Both local and national media have largely failed to cover recent proposals by Affordable Care Act (ACA) health insurance providers to increase premiums in Maryland and Virginia, and media have all but ignored the connection between Republican efforts to weaken the ACA and increasing health care costs.

On May 4, two of Virginia’s ACA health insurance providers requested that state officials approve significant premium increases in 2019. Cigna and CareFirst BlueCross BlueShield both proposed average premium hikes that are in the double digits. They were joined days later by several other Virginia insurers and both of Maryland’s providers, Kaiser and CareFirst, the latter of which requested a 91 percent rate increase for members on its PPO plan.  

These increases are not unexpected; many organizations, as well as the Congressional Budget Office, predicted that insurance rates would skyrocket if the Trump administration and the Republican-held Congress eliminated the ACA’s individual mandate, which required people to have health insurance or pay a penalty. On December 22, President Donald Trump signed the Republican tax bill into law, officially repealing the individual mandate and ensuring a rise in insurance premiums. Both Cigna and CareFirst BlueCross BlueShield have already blamed the termination of the mandate for their soaring rates.

Without the individual mandate, people are more likely to withdraw from the market, meaning that cost sharing is spread among fewer people, and, as a result, the burden increases for everyone. Additionally, young and healthy people are the most likely to forego purchasing health insurance, leaving the market saturated with older and unhealthy people who require more medical attention, which pushes premiums up. Trump’s former Health and Human Services secretary, Tom Price, admitted as much during a May 1 speech at the World Health Care Congress in Washington, where he said that repealing the mandate would lead to “younger and healthier” people exiting the exchanges and “consequently, that drives up the cost.”

Virginia and Maryland media largely ignored the story

Four major TV news stations in the Baltimore media market mentioned premium increases a combined four times in evening weekday coverage. Two stations didn't mention them at all. Between May 7 and May 14, rising premiums were mentioned four times among the four major local TV news stations during their weekday evening news coverage*; only one network noted the role of Republican health care reform in proposed premium increases:

• ABC’s WMAR did not mention the looming premium hikes in its 12 hours of weekday evening news coverage.

• Fox’s WBFFDT also neglected to mention the premium increases in its 12 hours of weekday evening news coverage.

• NBC’s WBALDT discussed the proposed increases once during nine hours of coverage, and the report did not explain their connection to the repeal of the individual mandate.

• CBS’ WJZ mentioned requested increased premiums three times in its 15 hours of coverage, but none of the mentions extended beyond a brief headline, and the network did not explain that the expected increases are related to the repeal of the individual mandate.

Three major Maryland newspapers ran a total of just two articles that mentioned rate increases. Since Maryland insurers requested double-digit premium hikes on May 7, only two of three major print newspapers have printed a report on it:

• The Baltimore Sun ran one article about the proposed soaring premiums between May 7 and May 14. The article accurately pointed out the connection between the proposed increases and the individual mandate repeal.

• The Daily Times in Salisbury mentioned expected rising premiums in one article (which ran twice, on May 12 and May 14).  

• Annapolis’ The Capital did not report on potentially rising health care costs.

Four major TV news stations in Virginia’s largest media market mentioned premium increases a combined three times in evening weekday coverage. Two stations didn't mention them at all. Of the four stations carrying local news in the Norfolk-Portsmouth-Newport News media market, only two discussed potential premium increases between May 4 and May 14:

• CBS’ WTKR mentioned the proposed rate increases and their connection to the repeal of the individual mandate one time in the 17.5 hours of evening weekday news programming.

• ABC’s WVEC mentioned that premiums were likely to rise twice in the 17.5 hours of evening weekday news programming. Once the issue was mentioned during an off-topic segment about underfunding of Virginia’s prison system, and the other time it came up during a discussion about a health care plan proposed by Sen. Tim Kaine (D-VA). Neither segment actually noted that Virginian health insurers had already requested a rise in premiums, although the second segment did mention Kaine’s insistence that the Trump administration's watering down of the ACA is leading to increased premiums.

• Fox affiliate WVBT did not mention the expected premium hike during its four and a half hours of evening weekday news programming.

• NBC affiliate WAVY also did not mention the looming premium increases during the station’s 17.5 hours of scheduled evening news programming.

Three major Virginia newspapers ran a combined five articles about the proposed premium hikes, but mostly excluded important context about the GOP sabotage effort. Between May 4 -- when several Virginia insurers first requested premium hikes -- and May 14, three major Virginia newspapers ran five articles that mentioned potential rate increases:

• The Richmond Times-Dispatch ran one article informing readers about potential rate increases, but it failed to connect the rising premiums to the Republican-led repeal of the individual mandate.

• The Virginian Pilot also printed one article about the premium jumps; it was the only article among those in Virginia’s top three newspapers to explain that the repeal of the mandate was largely to blame for the increases.

• The Roanoke Times mentioned rising health insurance premiums in three articles; only one of them informed readers about the Republican Party’s complicity in their rise.

National news outlets hardly mentioned the expected rise in premiums

The looming premium hikes were mentioned a total of six times on all evening national cable news outlets. From May 4 to May 14, the requested premium increases were mentioned twice on Fox News, twice on CNN, and twice on MSNBC. In almost every instance, the premium increases were brought up in the context of Democratic messaging for the 2018 midterm elections, and none of the discussions mentioned specific examples of where or by how much premiums could potentially rise. During a May 5 interview with Tom Price, the former health and human services secretary attempted to clarify his statement from May 1 in which he acknowledged that ending the individual mandate will lead to higher premiums if other reforms are not implemented; this was the only segment that tied the increases to the GOP-led health care reform effort.

Of the three national broadcast evening news programs, only one mentioned the expected rise in premiums. CBS Evening News was the only national broadcast evening news program to mention the premium increases; the brief mention failed to explain the role of the Republican individual mandate repeal in rising premiums. The other two broadcast evening news programs, NBC Nightly News with Lester Holt and ABC World News Tonight with David Muir, did not report on the news.

Only one major U.S. newspapers mentioned the premium increases. The Washington Post was the only major newspaper to discuss the premium hikes in a news article. The paper published two articles that referred to the proposed premium hikes. The New York Times published one opinion piece about the proposed increases and tied the change to the GOP’s individual mandate repeal. The New York Times, Wall Street Journal, Los Angeles Times, USA Today, the New York Post, and Chicago Tribune have not reported on the proposals in their print editions.

In the past, media outlets have often left audiences in the dark over the negative effects of the Republican health care push. And while local media outlets have covered this issue better than national outlets, so far, the reporting on potentially increasing premiums from Virginia and Maryland outlets has been lackluster. As insurance companies continue to propose higher premiums across the country, national and local media outlets must do a better job preparing their audiences for the upcoming changes to their health care.

Methodology

Using Nexis, Media Matters searched three widely circulated Virginia-based print newspapers, the Richmond Times-Dispatch, The Virginian Pilot, and The Roanoke Times, from May 4 to May 14 and reviewed relevant articles that included variations of the terms “premium,” “rate,” “insurance,” “health,” or “coverage,” and “increase,” “change,” “go up,” “rise,” or “jump.”. The same search was used to search widely circulated Maryland-based newspapers, The Baltimore Sun, Annapolis’ The Capital, and The Salisbury Daily Times, from May 7 to May 14. The search was replicated for major national print outlets, including The New York Times, The Washington Post, Los Angeles Times, USA Today, the New York Post, and the Chicago Tribune between May 4 and May 14. The database Factiva was used to search for relevant articles from The Wall Street Journal during the same time frame with the search terms “health care,” and “premium.” Articles that only appeared online were not included.

Using iQ Media, Media Matters searched Norfolk-Portsmouth-Newport News, the largest local news market in Virginia, between May 4 and May 14 and relevant transcripts that included some variation of the terms “health care,” “healthcare,” “premium,” or “insurance” on local CBS, ABC, Fox, and NBC stations. The same search was conducted in Maryland’s largest news market, Baltimore County, between May 7 and May 14. Weekend coverage was not counted.

Media Matters searched Fox News, CNN, and MSNBC for “health care” or “premium” using SnapStream between the dates of May 4 and May 14 and reviewed all relevant mentions of the expected premium hikes. Mentions were included only if they addressed rising premiums specifically.

*Each local station varies in its news programming depending on the network and market. For this reason, the number of times the premium rises were mentioned was presented as a proportion of the individual station’s total evening news programming per week.