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Health Care Reform

Issues ››› Health Care Reform
  • Five guidelines for reporting on Trump's sabotage of health care subsidies

    News media face a challenge as Trump rescinds subsidies for millions of working-class Americans

    Blog ››› ››› JULIE ALDERMAN


    Sarah Wasko / Media Matters

    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 problematicexperts” 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:

    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.

  • Local TV coverage of Graham-Cassidy largely overlooked some of its scariest flaws

    Cuts to Medicaid were more likely to be mentioned, but effects felt by many disadvantaged communities were neglected

    Blog ››› ››› CRAIG HARRINGTON & JULIE ALDERMAN


    Sarah Wasko / Media Matters

    Evening news coverage in several crucial local television markets failed to adequately convey the ramifications of the so-called “Graham-Cassidy” health care plan, the latest Republican attempt to repeal the Affordable Care Act (ACA). A majority of local news coverage last week in the selected markets focused on GOP attempts to wrangle support for the pending legislation with few, if any, significant mentions of how the bill would affect residents.

    Media Matters analyzed local television coverage of the Graham-Cassidy bill between September 18 and 22 in five major markets represented by Republican senators -- Lisa Murkowski (R-AK), John McCain (R-AZ), Susan Collins (R-ME), Rob Portman (R-OH), and Shelley Moore Capito (R-WV) -- who, at the time, had not yet committed their votes for or against the legislation (McCain and Collins have since said they could not support the legislation). According to this analysis, local affiliates of ABC, CBS, Fox Broadcasting, and NBC in the selected markets aired a total of 43 segments about the legislation during their evening newscasts, but much of the coverage involved little substance:

    • The loss of ACA guarantees for coverage of essential health benefits (EHBs) was mentioned zero times.
    • Graham-Cassidy proposals specifically targeting Planned Parenthood were mentioned just three times, while the legislation’s disproportionate impact on women was mentioned just once.
    • The disproportionate impact of Graham-Cassidy on low-income Americans was mentioned just three times.
    • Predicted insurance premium spikes resulting from Graham-Cassidy were mentioned just two times.
    • Projected insurance coverage losses for millions of Americans were mentioned just seven times.
    • The loss of ACA protections for Americans with pre-existing health conditions was mentioned just nine times.
    • Projected cuts and restrictions to the Medicaid program were mentioned just 19 times across 43 segments.

    Dangerous Medicaid cuts, insurance losses underreported

    Of the 43 total segments across all five markets, just 19 -- roughly 44 percent -- mentioned that  the Graham-Cassidy proposal to convert Medicaid funding into federal block grants while rolling back the ACA’s expansion of the program would result in significant benefit cuts for millions of Americans. According to a September 20 analysis from the Center on Budget and Policy Priorities (CBPP), the steep cuts Graham-Cassidy would make to Medicaid in 2027 make the bill “likely [to] be even more damaging” than simply repealing the ACA in full would.

    According to a January 2017 report from the Congressional Budget Office (CBO), completely repealing the ACA’s individual insurance mandate, its expansion of Medicaid, and its provision of tax credits for individual insurance market customers would result in 32 million fewer people having insurance by 2026. Graham-Cassidy promises to do all three, which is why a September 20 analysis from the Center for American Progress predicted insurance losses of 32 million by 2026 should the bill become law. Unfortunately, this staggering reversal of Obama-era insurance gains was mentioned only seven times by qualifying local news coverage -- roughly 16 percent of segments.

    Loss of protections for pre-existing conditions, essential health benefits

    Of the 43 segments included in this analysis, just nine -- roughly 21 percent -- mentioned that  the Graham-Cassidy proposal would weaken ACA protections serving millions of Americans living with pre-existing health conditions. As Larry Levitt of the Kaiser Family Foundation (KFF) explained to Axios, though Graham-Cassidy does not completely repeal ACA rules regarding pre-existing conditions, "they might end up only existing on paper." The bill would replace ACA protections against charging higher premiums to customers with existing medical problems with language that professors told PolitiFact is " vague and subject to broad interpretation.” A new draft of the bill issued over the weekend includes even more “weakened protections for people with pre-existing conditions,” wrote Los Angeles Times columnist Michael Hiltzik. As Hiltzik explained, the previous draft “would have allowed states to apply for a waiver of federal rules” regarding individuals with pre-existing conditions, while the newest draft “doesn’t even require a waiver” to skirt the requirements.

    None of the segments reviewed for this analysis mentioned that Graham-Cassidy proposes to roll back essential health benefits (EHBs) enshrined by the ACA, by letting states opt out of requiring insurers to cover some particularly costly health care products. As FamiliesUSA explained in a June 27 blog, hollowing out these insurance requirements would be detrimental to millions of Americans who currently need or may one day seek treatment for mental health and substance abuse disorders or require prenatal and maternity care. By rescinding EHB guarantees, Graham-Cassidy “would be a return to the days before the ACA” when “millions of people purchasing coverage on their own couldn’t get coverage for critical care,”including maternity care, ambulatory care, and hospitalization.

    Low-income families, the elderly, people with disabilities and mental health concerns

    Local TV coverage often neglected the disastrous effects of Graham-Cassidy’s Medicaid cuts on low-income communities that are served by the program. Just three segments (7 percent) mentioned that the law would harm low-income Americans by rolling back the ACA’s expansion of Medicaid benefits to “poor, working-age adults, a population traditionally not eligible for coverage.” As CBPP noted in its breakdown of the legislation, individual states would face “no requirement to offer low- and moderate-income people coverage or financial assistance.” Indeed, the toll Graham-Cassidy would have on working- and middle-class Americans is particularly harsh given that the legislation is also expected to result in a spike in insurance premiums -- a fact mentioned just twice in 43 segments.

    Graham-Cassidy’s disturbing impact on older Americans merited only four mentions -- in just over 9 percent of segments -- despite concerns voiced by the AARP that the bill “would result in an age tax for older Americans who would see their health care costs increase” as a result of the loss of consumer protections surrounding EHBs and pre-existing conditions.

    At the same time, the impact of the legislation on the tens of millions of Americans living with a disability was virtually absent from local coverage of Graham-Cassidy, and the legislation’s harmful effects on people dealing with mental illness was entirely neglected. Just one segment out of 43 mentioned that Graham-Cassidy would harm people with disabilities by restricting programs they rely on, such as Medicaid, and removing protections they have under current law. The harmful effects the law would have on health care providers and patients dealing with mental illness were never mentioned.

    Graham-Cassidy’s impact on women’s health overlooked

    Just three of 43 segments mentioned that the Graham-Cassidy legislation would freeze federal funding for Planned Parenthood. According to Stats, the law “effectively defunds Planned Parenthood by prohibiting Medicaid reimbursements to organizations that meet a narrow description” clearly intended to target Planned Parenthood. Planned Parenthood is a comprehensive national health care provider that disproportionately serves low-income women, but which is misleadingly portrayed as, at best, nothing more than an abortion clinic and, at worst, a criminal enterprise.

    In addition to the financial hit to Planned Parenthood, which right-wing opponents erroneously claim can be replaced by other community health centers, a Washington Post review of the legislation revealed that Graham-Cassidy is actually designed to impose a backdoor ban on constitutionally protected rights to an abortion. The legislation as currently proposed would begin funneling tax credits for individual market insurance plans through the Children’s Health Insurance Program (CHIP) in 2021, making the money subject to the Hyde amendment, “which prohibits taxpayer funds from paying for abortions except in cases of rape, incest or if the woman’s life is at stake.”

    In addition to the restrictions Graham-Cassidy would impose on reproductive health care, the bill also limits ACA-enshrined protections for maternity care and contraceptive coverage, thereby increasing the cost burden for women who wish to prevent, maintain, or terminate a pregnancy. Despite the fact that Graham-Cassidy seems uniquely designed to harm women’s health, local TV news mentioned the disproportionate impact it would have on American women only once during the survey period.

    Impact on minority communities

    Local coverage of the Graham-Cassidy proposal failed entirely when discussing how the law would negatively affect minority communities if enacted. According to data compiled by the Centers for Disease Control and Prevention (CDC), while roughly 21 percent of all Americans rely on Medicaid as their primary form of health insurance, the number spikes to over 34 percent for Native Americans and Native Hawaiians or Pacific Islanders, over 33 percent for African-Americans, and over 30 percent for Hispanic Americans. Given their increased reliance on Medicaid, minority communities are among several disadvantaged groups that are particularly ill-equipped to handle additional cuts to the program.

    Furthermore, by eliminating protections for people with pre-existing conditions, the legislation would leave many minority communities at the mercy of massive premium increases in an unregulated insurance marketplace. Due to a confluence of environmental factors, some of the “health disparities affecting people of color” include increased susceptibility to cancer, heart disease, HIV/AIDS, diabetes, osteoporosis, and other ailments.

    A tax giveaway to the wealthy

    Another aspect of the Graham-Cassidy bill that went unmentioned during the survey period was that Graham-Cassidy’s proposed expansion of the existing health savings account (HSA) model is effectively a tax giveaway to wealthier Americans. The legislation would increase the amount of pretax income families and individuals can contribute to HSAs, but it would do nothing for low- and middle-income Americans who already cannot afford to save money. As CBPP vice president Edwin Park noted in a November 2016 takedown of GOP proposals to expand HSAs, such a plan “would mostly help wealthy, not uninsured” people. Economist Kathryn Phillips further elaborated in a December blog for Health Affairs that HSAs “primarily benefit the wealthy, the healthy, and the educated” by providing a savings vehicle to tackle modest expenses. Additionally, KFF found in 2006, when the GOP was vetting a major health care overhaul during the Bush administration, that HSAs can increase out-of-pocket costs for “people with chronic conditions, disabilities, and others with high-cost medical needs” and would do nothing to increase coverage among the uninsured.

    Methodology

    Media Matters used iQ media to search evening newscasts (airing at 9 p.m., 10 p.m., or 11 p.m.) from local affiliates of ABC, CBS, Fox Broadcasting, and NBC in Anchorage, AK; Cincinnati, OH; Charleston, WV; Phoenix, AZ; and Portland, ME for segments that aired between September 18 and 22 about Graham-Cassidy. The markets included were either the largest television market in the selected states or, in the case of Cincinnati, a large market where Sen. Portman lives. We identified and reviewed all segments that included one or more the following words or phrases: Graham, Cassidy, Senate health, GOP health, Republican health, Affordable Care Act, ACA, Obama care, Obamacare. Segments were then coded for mentions of the following issues regarding Graham-Cassidy:

    • cuts to Medicaid;
    • increase in uninsured people;
    • impact on the elderly;
    • impact on minority communities;
    • impact on low-income people;
    • impact on disabled people;
    • impact on women;
    • increase in reliance on health savings accounts (HSAs);
    • increase in premiums;
    • potential rollback of essential health benefits (EHBs);
    • impact on people with pre-existing conditions;
    • freeze in Medicaid funding for Planned Parenthood;
    • impact on mental health care;
    • impact on addiction care; and
    • impact on rural hospitals.

    We also coded for mentions that:

    • HSAs primarily help the wealthiest and/or do nothing to help low-income or uninsured people; and
    • a bipartisan group of governors criticized the bill in a September 18 letter.
  • How GOP leaders are using TV to misinform the public about the potential health care repeal

    Interviews with Graham-Cassidy supporters spread misinformation, devolve into misleading deflection

    Blog ››› ››› CRAIG HARRINGTON


    Sarah Wasko / Media Matters

    Republican senators took to the airwaves this week to shore up support for the so-called “Graham-Cassidy” health care bill, the latest GOP proposal that aims to dismantle much of the Affordable Care Act (ACA) with a series of proposals adopted from previously failed legislation. The often contentious interviews frequently devolved into stonewalling and deflection when reporters pressed lawmakers for answers about the ways the legislation would affect tens of millions of Americans who rely on programs such as Medicaid, live with pre-existing medical conditions, or have gained coverage under the ACA.

    Republican lawmakers have attempted to build support for the latest attempt to repeal and replace the ACA, which is in jeopardy of collapse amid reports that Sen. John McCain (R-AZ) is opposed to the bill, by once again recycling worn-out myths about the Obama-era health care reform law and spreading falsehoods about the proposed legislation. With Republicans set to appear on the Sunday morning political shows this weekend to build support for the bill, which many lawmakers seem to know little about, their refusal to engage in a factual debate about the legislation should be a red flag for the journalists conducting those interviews.

    Sen. Bill Cassidy

    During September 20 appearances on CNN’s New Day and MSNBC’s Morning Joe, Sen. Bill Cassidy (R-LA) spread several falsehoods about the health care repeal legislation that bears his name. (He spread much of the same misinformation from the friendly confines of Fox News, where he was allowed to push his talking points completely unchallenged.) During his CNN and MSNBC appearances, Cassidy falsely claimed the proposal would result in more people getting health insurance coverage and asserted that the new bill protects the tens of millions of Americans living with pre-existing medical conditions. When CNN’s Chris Cuomo pressed Cassidy to provide proof of his claims, Cassidy pivoted to attack the ACA’s individual insurance mandate. And when MSNBC contributor Mike Barnicle confronted him about coverage cuts for “low-income seniors, children, and people with disabilities,” Cassidy evaded the question while claiming that his bill would simply reroute money currently allocated to those groups through the existing Children’s Health Insurance Program (CHIP):

    In reality, the Center for American Progress, Center on Budget and Policy Priorities (CBPP), and The Commonwealth Fund each reported that, according to previous estimates from the Congressional Budget Office (CBO), the Graham-Cassidy proposal to end private market health insurance tax credits, along with its severe cuts to Medicaid and rollback of the ACA’s Medicaid expansion, would result in 32 million people losing health insurance over the next decade. And as Larry Levitt of the Kaiser Family Foundation explained to Axios, though the Graham-Cassidy bill would not repeal the ACA's rules about pre-existing conditions, "they might end up only existing on paper." That's because, as PolitiFact has also noted, the bill removes ACA protections against charging higher premiums to customers with existing medical problems and the language about pre-existing conditions "is vague and subject to broad interpretation.”

    Sen. Lindsey Graham

    During a September 20 appearance on Fox News’ Fox & Friends, Sen. Lindsey Graham (R-SC) emphasized the supposed need to pass his health care agenda because “Obamacare is collapsing around us.” Graham also asserted that under the ACA, “access to health care is going down” nationwide:

    Graham’s claim that the ACA “is collapsing” echoes years of conservative smears about the law, which exaggerate any hiccup in the implementation of ACA reforms as proof of an impendingdeath spiral.” In reality, the insurance marketplaces established by the law have stabilized considerably over the past year, and lingering issues are largely the result of Republican sabotage, not a failure of the ACA. Graham’s additional claim that the newest GOP bill is a solution to reduced health care access could not be further from the truth: The number of uninsured Americans reached an all-time low in 2016 before the Trump administration launched its efforts to dismantle the ACA and, as previously noted, Graham’s bill would strip insurance from millions of Americans.

    Sen. Ron Johnson

    During a September 19 interview on CNN’s New Day, bill co-sponsor Sen. Ron Johnson (R-WI) bemoaned health care reforms instituted by the ACA, which he called “Washington, D.C.’s one-size-fits-all model” for health care coverage. Johnson reiterated his support for the proposal in the Graham-Cassidy bill to convert ACA revenue into block grants to states, which he claimed would be “far more responsive to their citizens than Washington, D.C., will.” Co-host Alisyn Camerota largely let Johnson push his talking points unchecked, and she seemed more interested in Johnson’s plan to recruit additional Republican supporters than with the ways the legislation would affect millions of Americans:

    Johnson approached his September 21 interview on MSNBC’s Morning Joe with a similar strategy, stressing that Graham-Cassidy would help states be more responsive to their citizens and deflecting questions about concerns from several Republican governors that the bill’s Medicaid cuts will devastate low-income communities. When co-host Willie Geist pressed Johnson about whether some Medicaid recipients would be “denied coverage they have now” by Graham-Cassidy’s rollback of the program, Johnson again deflected those concerns and suggested the problem could be avoided if governors “manage their programs properly”:

    In fact, according to CBPP, any proposal to convert federal Medicaid funding into a block grant system would inevitably lead to major funding cuts and program restrictions. CBPP estimated that millions of Americans would lose Medicaid coverage from the block grant system proposed by Graham-Cassidy, a concern shared by the bipartisan group of governors opposed to the bill.

    Sen. John Barrasso

    On the September 19 edition of MSNBC’s MTP Daily, Sen. John Barrasso (R-WY) falsely claimed that Medicaid had “failed” as a result of ACA reforms and argued that the program insuring low-income Americans is unpopular with patients. (Host Katy Tur, however, correctly noted that Medicaid is extremely popular.) Barrasso also asserted that “this bill protects everyone with a pre-existing condition” and smeared ACA patient protections requiring insurance plans to cover essential health benefits (EHBs), which protect consumers from inadequate plans. When Tur pressed him to provide support for his claims, Barrasso simply talked over her repeated inquiries while reiterating the same talking points:

    On the September 20 edition of CNN Newsroom, Barrasso had a less contentious interview with co-hosts John Berman and Poppy Harlow, during which he spread even more misinformation about the Graham-Cassidy plan. Barrasso bizarrely claimed that Graham-Cassidy would not kick millions of people off their plans, but would instead empower millions to drop coverage with “the free choice they have as Americans.” He also falsely claimed the Graham-Cassidy bill would result in states “get[ting] more money to deal with” the health care needs of their own residents. A September 20 report from Avalere Health, however, has revealed that the bill would actually “reduce federal funding to states by $215 billion” through 2026, by $489 billion through 2027 when block grants for Medicaid run out, and by a staggering $4 trillion through 2036. In the end, Graham-Cassidy would redistribute billions of dollars from states that enacted ACA provisions to those (like Wyoming) that refused to do so:

    Media Matters research coordinator Julie Alderman contributed to this research

  • “Free Democrat ad”: Right-wing media assail Jimmy Kimmel for criticizing Bill Cassidy’s lies about Obamacare repeal 

    ››› ››› BOBBY LEWIS

    Right-wing media figures attacked Jimmy Kimmel, host of ABC’s Jimmy Kimmel Live!, after Kimmel sharply criticized Sen. Bill Cassidy (R-LA) as having  “lied right to my face” about health care in May. Kimmel pointed out that the Affordable Care Act repeal package Cassidy is co-sponsoring does not protect all children with pre-existing conditions, even though Cassidy told Kimmel he would support only those bills that passed that test. 

  • Seven reasons media shouldn't fall for the latest health care "compromise"

    The latest Obamacare repeal plan rehashes the same unworkable ideas as the others

    Blog ››› ››› JULIE ALDERMAN


    Sarah Wasko / Media Matters

    As the budget reconciliation period draws to a close in the Senate, a handful of Republicans are pushing a last-ditch effort to repeal and replace the Affordable Care Act (ACA), branding their proposal as a “compromise.” While media may be tempted to accept that framing, the proposal is built on the same unworkable, recycled ideas that undermined previous ACA repeal plans.

    Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC) have been shopping a plan, known informally as the Graham-Cassidy health care bill, to repeal and replace the ACA for months. Just last week, Sen. John McCain (R-AZ), one of three Republican senators who voted against the last iteration of ACA repeal, said he would support the Graham-Cassidy bill (but after he reads a draft and if it goes through committee hearings). McCain’s support means the bill has a chance of reaching the 50-vote threshold it would need to pass the Senate under budget reconciliation rules, which expire September 30.

    The Graham-Cassidy effort is largely a regurgitation of the same unworkable solutions Republicans have been putting forward for years. The biggest difference seems to be how the plan’s supporters are selling it. As Vox noted, the Republicans who support the bill “have spent the past two months selling it as a compromise plan” to gain support on Capitol Hill and in the media. Media cannot accept this framing. Here are a few reasons why:

    1. Graham-Cassidy’s Medicaid block grants would increase the number of uninsured and hurt low-income people, the elderly, and the disabled

    2. Graham-Cassidy would repeal the individual and employer mandates, resulting in less coverage and higher premiums

    3. Graham-Cassidy would end ACA subsidies by 2020, leaving many people without affordable coverage options

    4. Graham-Cassidy would allow insurers to make coverage “unaffordable” for seniors

    5. Graham-Cassidy’s reliance on HSAs would hurt people with chronic illnesses and benefit the rich

    6. Graham-Cassidy would allow states to change what qualifies as an essential health benefit, giving insurers “a backdoor way” to discriminate against people with pre-existing conditions

    7. Graham-Cassidy would freeze Medicaid funds to Planned Parenthood, leaving many women without a health care provider

    Graham-Cassidy’s Medicaid block grants would increase the number of uninsured and hurt low-income people, the elderly, and the disabled

    New York magazine reported last month that the Graham-Cassidy plan would “turn both Medicaid expansion and Obamacare-tax-credit money into a block grant for states” and “put a long-term per capita cap on Medicaid.” This same provision was adopted in the American Health Care Act (AHCA), the bill the Republican-led House passed this summer to repeal and replace the ACA.

    Per capita caps on Medicaid funding make as little sense today as they did earlier this summer. Block-granting Medicaid “is not a new or innovative idea,” according to Families USA, but rather "just another way to cut Medicaid.” In a piece for The Washington Post, political scientist Ryan LaRochelle explained that “turning Medicaid into a block grant would result in less funding.” Edwin Park of the Center on Budget and Policy Priorities (CBPP) also pointed out that block-granting Medicaid would “threaten benefits for tens of millions of low-income families, senior citizens, and people with disabilities.”

    Graham-Cassidy would repeal the individual and employer mandates, resulting in less coverage and higher premiums

    Graham-Cassidy, like two previous bills -- the Better Care Reconciliation Act (BCRA) and the Health Care Freedom Act -- that failed in the Senate, would repeal the ACA’s employer mandate, which “requires larger companies to offer affordable coverage to their employees,” The Washington Post reported. The Graham-Cassidy plan also eliminates the ACA’s individual mandate, which the Post noted “requires most Americans to have health coverage or pay a fine.” This proposal was floated earlier this year by Republican members of the House Appropriations Committee.

    Repealing these mandates would have devastating consequences. The Commonwealth Fund found that repealing the individual mandate “would significantly reduce health insurance enrollment and cause individual market premiums to rise.” Additionally, CBPP policy analyst Tara Straw concluded that ending the employer mandate “would erode employer-sponsored insurance and increase the ranks of the uninsured.”

    Graham-Cassidy would end ACA subsidies by 2020, leaving many people without affordable coverage options

    Under the Graham-Cassidy bill, “ACA subsidies would be eliminated” by 2020, according to The Washington Post. This would include ending “cost-sharing reductions” (CSR), which help insurers offset the costs of covering low-income customers, something President Donald Trump has hinted he may do in the near future.

    Ending CSR payments would increase individual market insurance premiums by nearly 20 percent, according to the Kaiser Family Foundation (KFF). And, as CBPP noted, getting rid of these subsidies specifically would “shift additional costs and risks onto states”; “leave low- and moderate-income people with no guarantee of affordable or adequate coverage”; and “create significant near-term uncertainty and disruption in the individual market.”

    Graham-Cassidy would allow insurers to make coverage “unaffordable” for seniors

    The Graham-Cassidy legislation would reinstitute the so-called “age tax,” which, The Washington Post reported, would mean that “insurers would be able to charge older customers up to five times as much as they charge younger customers.” This provision was also included in the Senate health care bill that failed to pass the chamber last month.

    This “age tax” would make coverage “unaffordable” to seniors, according to the American Association of Retired Persons (AARP). An AARP representative told CNBC in June that currently “health care is barely affordable for those people who are over age 50” and cautioned that the “‘age tax’ … would just make it unaffordable for them.” A report AARP published in March found that this “age tax” could cost some older adults over $8,000 per year in premium increases.

    Graham-Cassidy’s reliance on HSAs would hurt people with chronic illnesses and benefit the rich

    Like the Senate health care bill, under the Graham-Cassidy plan, “people can contribute more to their health savings accounts than under the ACA, among other changes making HSAs more attractive,” The Washington Post reported.

    This reliance on health savings accounts (HSAs) would benefit the rich by letting them set aside more pretax income, but would cause harm to low-income people and those with high medical costs who already cannot afford to save money. As CBPP’s Park noted, similar HSA proposals “would mostly help wealthy, not uninsured” people. Economist Kathryn Phillips explained that HSAs “primarily benefit the wealthy, the healthy, and the educated.” Additionally, KFF found that HSAs can increase out-of-pocket costs for “people with chronic conditions, disabilities, and others with high-cost medical needs” and would do nothing to increase coverage among the uninsured.

    Graham-Cassidy would allow states to change what qualifies as an essential health benefit, giving insurers “a backdoor way” to discriminate against people with pre-existing conditions

    The Graham-Cassidy legislation, like the failed Senate bill, would allow states to “change what qualifies as an essential health benefit,” according to The Washington Post. Under the ACA, insurers are required to cover things designated as essential health benefits (EHBs), including hospitalization, maternity care, ambulatory care, and other important services.

    According to a May 2 report from The Brookings Institution, allowing states to set their own standards for what qualifies as an EHB could “weaken ACA protections against catastrophic costs for people with employer coverage nationwide.” And as economist Gene Sperling and former White House economic advisor Michael Shapiro explained in The Atlantic, eliminating some EHBs would give insurers a “backdoor way” to price out people with pre-existing conditions. Sperling and Shapiro added, “If these benefits are not covered, a plan is all but worthless to those with serious pre-existing conditions.”

    Graham-Cassidy would freeze Medicaid funds to Planned Parenthood, leaving many women without a health care provider

    Under the Graham-Cassidy proposal, “Planned Parenthood would face a one-year Medicaid funding freeze,” The Washington Post wrote. A similar provision was included in the House and Senate bills brought up this summer to repeal and replace the ACA.

    The Republican crusade against Planned Parenthood would leave millions of American women stranded. In a blog post for Health Affairs, public health professor Sara Rosenbaum wrote that the right-wing argument that community health care centers could “absorb the loss of Planned Parenthood clinics” is “a gross misrepresentation.” The Guttmacher Institute found that in 103 counties, Planned Parenthood is the only “safety-net health center” that provides accessible contraception services. And, as The New York Times editorial board explained, Planned Parenthood serves more patients and has “higher quality care than centers without an emphasis on reproductive health.”

    While those who support the Graham-Cassidy bill may try and frame it to the media as a newfound compromise on health care reform, it’s not. The supposed compromise proposal is based on the same unpopular proposals Republicans have fought for years to enact. And just like those plans, this one would wreak havoc on the health care system as it exists. Media need to say so.

  • For months, pundits have called Trump a populist, but his policies have been about giveaways to the rich

    ››› ››› JULIE ALDERMAN

    Several media outlets are suggesting that President Donald Trump’s August 30 speech calling for tax reform was a “populist pitch,” and dozens of media figures and outlets have been calling the president a “populist” since his inauguration. A closer examination of Trump’s policies, however, show a pattern of decisions that will create devastating impacts on Americans, particularly low-income residents, while providing handouts to corporations and the wealthiest citizens.

  • Right-wing media figures and online bots are going after “weak, spineless” Mitch McConnell

    ››› ››› DINA RADTKE & NICK FERNANDEZ

    Right-wing media condemnation reached a fever pitch on August 9 after Senate Majority Leader Mitch McConnell (R-KY) commented that President Donald Trump had “excessive expectations” for health care reform, which many Trump loyalists in the conservative mediasphere interpreted as an attack on the president. In response, Trump sycophants along with online bots and trolls used their platforms to besmirch McConnell’s character, call for him to retire, and popularize the hashtag #DitchMitch on Twitter.

  • Prime-time cable programs ignored the voices of activists in their health care coverage

    Blog ››› ››› GRACE BENNETT


    Sarah Wasko / Media Matters

    During last week’s health care “vote-a-rama,” prime-time cable news coverage largely neglected the voices of activists, despite their crucial role in helping to block Republican efforts to repeal the Affordable Care Act (ACA).

    Media Matters reviewed four nights of cable news coverage -- from 5 to 11 p.m. -- between when the “motion to proceed” was passed (which opened debate on possible plans to overturn the ACA) and the GOP “skinny repeal” bill was defeated in the Senate. During those four nights of coverage, cable news programs largely failed to include the perspectives of activists, and both CNN and Fox News disregarded these voices altogether:

    • CNN and Fox News did not host a single activist over four nights of health care coverage

    • MSNBC hosted five activists during the same time period, but they accounted for less than 10 percent of its prime-time guests included in discussions about health care.


    Sarah Wasko / Media Matters

    Cable news coverage of health care has consistently disregarded diverse voices in favor of pundits

    Throughout Republican efforts to overturn the ACA, cable news repeatedly failed to offer diverse voices. Guests in conversations about health care were predominately white male pundits, while African-Americans, Hispanics, Asian-Americans, and women -- all of whom stand to lose disproportionately if the ACA is overturned -- received far less screen time.

    Additionally, cable news programs often ignored the personal stories of those that would be most affected by Republican health care policies, choosing to focus on the legislative process, at the expense of the human cost of the GOP’s repeated actions to undo the ACA. As Senate Republicans searched for a way to overturn former President Barack Obama’s signature health care act last week, cable coverage continued to erase the voices of those most intimately involved in the health care debate. CNN and Fox News failed to include a single activist amongst the combined 97 guest appearances on the channels during discussions of health care, and while MSNBC did host five activists, they made up less than 10 percent of the network's total guests hosted during prime-time to discuss health care.  

    Activists played a pivotal role in saving the ACA

    While this isn't the first time cable news failed to seek out the voices of activists, their disregard for activists' voices is shocking considering the influential role they have played throughout the health care battle. Employees and volunteers for organizations like MoveOn, ADAPT, and Planned Parenthood organized health care rallies across the country, and helped organize tens of thousands of calls to House and Senate offices on behalf of the ACA. Activists also kept constant pressure on elected officials, staging all-night protests in lawmakers' offices, and showing up to elected officials’ town hall meetings and other public appearances. Activists played a crucial role in pressuring Senators to vote no on repeal and replace bills, and in keeping public attention on health care in midst of numerous distractions, like the ongoing investigation into Russian interference in the 2016 elections. Activists deserve credit for their role in the health care battle, and comprehensive news coverage needs to include their voices.

    Methodology 

    Media Matters searched Nexis for mentions of “health care,” “the Affordable Care Act,” “Obamacare,” “Republican health,” “GOP health,” “the Better Care Reconciliation Act,” or “BRCA” on prime-time cable news between July 25 (after the Senate passed the motion to proceed to debate) and July 28 (after the failure of “skinny repeal”). Segments were coded if they included a significant discussion of the Republican health care bill. “Significant discussion” was defined as at least two speakers in the segment engaging on the topic with one another. Guests that partook in discussions that included a “significant discussion” about health care were included in this study. Guests were considered “activists” if they were affiliated with a group actively working against GOP efforts to dismantle the Affordable Care Act. 

    Prime-time cable news refers to CNN, Fox News, and MSNBC weekday programming between 5 and 11 p.m.