Health Care Reform

Issues ››› Health Care Reform
  • Right-Wing Media Push Absurd Pizza Lobby Claim That Franchises Are Burdened By Basic Food Labeling

    Pizza Franchises Are Lobbying Trump To Kill Another Public Protection Enshrined In ACA

    Blog ››› ››› ALEX MORASH & CRAIG HARRINGTON

    A pizza industry lobbying campaign against food labeling requirements mandated by the Affordable Care Act (ACA) has gained momentum in recent weeks as right-wing media promote exaggerated complaints that it would be “costly and burdensome” to require chain restaurants to display calorie information on menu items. Conservative outlets are urging President Donald Trump to rescind the long-delayed implementation of certain food labeling requirements, while completely ignoring that the long-term benefits of such public protections vastly outweigh the short-term costs.

    On the April 19 edition of Fox News’ Fox & Friends, Domino's franchisee owner Chris Reisch asked Trump -- who is an obsessive Fox & Friends viewer -- to stop a rule that was passed as part of the ACA and goes into effect on May 5, requiring chain restaurants to display the calorie counts of items on their menus. Reisch preposterously claimed the food labeling requirement would force him to “have a book at the counter” to display the calorie count of the 34 million topping combinations of Domino’s pizza and promoted the openly ridiculous claim that kitchen staff might face jail time for putting too many toppings on a pizza:

    During his interview, however, Reisch did not disclose that he was recently on Capitol Hill lobbying against food labeling, overtime pay, and labor rights on behalf of the American Pizza Community (APC) -- the lobbying arm of the pizza industry.

    According to The Washington Post, the APC is leading “a desperate push” to curb food labeling standards before they go into effect, “more than seven years after [the ACA] was signed into law” and years after most other chain restaurants already complied with the new standards. Having already gone to Congress with its complaints, the pizza industry may have hoped to reach the president directly via Fox & Friends, which culminated a month-long chorus of right-wing outlets slamming the rule on the industry’s behalf.

    In the past few weeks, right-wing outlets and fringe conservative sites have assailed the ruling, citing its supposedly onerous costs and bemoaning the confusion it could cause for customers. Since March 22, The Washington Free Beacon, PJMedia (twice), the National Review, NewsBusters, Investor’s Business Daily, CNS News, and FoxNews.com have promoted varying arguments that the rule would be “costly and burdensome,” that it “lacked common sense,” and that it amounted to little more than “pizza shaming.” CNS News hyped a report from the food services industry that incorrectly estimated the cost of compliance at $1 billion in its first year and NewsBusters questioned if the government should have any role in mandating that companies disclose nutritional information to the public.

    In reality, the actual ACA rule requires restaurant chains with 20 or more locations to display the calorie counts of all standard menu items, and has exceptions for temporary items. When the Food and Drug Administration (FDA) published its food labeling standards in November 2014, it estimated that the industry-wide costs would be roughly $1 billion over a 20 year period -- a sum that pales in comparison to the $767 million profit Domino’s earned in 2016 alone. Overall, the FDA estimated that the benefits of Americans eating healthier because of the additional nutritional information would exceed the total cost of implementation by over $8 billion:

    Reisch’s claim that the rule would be too costly loses steam in light of the FDA’s findings but it is even more bizarre considering he admitted that Domino’s already has this information and posts the calorie counts of its pizzas and toppings online. On April 17, MarketWatch reported that pizza companies are opposed to displaying calorie counts on menus even though “Americans are paying more attention to food ingredients” and polling showed up to 68 percent want chain restaurants to post calorie information. On her Food Politics blog, nutrition and public health professor Marion Nestle pointed out that the fierce pushback against posting calories on menus, regardless of the low cost and outsize health benefits, shows that these companies “would rather you did not have this information.” This attitude makes it that much more important for government to protect consumers access to this knowledge.

  • This Kentucky Paper Shows How To Cover Draconian Medicaid Changes Across The U.S.

    Blog ››› ››› CAT DUFFY

    Kentucky’s Courier-Journal led the way in reporting on Republican Gov. Matt Bevin’s push to fundamentally change the state’s Medicaid program through a waiver request that would implement draconian policies to cut coverage and hurt vulnerable communities. The Courier-Journal’s coverage of the Medicaid waiver highlights some best practices -- such as discussing specific policy impacts and citing local experts and people affected by the proposal -- thus providing a model newspapers in other states with similar proposed changes to Medicaid should emulate.

    In June 2016, Bevin released a Medicaid waiver proposal called Kentucky HEALTH, which included a series of draconian policies that would gut the state’s existing Medicaid program. Bevin’s waiver has been soundly criticized by experts who emphasize that it would create barriers to obtaining coverage, decrease the use of key preventive services, and harm the overall health of Kentucky’s Medicaid population. Work requirements in particular have been criticized as poor-shaming, since the majority of Medicaid recipients come from working homes and such a policy has never been approved in the entire history of the program.

    However, the election of President Donald Trump and the installation of new leadership at the Department of Health and Human Services mean a new openness to previously rejected policies like work requirements. This shift has spurred a couple other Republican-led states -- Wisconsin and Florida -- to explore the possibility of obtaining waivers so they can include policies like mandatory drug testing and work requirements, a trend that could negatively impact Medicaid beneficiaries across the country.

    The Courier-Journal’s coverage of Bevin’s proposal models the best practices for state-level reporting on attempts to impose cruel restrictions on Medicaid programs -- a model that other outlets should adopt as more state legislatures attempt to enact radical reforms. Here’s what The Courier-Journal did correctly, and the one thing the paper could have improved on:

    1. Discuss Specific Policies Within Medicaid Waiver Proposals And Outline Their Impact On Local Public Health Issues

    The Courier-Journal consistently reported on the specific policies Bevin included in his Kentucky HEALTH proposal, not just generalities about the waiver, and highlighted the impact these changes would have on the citizens of Kentucky. A Media Matters study of the paper’s coverage showed that the majority of its reporting clearly outlined the major policies included in Kentucky HEALTH such as the requirement that “most ‘able-bodied working age’ adults … put in up to 20 hours a week working” or volunteering, the provision to “charge premiums for coverage that is now largely free,” and the elimination of “dental and vision benefits from basic Medicaid coverage.”

    Additionally, The Courier-Journal analyzed how the specific policies would impact Kentucky’s Medicaid beneficiaries. Reporting highlighted the impact the waiver would have on the detection of diabetes -- a huge public health issue in Kentucky -- and the negative impacts on public health of eliminating dental and vision benefits.

    2. Include Information On Public Hearings And Information Sessions -- Opportunities For Citizens To Make Their Voice Heard On Medicaid Proposals

    The Courier-Journal consistently included information on the timing and location of public hearings and other opportunities for citizens to express their views. After Bevin revealed his Kentucky HEALTH proposal, there was a public comment process, in which Kentucky’s Department for Medicaid Services held a series of public hearings and accepted comments from residents. The Courier-Journal outlined how to get more information on the proposal and public hearings, including the dates, times, and locations. As the backlash over the GOP’s American Health Care Act illustrated, when people show up it forces politicians to listen.

    3. Seek Out Testimony From Local Experts And Individuals Impacted By The Medicaid Proposals

    The Courier-Journal bolstered its comprehensive reporting by citing local experts and interviewing individuals who would be impacted by Bevin’s proposal. The Courier-Journal received comments from health care experts like Bill Wagner, the executive director of Family Health Centers, and public health advocates like Sheila Schuster and Emily Beauregard of Kentucky Voices for Health. Articles cited feedback from Kentucky doctors and health care organizations that identified the grave public health problems posed by Bevin’s proposed changes.

    The newspaper also contextualized its reporting by including testimony from individuals who had personal experience with Kentucky’s Medicaid program or would be impacted by the proposal. This type of reporting humanizes public policy debates and provides concrete examples of the consequences of such drastic changes.

    4. Contextualize Proposed Changes To The State’s Existing Medicaid Program

    The Courier-Journal consistently included information on the massive gains in health care coverage achieved by the ACA-facilitated Kentucky Medicaid expansion in its reporting on Bevin’s proposal, which is essential to properly contextualize the policy discussion. Medicaid expansion in Kentucky dramatically increased access to health care for vulnerable communities, aided in the fight against the opioid epidemic, and improved public health through increased use of preventive services. It is important for newspapers to ground their reporting on potential changes to Medicaid in the context of how Medicaid expansion affected public health -- particularly given the false claims propagated by Bevin and his officials about Medicaid’s stability.

    But There’s Still Room For Improvement -- Outlets Must Clarify When Proposals Address Nonexistent Problems

    The Courier-Journal set the gold standard for reporting on state-based attempts to gut Medicaid programs in Kentucky, but there is still room for improvement. The paper largely failed to note that Bevin’s proposed work requirement is a solution in search of a problem. Work requirements operate under the false assumption that programs like Medicaid undermine individual work ethic when in reality, the majority of Kentuckians who gained insurance under the Medicaid expansion were low-wage workers. The Kaiser Family Foundation noted that, nationwide, “nearly 8 in 10” Medicaid-enrolled adults “live in working families, and a majority are working themselves.” Only two of the newspaper’s articles mentioned that the majority of the state’s Medicaid beneficiaries have jobs.

    Right-wing media and politicians like Bevin often demonize Medicaid and push work requirements as a mechanism for fostering personal responsibility and forcing people to have “skin in the game.” Similarly, Wisconsin just released a waiver proposal that would institute mandatory drug testing for Medicaid beneficiaries, which reinforces stigmatizing stereotypes rather than helping actual substance abusers. It is incumbent on news outlets to contextualize proposals to change Medicaid by identifying the actual problems they purport to solve -- and noting when they’re merely right-wing fictions.

    Graphics by Sarah Wasko. 

  • Top Kentucky Newspapers Consistently Reported On The Substance And Impact Of Kentucky's Medicaid Waiver

    ››› ››› CAT DUFFY

    A Media Matters analysis of the top two Kentucky newspapers’ coverage of an effort to radically alter the state's Medicaid program found that while both substantively covered the changes and impacts, The Courier-Journal led the way in in-depth reporting on the impacts of a Medicaid waiver on the state. The waiver request submitted by Gov. Matt Bevin included instituting draconian policies like a work requirement and mandated monthly premiums.

  • Kansas Nightly News Fails To Educate The Public About The Medicaid Expansion 

    ››› ››› CAT DUFFY

    A Media Matters study of broadcast TV coverage in the Kansas City market found that NBC, ABC, CBS, and Fox collectively spent less than eight minutes over a 43-day period covering the state legislature’s debates over the proposal to accept the Affordable Care Act’s Medicaid expansion, which would extend coverage to more than 150,000 Kansans. 

  • Obamacare Repeal And The Myth Of Trump As The "Great Negotiator"

    Blog ››› ››› MEDIA MATTERS STAFF

    Before House Republicans and President Donald Trump were forced to pull the American Health Care Act (AHCA), their ill-fated first attempt to gut health care reform and repeal the Affordable Care Act (ACA), media repeatedly trumpeted Trump's supposed ability to get the bill passed because of his mastery of the "Art of the Deal." Here's a look back at how they described the "great negotiator," which was "the whole point of Trump":

  • The GOP Health Care Bill Actually Does What Conservatives Said Obamacare Would Do -- And Worse

    Blog ››› ››› CAT DUFFY

    Speaker of the House Paul Ryan (R-WI) scheduled the vote on the Republican health care bill, the American Health Care Act (AHCA), on the seventh anniversary of the passage of the Affordable Care Act (ACA), also known as Obamacare. Despite seven years of Republicans pledging to repeal and replace the ACA, all they’ve managed to come up with is a bill that is the manifestation of some of the worst myths and baseless critiques that right-wing media leveled against the ACA.

    The Republican Party introduced their health care bill earlier this month. The proposed legislation severely cuts Medicaid, reduces tax credits while giving a massive tax cut to the wealthy, and dramatically increases the number of uninsured Americans, effectively erasing the gains made by the ACA. While right-wing media has spent the better part of a decade demonizing the ACA, three of their biggest myths -- allegations that the ACA hurts seniors, that Democrats rammed the law through Congress, and the never-ending predictions of a “death spiral” -- are actually valid criticisms of the GOP health care law.

    The most famous right-wing media myth surrounding the ACA is the death panel -- the false allegation that the ACA created a panel of government bureaucrats that would ration health care for the elderly. PolitiFact dubbed the falsehood the “Lie of the Year” in 2009. However, right-wing media figures continued to push the myth for years. The specter of a death panel that might euthanize a grandmother fit into right-wing media’s narrative that the ACA would hurt seniors. Conservative media figures forwarded a variety of lies about how Obamacare was “sticking it to the seniors,” ranging from assertions that the ACA’s medical tax would apply to wheelchairs (it doesn’t) to false allegations that the law eviscerated Medicare by raiding its funding.

    In reality, the ACA improved senior care by reducing prescription drug costs for the elderly and extending coverage to key services. The ACA improved access to care by increasing Medicare payments for primary services and instituted crucial protections to improve the “quality and coordination of care.” The health care law also extended the solvency of Medicare by over 10 years, after which “payroll taxes and other revenue will still cover 87 percent of Medicare hospital insurance costs.”

    The AHCA, on the other hand, worsens the health care outlook for seniors. The bill loosens the age-rating protections that limit how much insurers can charge seniors, allowing them to discriminate against the elderly by charging them five times more than younger individuals. While allowing insurers to jack up premiums for the elderly, the AHCA also provides substantially less generous tax credits for purchasing health care, likely far below what would be needed to purchase comprehensive coverage. This disproportionately hurts working-class seniors. According to Vox, a 64-year-old who makes $26,500 a year will see “more than a 750 percent increase in premiums from Obamacare to the Republican bill.” As The Atlantic’s Vann Newkirk explained, “proportionally, the group of people that would see the most coverage losses under the AHCA is the population of people aged 50 and older.” And while the ACA increased Medicare’s solvency, the AHCA repeals the Medicare payroll surtax on the wealthy, which will “weaken Medicare’s financial status” by depleting its funding “three years sooner than under current law,” according to the Kaiser Family Foundation. Essentially, despite right-wing media having pushed the image of seniors as one of Obamacare’s main victims, it is actually the Republican health law that actively worsens access to health care while increasing costs for the elderly (just ask the AARP). 

    Another anti-Obamacare talking point featured conservative media figures decrying the allegedly undemocratic process by which Congress passed the ACA, claiming that Democrats were trying to “ram it down America’s throat.” Right-wing media took then-Speaker of the House Nancy Pelosi’s (D-CA) comment “we have to pass the bill so that you can find out what is in it” at the National Association of Counties out of context, to scandalize the health law as a secretive, closed door deal.

    Despite the rampant right-wing smears, the debate over the ACA was “one of the most transparent” in recent history, as Congress debated the legislation for over a year before it was signed into law. The full context of Pelosi’s now notorious speech reveals that her comment was about the need to have conversations about the substance of the ACA outside of the “fog of the controversy,” because negative talking points dominated the discussions of the law.

    The clear differences between the legislative processes for the ACA and the GOP health care bill lays bare right-wing media’s hypocrisy. As Politico’s Dan Diamond noted, “in 2009, Dems took 119 days between introducing [the] bill [and] taking a floor vote,” while “in 2017, [the] GOP will do it in 17 days.” The GOP has pledged to hold a vote on the bill in the House on March 23, despite the fact that the CBO has not finished scoring the substantial amendments released this week. Topher Spiro, the Center for American Progress’ Vice President for Health Policy, highlighted the hypocrisy, pointing out “Republicans *literally* have to pass the bill to find out what it does,” since it is highly likely there would be “no CBO score before the vote.” Instead of defending the democratic process they found so dear in 2009, conservative media figures portrayed the AHCA’s passage as inevitable and allowed guests to insist that the Republicans are using “regular order” to normalize the rush to pass the disastrous bill. The hypocritical treatment of these starkly contrasting legislative processes illustrates how right-wing media fealty to democratic norms only exists when it furthers their own narratives.

    The third manifestation of conservative hypocrisy on health care stems from right-wing media’s continued predictions over the last seven years about the possible collapse of the Affordable Care Act’s insurance markets into a death spiral. Conservative outlets claimed the law was in a death spiral each time premiums increased, when Aetna withdrew from the exchanges, when they alleged there weren’t enough healthy enrollees, and when some of the co-ops failed. None of these alleged death spirals were real -- in fact, the newest CBO report confirms the ACA is not collapsing and will continue to stabilize, despite claims to the contrary.

    By eliminating the individual mandate and replacing it with a much weaker “continuous coverage” requirement, the AHCA seriously risks a death spiral because it “could have the unintended consequence of discouraging healthy people from buying coverage.” Whereas the ACA’s individual mandate incentivizes purchasing insurance to avoid a penalty, under the continuous coverage requirement a healthy uninsured individual is likely to wait until they are sick to join the market, massively increasing costs. The Century Foundation outlined how the AHCA could result in a death spiral because coverage losses and cuts in financial assistance will result in few healthy enrollees. Families USA noted that the only way the AHCA creates stable markets is “by making it nearly impossible for older adults and the sick to find affordable coverage, leaving only the healthy or wealthy in the market.” While the predictions of the ACA’s demise have been greatly exaggerated, the Republican health law might actually lead to the death spiral right-wing media have long been hyping.

    The false claims right-wing media have made over time about the ACA highlight only a few of the ways in which the AHCA would devastate the American health care system. The AHCA pays for a $600 billion tax cut for the wealthy by cutting Medicaid -- the program that provides essential health care for the disabled, the elderly, and low-income communities -- by 25 percent. The newest reported proposal to eliminate the ACA’s essential health benefits package will gut access to substance abuse treatment for victims of the opioid epidemic and likely increase costs for women as insurers can drop maternity coverage. By defunding Planned Parenthood, the AHCA will deprive many low-income communities of their only safety-net health center and result in thousands of additional births per year. If the law passes -- despite the apparent cancellation of the first scheduled attempt -- the AHCA could create the apocalyptic fantasy right-wing media desperately sought to find in the ACA.

    *Image by Sarah Wasko

  • How Conservatives Smeared Obamacare And Laid The Groundwork For Trumpcare

    ››› ››› JULIE ALDERMAN

    For over seven years, right-wing media have launched an assault on the Affordable Care Act (ACA) -- a law that has yielded great gains in the economy and public health, especially for the most vulnerable -- pushing multiple myths and false claims about the law. On the law’s seventh anniversary, Republicans hoped to repeal the ACA and pass the American Health Care Act (AHCA), which contains a wish list of harmful conservative media-backed policies.

  • TV News Coverage Of Trump’s Policies Overwhelmed By His Wiretapping Lie

    Blog ››› ››› ALEX MORASH

    Broadcast and cable news coverage of ruinous economic policies rolled out by the White House last week was overwhelmed by the president’s false accusation that his predecessor illegally wiretapped Trump Tower during the 2016 election.

    On March 13, the Congressional Budget Office (CBO) reported that up to 24 million Americans would lose access to health insurance over the next 10 years if the Republican plan to repeal and replace Obamacare goes into effect. On that same day, the Trump administration unveiled an overlooked executive order that encourages cabinet secretaries and agency directors to create a plan to completely reshape a federal bureaucracy of over 2.8 million employees. And on March 16, the Trump administration unveiled its budget outline for the 2018 fiscal year, featuring proposed “massive cuts” to nondefense spending. The proposed cuts, which would offset an increase in spending on military programs and a border wall, would hit almost every facet of the federal government, but they would come down particularly hard on funding for small programs including Meals on Wheels, the Corporation for Public Broadcasting, and PBS.

    Yet according to Media Matters research, from March 13 to 17, President Donald Trump’s false wiretap claim dominated TV news coverage, overshadowing discussion of these important policy moves. While Trump’s lie certainly merits extensive media coverage, it’s also crucial to share details of his policymaking with the public.

    Trump ignited a media firestorm in early March when he repeatedly accused former President Barack Obama of illegally wiretapping him in the midst of last year's election. Right-wing media, led by Fox News, sprang to his defense even though the president offered no evidence to support his claim. Meanwhile, legitimate reporters exposed the bizarre accusation’s source as “the right-wing fever swamps” of fringe media and reported that it was pushed by a Russian state-sponsored news network. During March 20 testimony before the House Intelligence Committee, FBI Director James Comey put Trump’s wiretapping lie to rest, telling the committee, “I have no information that supports those tweets.”

    Yet nearly two weeks after Trump initially made the claim, his smear of Obama still had such an influence on television news coverage that it overshadowed every other discussion about Trump’s policy agenda last week. Media Matters identified 226 segments from March 13 through 17 that focused on Trump during evening programming on CNN, Fox News, and MSNBC and major news programs on ABC, CBS, NBC, and PBS. Of those segments, 64 focused on Trump’s wiretapping allegations -- a figure that dwarfed every other major issue Media Matters identified. Coverage of Trump’s health care plan came in a distant second place, with 37 segments, and stories related to the portion of Trump’s 2005 tax returns obtained by Rachel Maddow ranked third (26 segments). Trump’s proposed budget outline was discussed in just 14 segments, and his executive order to reshape the federal workforce registered just four mentions.

    With television news forced to dissect and debunk Trump’s outrageous claims, coverage of pressing economic issues was eclipsed. Coverage of the efforts to repeal the Affordable Care Act -- which health care experts have said would be particularly harmful to low-income Americans, seniors, and people dealing with illnesses -- could not overtake that of Trump’s wiretapping tweet, even with the Trump administration attempting to smear the CBO numbers in the press. The executive order, which was described by CNN reporter Stephen Collinson as part of Trump’s larger goal to “dismember government one dollar at a time,” barely registered in news coverage at all. And Trump’s budget cuts, which would decimate social safety net programs, were discussed 14 times during evening news coverage on March 16 and 17, while Trump’s lie about wiretapping was discussed 35 times on those two days.

    Trump’s promotion of a discredited lie accusing his predecessor of illegal conduct while in office merits extensive media coverage, but the policies he has enacted or plans to enact can be just as destructive as the misinformation he spreads. Media cannot afford to let Trump's misleading claims dominate the news cycle, drowning out crucial coverage of the pain his policies may cause the United States.

    Methodology

    Media Matters conducted a Nexis search of transcripts of evening news programming (defined as 6 p.m. through 11 p.m.) on CNN, Fox News, and MSNBC, as well as the major news programs on ABC, CBS, NBC and PBS, from March 13, 2017, through March 17, 2017. We identified and reviewed all segments that included any of the following keywords: Trump or executive order or federal government or federal employ! or federal worker or federal workers or civil service or government workers or government worker or federal government or budget.

    The following programs were included in the data: ABC's World News Tonight, CBS' Evening News, NBC's Nightly News, and PBS' NewsHour, as well as CNN's The Situation Room, Erin Burnett OutFront, Anderson Cooper 360, and CNN Tonight, Fox News' Special Report, The First 100 Days, Tucker Carlson Tonight, The O'Reilly Factor, and Hannity, and MSNBC's For The Record, Hardball, All In with Chris Hayes, The Rachel Maddow Show, and The Last Word With Lawrence O'Donnell. For shows that air reruns, only the first airing was included in data retrieval. This survey includes CNN’s second live hour of Anderson Cooper 360 during the 9 p.m. to 10 p.m. time slot.

    For this study, Media Matters included only those segments that contained substantial discussions of Donald Trump. We defined a "substantial discussion" as any segment where a host dedicates a monologue, or portion of a monologue, to Trump, his activities, or the policies he is pursuing as president of the United States, or any segment where two or more guests discuss Trump, his activities, or the policies he is pursuing as president of the United States. We did not include teasers or clips of news events, or rebroadcasts of news packages that were already counted when they first aired in the 6 p.m. to 11 p.m. survey window.

  • STUDY: Major North Carolina Newspapers Largely Failed To Report On The Devastating Impacts Of The GOP Health Bill

    ››› ››› CAT DUFFY

    Three of the top North Carolina newspapers largely failed to explain the major impacts of the proposed Republican health care bill, the American Health Care Act (AHCA). A Media Matters analysis of originally reported articles about the bill in the Winston-Salem Journal, The News & Observer, and The Charlotte Observer found little to no mention of its impact on women and minority communities, insufficient reporting on its impact on seniors, and minimal coverage of its hidden, massive tax breaks for the wealthy.

  • Experts Explain How GOP Repeal Of The ACA Will Hurt Americans

    ››› ››› CAT DUFFY

    Cable networks have hosted a variety of health care experts to discuss the negative impact that the Republican health care bill and repeal of the Affordable Care Act (ACA) will have on different aspects of the American health care system, including coverage, health care costs, Medicaid, and women’s health care.