Texas in January found that the law had already “delayed and in some cases prevented” abortions altogether.
Bee interviewed Texas Republican state Rep. Dan Flynn -- one of the authors of HB-2 -- and exposed the flawed logic behind the arguments that HB-2 supports women’s health care. Bee pointedly asked, “How does removing access to health care increase health care?” and she corrected Flynn when he asserted that abortion involves “cutting on people’s bodies,” noting that “you don’t cut a woman in an abortion, though.” And Bee debunked Flynn’s claims of increased safety and clinic access, asking, “Have you thought about regulating the safety of back alleys? Because that’s where a lot of women will be having their abortions now.”
Crucially, Bee also spotlighted Americans United for Life (AUL), “an anti-choice group that creates boilerplate bills for lawmakers around the U.S.” that restrict abortion rights. Bee called out Flynn’s lack of knowledge about reproductive health, saying, “you don’t seem to know anything specifically about abortion, really at all,” and explaining -- in a way most news media fail to do -- the process through which AUL’s restrictive anti-choice model legislation is passed in state legislatures.
Full Frontal offered a clinic in how to properly debunk conservative misinformation on abortion. From her deep dive investigations into long-standing myths to her monologues responding to contemporary events, Samantha Bee set the bar for news coverage of abortion issues.
Media Matters searched Nexis and iQ media for mentions of “abortion,” “Planned Parenthood,” “women’s health,” “reproductive rights,” “Center for Medical Progress,” “Roe v. Wade,” and “Whole Woman’s Health” in editions of ABC’s World News Tonight, CBS’ Evening News, NBC’s Nightly News, and TBS’ Full Frontal that aired between January 1 and November 30. For this study, Media Matters included only those segments where the stated topic of discussion was abortion or where the discussion contained "substantial discussion" about abortion (defined as a discussion in which two or more speakers had at least one direct exchange on abortion). We identified four types of segments: a host monologue, a news package or news report, a panel discussion, or an interview. We did not include teasers for upcoming segments. Segments identified were timed using iQ media.
Sarah Wasko contributed graphics to this piece