President Donald Trump announced on October 12 that he would be ending cost-sharing reduction (CSR) payments to insurers, which have been a crucial part of the Affordable Care Act (ACA) that have helped ensure low-income Americans can afford health insurance. During the fight over the ACA this summer, media outlets made a litany of mistakes in their health care coverage. Given the dire consequences of this latest move to dismantle the ACA, it’s increasingly important that coverage avoids a few key pitfalls.
Do: Call this what it is -- part of a long-term effort to sabotage the health care system
Ending cost-sharing reduction (CSR) payments is the latest move in the Republican-led effort to sabotage the ACA, and media must say so. Republican efforts to take down the ACA are nothing new, but they have been regalvanized under Trump’s presidency. A lot of the destruction Trump and his cronies have caused has been in the shadows, and that strategy has fooled the media into neglecting to mention the role of sabotage whenever anything goes wrong in the health care market.
The ACA was doing fine before Trump got his hands on it. Despite the near constant complaints from right-wing media figures of a “death spiral,” analyses found that the Obamacare markets were “stabilizing.” Even the Trump administration’s own Centers for Medicare and Medicaid Services released a report finding stable markets in 2016.
This sabotage really shouldn’t be surprising. Trump said he would “let ObamaCare implode,” if congressional efforts to repeal and replace the ACA failed. As Topher Spiro of the Center for American Progress wrote, “It’s now impossible for Republicans to blame Obamacare for any premium increases or insurer exits” given all the attempts to ruin the law.
Do: Elevate experts who know what they’re talking about
Health care is complex. There’s no need for media to muddle that complexity with falsehoods from talking heads spouting partisan lies or useless punditry. Fox News, predictably, often relies on its “Medical A-Team” to make dubious claims and lie about health care. CNN similarly has problematic “experts” whom the network often leans on for health care analysis, including Stephen Moore, who has somehow built a career on pushing shoddy predictions, misinformation, and misleading claims. Cable news also too often gives valuable time to pundits who focus on “optics” or politics, rather than policy.
When real experts have appeared on cable news, however, these doctors, health care beat reporters, and current and former health care officials have effectively debunked misinformation and accurately explained the debate at hand. These are the kind of people media should be hosting. Tell Stephen Moore to take the day off.
Do: Let people know how Trump’s sabotage will impact them
Ending CSR payments is going to rattle the markets and increase costs for both the country and millions of Americans. Here are just a few reasons why:
HealthAffairs.org’s Timothy Jost noted that without CSR payments, “some insurers might well decide that the government is an unreliable partner and give up on the exchanges for 2018.”
The nonpartisan Congressional Budget Office estimated that premiums for some plans “would, on average, rise by about 20 percent in 2018 relative to the amount in CBO’s March 2016 baseline and rise slightly more in later years.”
And the Kaiser Family Foundation found that ending these payments “would result in a net increase in federal costs of $2.3 billion” next year compared to current projections.
These facts should be front and center in every report and interview about Trump’s newest move. In the past, local newspapers, cable morning shows, Sunday political shows, prime-time cable news, broadcast news, and national newspapers have omitted key consequences of health care proposals from their reporting. Media should learn from past mistakes and bring attention to these consequences.
Don’t: Fall for the conservative “bailout” spin
Conservatives have repeatedly tried to frame CSRs as “bailouts” to the insurance industry. The problem with that is they’re wrong.
Trump used the “bailout” spin in July:
If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!
— Donald J. Trump (@realDonaldTrump) July 29, 2017
Fox & Friends did this morning:
And Sen. Ted Cruz (R-TX) did the same thing on Fox News’ America’s Newsroom today:
As The Washington Post Fact Checker explained, “A bailout means a company is being propped up with government money after making bad decisions. That’s not the case here.” Additionally, according to the Commonwealth Fund, the payments are reimbursements the federal government gives to insurers for providing subsidies that include “lower copayments and deductibles for people in households earning between 100 percent and 250 percent of the federal poverty level.”
Republicans want people to think these payments are bailouts, because that sounds a lot more scandalous than helping low-income people buy insurance. Media shouldn’t adopt that frame.
Don’t: Let Republicans off the hook for their hypocrisy
Many of the ways Trump has acted to sabotage the ACA have been through executive order or unilateral action from the executive branch. Predictably, under former President Barack Obama, Republicans routinely freaked out over any executive order or unilateral action het put into place. If they come out supporting Trump’s use of unilateral action to end these payments, they should be called out as hypocrites.
Two Republicans vocal in their opposition to Obama’s use of executive orders were Cruz and Rep. Jim Jordan (R-OH). When Cruz appeared on the October 13 edition of Fox News’ America’s Newsroom to cheer Trump’s decision to end these payments, he was not asked about this hypocrisy:
Jordan, however, was challenged on this point during his appearance on the October 13 edition of CNN’s New Day, with co-host Chris Cuomo pressing him on his previous criticism of unilateral action by the executive branch:
All journalists should follow Cuomo’s line of questioning when speaking to any lawmaker in the coming days who was critical of Obama’s use of executive power, especially on health care.