The New Hampshire Union Leader misleadingly used the findings of a study on Oregon's Medicaid expansion to attack the program, claiming it did not improve the health of patients and led to increased emergency room visits, and warning that New Hampshire "must not fall into that trap." However, contrary to the Union Leader's assertion, studies of Oregon's expansion show improvements in preventable diseases and mental health, and while ER visits were shown to rise initially, the number of people using the ER has dropped as people become more educated about their insurance coverage.
In a January 7 editorial, the Union Leader, which has a history of misinforming the public on Medicaid expansion, said Medicaid expansion is an effort to "move working-class and eventually middle-class Americans into government dependency." The paper claimed this would have a devastating effect on New Hampshire because the program is "poorly designed" and "does not even achieve its stated goals," using a recently released Harvard study of Oregon's 2008 Medicaid expansion experiment to show how the program "did not improve health outcomes or reduce health care costs" and "even increased visits to hospital emergency rooms."
But the Union Leader's claim that Medicaid did not improve health outcomes is inaccurate and fails to tell the whole story. A digest of the study published by the National Bureau of Economic Research contests the Union Leader's claims, saying the report found "higher healthcare utilization, lower out-of-pocket medical expenditures and medical debt, and better self-reported health." Past reports on Oregon's Medicaid experiment have also shown improvements in mental health and chronic disease detection among those covered by the expansion.
Two of New Hampshire's top newspapers, the Union Leader and Concord Monitor, ran weekly opinion columns from members of the Josiah Bartlett Center (JBC), a Koch brother-funded ally of the American Legislative Exchange Council (ALEC), but failed to disclose the authors' conservative funding allowing them a platform to air their conservative agendas and legitimizing the viewpoints of their special interest backers.
Ohio's major newspapers cited sham think tank Buckeye Institute 44 times in six months, promoting the opinions of its conservative allies including the American Legislative Exchange Council (ALEC), the Koch brothers, and big tobacco. Despite these connections being well-documented, every article failed to disclose Buckeye's ties to ALEC and its funding from the Koch brothers and dark money conservatives.
The Pittsburgh Tribune-Review cited deceptive statistics from the Heritage Foundation to attack the immigration reform effort, falsely claiming that the Obama administration is not enforcing current laws and arguing that it would continue this practice under a comprehensive immigration reform law.
A December 15 editorial by the Tribune-Review cited a post by the Heritage Foundation to claim that "the deportation of illegal aliens, in fact, has sunk to its lowest level in 40 years" and that the Department of Homeland Security has accepted 81 percent of 580,000 applicants for provisional legal status under a program called the Deferred Act of Childhood Arrivals (DACA). The Tribune-Review argued that these numbers show that the Obama administration is not committed to border enforcement and therefore should not be trusted to roll out a comprehensive immigration reform plan.
But the Tribune-Review's analysis should be taken with a grain of salt since its Heritage Foundation numbers come from "secret numbers" obtained by the anti-immigrant nativist Center for Immigration Studies, which is known for fabricating information and pushing misleading studies.
Ignoring the dubious source of the numbers, the editorial still fails to take into account the nearly 2 million people the administration has deported over the course of President Obama's tenure. The pace of deportations under Obama's administration is actually faster than the previous Republican administration. Even with possibly decreasing deportations -- which could also be a result of lower numbers of undocumented immigrants due to alternative enforcement measures coupled with the administration's priority of deporting high-risk individuals given its finite resources, the cost of deportation, and the current backlog of cases -- the Obama administration has prosecuted a record number of undocumented immigrants in 2013.
Newly released documents have exposed the agenda of the conservative North Carolina-based J.W. Pope Civitas Institute showing that the organization is seeking funds to engage in a campaign to decimate Medicaid funding in the state. North Carolina media should take care to disclose these revelations to ensure readers know what's really behind the Civitas Institute's forthcoming Medicaid attacks.
On December 5, The Guardian released documents noting that conservative groups across the United States "are planning a co-ordinated assault against public sector rights and services in key areas of education, healthcare, income tax, workers' compensation and the environment." The Guardian explained that the "proposals were co-ordinated by the State Policy Network, an alliance of groups that act as incubators of conservative strategy at state level." Indeed, according to a report by the Center for Media and Democracy, the State Policy Network (SPN) and its member organizations "work together in coordinated efforts to push their agenda, often using the same cookie-cutter research and reports, all while claiming to be independent and creating state-focused solutions that purportedly advance the interests or traditions of the state." The report added:
Although many of SPN's member organizations claim to be nonpartisan and independent, our in-depth investigation reveals that SPN and its member think tanks are major drivers of the right-wing, ALEC-backed agenda in state houses nationwide, with deep ties to the Koch brothers and the national right-wing network of funders, all while reporting little or no lobbying activities.
Among the groups cited in the Guardian papers was the Civitas Institute. The organization requested funding for a campaign to try to sway politicians into reducing the amount of money North Carolina gives to the state's Medicaid program, which it characterized as "failed," and if successful, export their messaging to other SPN affiliates around the country:
The Las Vegas Review-Journal erroneously claimed that Sen. Harry Reid (D-NV) is providing special treatment to part of his staff by not requiring them to purchase insurance on the Affordable Care Act (ACA) exchange, despite the fact that the law does not require leadership staff members to participate in the exchange.
A December 7 Review-Journal editorial attacked Sen. Reid for not forcing his leadership staff off of their employer-based coverage and onto the health insurance exchanges before misleadingly claiming that the GOP had "no culpability" in obstructing improvements for the ACA:
The Affordable Care Act requires the official staffs of each federal lawmaker to abandon their medical coverage through the Federal Employee Health Benefit program and purchase subsidized insurance through the law's exchanges. But, as reported Thursday by the Review-Journal's Steve Tetreault, the law allows the staff of congressional committees and leadership offices to stay off the exchanges and keep their current benefits, if their lawmaker bosses so decide.
Senate Minority Leader Mitch McConnell, R-Ky.; House Speaker John Boehner, R-Ohio; and House Minority Leader Nancy Pelosi, D-Calif., nonetheless diverted their entire staffs to the exchanges to obtain health insurance. Sen. Reid did not.
Kristen Orthman, a spokeswoman for Sen. Reid, said her boss is following the law and has proposed a fix to the staff coverage discrepancy, but Republicans won't go along. Imagine that: The GOP, which has no culpability in this mess, actually wants something in return for votes that are politically beneficial to Democrats whose poll numbers are tanking.
The attack on Sen. Reid is an attempt to score political points in an on going partisan battle over the ACA. The Review-Journal and conservative opponents are criticizing Reid for following the Grassley Amendment, an amendment to the ACA proposed by Sen. Chuck Grassley (R-IA) that forced members and legislative staff onto the exchanges instead of allowing them to keep their own employer-based insurance as millions of Americans have under the ACA. This tweak to the ACA law made the decision to place leadership committee staff on the exchanges optional.
In the wake of growing pressure on the American Legislative Exchange Council (ALEC) -- a shadowy right-wing group dedicated to pushing a conservative agenda at the state level -- and the exposure of its agenda and tactics, will local media finally acknowledge its influence on state politics when reporting on new legislation?
The Guardian reported on December 3 that ALEC has lost the membership of "almost 400 state legislators" and the funding of "more than 60 corporations" due to the organization's connection to controversial "stand your ground" laws, which received scrutiny following the shooting death of Florida teen Trayvon Martin. In an effort to rebuild those relationships, ALEC is holding its States & Nation policy summit in Washington, D.C., this week. The event includes Republican legislators such as Sen. Ron Johnson (R-WI), Rep. Paul Ryan (R-WI), and Sen. Ted Cruz (R-TX), as well as several governors.
Legislators and businesses from around the country will gather to discuss this year's model legislation, which, as the Center for Media and Democracy has highlighted, will run the gamut of policy areas including legislation "opposing U.S. consumers' rights to know the origin of our food," "undermining workers' rights," "stripping environmental protections," and "limiting patient rights and undermining safety net programs." The last category includes legislation to turn Medicaid into a block grant program, similar to the proposal that Ryan has offered in his budget proposals.
State and local media outlets in the past have often neglected to identify ALEC-influenced legislation and failed to report on their state legislators' involvement with the group. A new wrinkle proposed this year by ALEC, however, directly affects state legislators. The Kansas City Star highlighted a document that was published by The Guardian that, although not adopted, would have required state chairs to take a loyalty oath: "I will act with care and loyalty and put the interests of the organization first." As Star columnist Barbara Shelly wrote:
What? These are elected officials. They are to put the interests of their states and constituents first. Apparently at some level people realized that, because the draft job description was never adopted. But the very suggestion demonstrates ALEC's eagerness to control these lawmakers.
As legislative sessions begin next year, will state media outlets begin to question legislation offered by their state representatives, especially those who are known to be members of ALEC? Will state media outlets question their ALEC state chairmen about the loyalty oath and whether they are putting the interests of ALEC interests above those of their state and constituents?
ALEC's renewed push has essentially given local media a second chance to identify ALEC's influence in their states and potentially identify the corporate interests behind several pieces of legislation affecting their readers.
Local North Carolina newspapers cited two right-wing sham think tanks and published op-eds by their staffs while often failing to note their connections to the state's Republican party and to a major conservative donor.
The Las Vegas Review-Journal claimed the Affordable Care Act (ACA) is hurting employment by forcing businesses to shift workers to part-time to avoid offering health insurance. However, substantial evidence proves that the ACA is not having any widespread impact on employment patterns.
In a November 25 article, the Review-Journal claimed the large service industry of Nevada would be hit hard by the health care law's mandate to count employees working more than 30 hours a week as full time -- the threshold for which employers must begin offering health insurance benefits to employees -- because it will give employers an incentive to cut worker hours to avoid offering health insurance:
So local businesses and unions alike want to know: What's another tweak or two?
They've set their sights on proposed federal laws that would change an Obamacare provision on who gets health insurance through work. The rule says employees who work more than 30 hours a week qualify as full-time, and employers have to offer them insurance or risk fines of $2,000 to $3,000 per worker. The rule applies to any company with more than 50 full-time-equivalent workers.
The threshold is causing unintended consequences as employers cut hours to drop workers below the 30-hour threshold.
That could be a huge issue in Las Vegas, with its high share of hourly service jobs in hospitality and restaurants, said Shaun O'Brien, assistant policy director for health and retirement for big labor group AFL-CIO. And with average weekly hours worked coming in at 33.7 in August, according to local research firm Applied Analysis, plenty of locals hover close enough to the threshold to cross it.
The article quoted Randi Thompson, the Nevada state director of the National Federation of Independent Business (NFIB), to bolster the claim that the ACA will force employers to cut hours. However, as the Georgetown Center on Health Insurance Reforms (CHIR) reported, Thompson's own organization conducted a survey that concluded the opposite. According to the survey by NFIB, only 13 percent of small businesses surveyed would cut employees or employee hours as a result of the law. Furthermore, the survey found that these decisions to "reduce employee hours seem strongly tied to profitability rather than ACA."
In support reduction in hours argument, the article referenced a survey sponsored by the Chamber of Commerce that found that franchised businesses have "already cut hours more than a year before the employer mandate." However this survey was conducted by Pulse Opinion Strategies, a known Republican polling firm and, according to an NFIB researcher, still doesn't prove the ACA is creating a part-time workforce:
The numbers contrast with a survey released two weeks ago by the National Federation of Independent Business finding that only 13 percent of 921 small companies plan to cut hours. The NFIB, like the [International Franchise Association] and the Chamber [of Commerce], thinks people working less than 40 hours shouldn't count as "full-time." But the group admitted that its numbers don't show Obamacare creating a part-time workforce. Many of those planning to cut hours were too small to be subject to the mandate, anyway. "If they cut or were cutting, it's almost assuredly due to the profitability rather than the ACA for those people," NFIB researcher William Dennis said.
These findings have been backed up by economists as well. In his analysis of the ACA's effect on weekly hours, economist Dean Baker explains that while some employers may reduce hours to avoid providing coverage to employees, "the number is too small to show up in the data." Furthermore, few work near the 30-hour full-time cutoff:
An analysis of data from the Current Population Survey shows that only a small number (0.6 percent of the workforce) of workers report working just below the 30 hour cutoff in the range of 26-29 hours per week. Furthermore, the number of workers who fall in this category was actually lower in 2013 than in 2012, the year before the sanctions would have applied. This suggests that employers do not appear to be changing hours in large numbers in response to the sanctions in the ACA.
The Center on Budget and Policy Priorities further explains that the number of involuntary part-time workers has decreased since the implementation of the ACA, instead of expanding as the perpetrators of the myth would lead one to believe:
A more rigorous test examines the recent trend in the share of involuntary part-timers -- workers who'd rather have full-time jobs but can't find them. If health reform's employer mandate were distorting hiring practices in the way critics claim, we'd expect the share of involuntary part-timers to be growing. Instead, as shown in Figure 1, it is down about one percentage point from its peak.
Nor do the employment data provide any evidence that employers have cut workers' hours below 30 hours a week to avoid the requirement to provide health insurance. During the first half of this year, the share of workers putting in 30 or more hours a week actually rose to 80.7 percent from 80.2 percent in the comparable part of 2012. Although the increase is small, it refutes the claim that shortening of the workweek is widespread.
The Columbus Dispatch claimed that unemployment insurance [UI] benefits create a disincentive to work to attack President Obama's recent call to extend them into 2014. However, multiple economists have found that unemployment benefits are not disincentives to work during economic downturns, and that not extending them will hurt the economy and result in job loss.
The Richmond Times-Dispatch said Republican "political arguments" should not be blamed for the initial failures of the Affordable Care Act (ACA), despite the GOP's goal of obstructing of the law, hindering its rollout.
In a November 25 editorial discussing the ACA's rollout, the editorial board claimed that "political arguments" and "Republican boilerplate against the ACA" did not contribute to the failures of the rollout. From the Times-Dispatch:
Although President Barack Obama has accepted responsibility (sort of) for Obamacare's disastrous start, he continues to point fingers at others.
The Washington Post's Dana Milbank notes that Obama has whined about Republicans and the press. He has implied that GOP demands to repeal the Affordable Care Act have undermined the program's efficiency. Oh? Political arguments have no bearing on the mechanics of running Obamacare. Republican boilerplate against the ACA did not contribute to the fiasco. Conservatives may be reveling in the aftermath, but they did not cause the systemic failures.
The editorial fails to note the multiple instances of Republican obstructionism that have led to some of the problems with the law's implementation. As a November 1 Politico article noted, one of the causes of the flawed rollout was "calculated sabotage by Republicans at every step." The piece continued:
From the moment the bill was introduced, Republican leaders in both houses of Congress announced their intention to kill it. Republican troops pressed this cause all the way to the Supreme Court -- which upheld the law, but weakened a key part of it by giving states the option to reject an expansion of Medicaid. The GOP faithful then kept up their crusade past the president's reelection, in a pattern of "massive resistance" not seen since the Southern states' defiance of the Supreme Court's Brown v. Board of Education decision in 1954.
The opposition was strategic from the start: Derail President Barack Obama's biggest ambition, and derail Obama himself. Party leaders enforced discipline, withholding any support for the new law -- which passed with only Democratic votes, thus undermining its acceptance. Partisan divisions also meant that Democrats could not pass legislation smoothing out some rough language in the draft bill that passed the Senate. That left the administration forced to fill far more gaps through regulation than it otherwise would have had to do, because attempts -- usually routine -- to re-open the bill for small changes could have led to wholesale debate in the Senate all over again.
The New Hampshire Union Leader promoted a plan that would use Medicaid expansion funds available under the Affordable Care Act (ACA) not to expand Medicaid to cover more of New Hampshire's poorest residents, but to subsidize private insurance plans. However, under this plan, people would potentially pay higher premiums for their private plans or be left without health insurance.
In a November 17 editorial, the Union Leader advocated for using Medicaid expansion funds to extend New Hampshire's practice of providing subsidies for private insurance policies and mocked legislators who warned that this approach could leave consumers vulnerable to price hikes due to lack of marketplace competition:
That is why Senate President Chuck Morse's plan to use Medicaid dollars to subsidize private insurance for qualified Granite Staters is such a great proposal. He called the Democrats' bluff. Now they are throwing up every objection that they can, even ones that undermine the party's position on Obamacare.
State Senate Republicans had proposed moving newly Medicaid-eligible Granite Staters into subsidized private insurance plans purchased on Obamacare's state insurance exchange, and doing that by 2015. Last week Democrats hilariously complained that this was "unworkable" (Gov. Maggie Hassan's word) because there is no competition on New Hampshire's exchange, which is serviced by only Anthem and Delta Dental.
By pushing for Morse's proposal, the Union Leader failed to take into account two major impediments to the Senate plan. First, a special waiver must be proposed by the state and approved by the federal government before Medicaid funds can be used for private insurance. Knowing this could be a lengthy process, other states that have taken this route have already submitted proposals for approval. The Senate plan backed by the Union Leader forecasts only one year for federal approval, and would end expansion efforts if the plan had not been approved by the end of that year. A different proposal by the House also recommends using Medicaid expansion funds to offer private insurance subsidies, but that plan does not foresee moving people to private plans for at least three years.
The second problem with the Senate plan is the lack of competition in the state exchange marketplace. With only one provider on the marketplace so far, New Hampshire's exchange is not competitive enough to make the Senate private subsidy plan viable, nor does it have the time to grow competition before the Senate plan would be implemented. According to the Boston Globe:
Insurance Commissioner Roger Sevigny cautioned the Senate panel that its timeline is ambitious. Sevigny said he has not heard of any companies preparing to enter the marketplace as the Senate plan envisions in 2015 to join the lone provider, Anthem Blue Cross and Blue Shield.
The House plan rejected by the editorial is deemed more practical, because it would only shift Medicaid funds to private insurance if three providers are competing on the exchanges. According to Forbes, competition is vital to keeping prices low and quality of care high:
In the future, to stay competitive, insurers will need to increase value for their customers. They'll do so by including in their networks only those physicians and hospitals that provide higher quality at a lower cost. This will require providers to improve the processes and outcomes of the care they deliver.
This shift in competition will begin a virtuous cycle. The lower cost, higher-quality insurance plans will attract more people. A growing membership base will give them greater leverage to demand increased efficiency, higher quality and superior outcomes from doctors and hospitals in their networks. This, in turn, will result in further market-share growth as more consumers see the value.
As the Concord Monitor further explained:
Implementing Obamacare and expanding access to Medicaid, let alone doing so under an as-yet unwritten plan that requires federal approval, is enormously complicated. Almost every part of every endeavor is in flux. So without getting into the deep weeds, the sticking point is this: The governor and the House want the people newly eligible for Medicaid to be able to obtain coverage under the standard Medicaid programs now being overseen by three managed care companies until at least 2017 before shifting them to private plans with what amounts to a voucher to subsidize the cost. The added time could allow players other than Anthem, the only insurer signed up to participate in the health care exchange marketplace, to join, thus increasing competition and lowering costs.
Almost all of Ohio's leading newspapers ignored a new poll showing that Ohioans overwhelmingly support action on immigration reform, even as House Speaker John Boehner (R-OH) announced a decision on November 13 that effectively reduced any chances at reform this year.
A poll conducted by Harper Polling on behalf of three pro-reform organizations -- including one that counts News Corp (Fox News' parent company) president Rupert Murdoch as a co-chairman, and another that exclusively supports GOP candidates -- found that 74 percent of Ohio residents surveyed feel the immigration system is broken and that another 72 percent support an immigration proposal with a path to citizenship. The poll also found that 68 percent of respondents support a plan that would grant legal status to undocumented immigrants and citizenship to those who were brought to the country illegally as children.
On November 13, the Cleveland Plain Dealer was the only major daily Ohio newspaper to report these findings, despite Boehner's pronouncement that day that he would refuse to allow negotiations between the House and the Senate on an immigration reform bill. As the Washington Post noted, the decision dealt "a significant blow to the prospects of comprehensive immigration reform by this Congress."
MediaTrackers Ohio attempted to distort local media coverage of the Affordable Care Act (ACA) by using badly flawed comparisons to claim the ACA's exchanges will lead to "sticker shock" for Ohio residents. MediaTrackers' analysis applies to a small slice of Ohio consumers and doesn't take into account important parts of the law.
Local media looking at MediaTrackers' effort should note several omissions in their reports:
As part of its analysis, MediaTrackers published several articles comparing the costs of insurance premiums for plans on Ohio's federally run ACA exchange to quotes for plans at eHealth.com, an online marketplace that allows people to shop for insurance. MediaTrackers looked at costs for 27-year-old women and men and 50-year-old women and men. In all the scenarios, MediaTrackers compared "Obamacare 'Gold' plans from [the Department of Health and Human Services] and existing policies with similar deductibles listed at eHealth."
As The New York Times explained, all health insurance plans starting on January 1 must include essential benefits from 10 health categories meaning consumers are not forced to purchase insurance through the exchanges in order to qualify under the ACA and can purchase private insurance if it is cheaper for them.
However, even using MediaTrackers' scenario, it is misleading to present today's plans and the new ACA-compliant plans as equal. Replicating MediaTrackers' scant methodology as closely as possible, the cheapest current plans do not have several of the health benefits required under the ACA. For example, picking the cheapest plan on eHealth.com in Columbus, Ohio, with a $1,500 deductible will allow a 27-year-old man to pay around $100 per month, but it will not include mental health, substance abuse, oral, or vision care -- all benefits required under the ACA.
The Las Vegas Review-Journal promoted several myths about the Affordable Care Act (ACA) including that men will have excessive coverage, that young people will not sign up for insurance on the exchanges, and that heavy Medicaid enrollment will jeopardize the exchanges.