Affordable Care Act – Media Nation

It wasn’t the politics of health care that did in Trumpcare. It was the substance.

Nancy Pelosi and Chuck Schumer earlier this year. Photo (cc) 2017 by Lorie Scholl.

I find myself frustrated at the tone of much of the commentary following the humiliating withdrawal of the Trump-Ryan health-care bill Friday. I could find a bunch of stuff to link to, but we’ve all seen it. It’s all about winning. So much winning. And if the bill had been approved, most commentators would be hailing President Trump for his big victory.

Yes, Trump got the politics wrong. But of far greater significance is that he and House Speaker Paul Ryan got the substance wrong. There was nothing in their legislation other than a chest-thumping assertion that Obamacare is dead — and that we’re going to screw the poor, help the rich, and dismantle much of what was accomplished by the Affordable Care Act.

The two groups that defeated the legislation did so on principled grounds: Democrats and moderate Republicans who wanted Obamacare to remain entirely or mostly intact; and the House Freedom Caucus, whose extremist members don’t want any government involvement in health care whatsoever. On the other side, those who supported Trumpcare couldn’t point to a single provision that would have improved anyone’s lives other than the wealthy people who’d get a tax cut.

After the defeat, Trump blamed House minority leader Nancy Pelosi and Senate minority leader Chuck Schumer. He’s right — it’s on them. And we should thank them for saving the most important piece of social legislation since Medicare was approved in the 1960s. And these folks, too:

And the #groundwork of tens of thousands of #district based activists pounding on their own Congressperson via direct actions & phone calls https://t.co/7WyrtdZjZ2

— judymeredith (@judymeredith) March 25, 2017

Any major new program needs technical fixes along the way. Unfortunately, after Obamacare was approved, congressional Republicans refused to consider any such legislation. That, along with attempts by many Republican governors to undermine it in their states, is responsible for the ACA’s not working as well as it should.

On Friday, the ACA was saved. It now must withstand at least two years of Republican attempts to starve it of funds. But as Jonathan Chait of New York magazine points out, it’s not likely to be repealed after the debacle of this week. Trump and congressional Republicans won’t be in power forever. At some point, we’ll have an opportunity to get this right.

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Yes, Sen. Grassley, there are plenty of reasons to worry about the fate of Medicare

Keep your eyes open, journalists. Connect the dots. Sometimes it’s as easy as reading two stories in the same day’s newspaper — in this case, The Washington Post. A story on Republican efforts to come up with a repeal-and-replace plan for the Affordable Care Act includes this:

Some congressional Republicans have been more vocal in recent days about concerns that they are hearing from constituents on what comes after the law is repealed. Several also suggested that Democrats are deliberately spreading misinformation.

“I think you hear from two categories,” said Sen. Charles E. Grassley (R-Iowa). “One are people that think Medicare is going to be affected, and obviously we haven’t made very clear that there’s absolutely no connection with Medicare. And the other one is dealing with the people they think are going to lose their insurance as soon as we … repeal.”

Those dastardly lying Democrats! But wait. Elsewhere in the Post, we learn that Tom Price, who is Donald Trump’s choice to be the next secretary of health and human services, is in fact a sworn enemy of Medicare:

Starting early in his tenure on Capitol Hill, Price wrote a series of commentaries lambasting the popular Medicare program and exhorting changes along more conservative lines. “Its flawed structure increasingly fails our seniors on all counts — responsiveness, innovation, access, cost and quality,” he wrote in 2008 in the Washington Times. He has repeatedly introduced legislation that would have converted Medicare from the entitlement program it has been since its origins in the 1960s to a system of “defined contribution,” with the government giving older Americans fixed sums to help them purchase private health plans.

For what it’s worth, the bylines of Post reporters Julie Eilperin and Amy Goldstein appear on both stories.

And let’s not forget that House Speaker Paul Ryan spends most of his waking hours dreaming about doing away with Medicare.

I guess the most logical explanation for letting Grassley’s words stand without challenge is that destroying Obamacare will not destroy Medicare. Instead, it will require a separate vote.

From the archives: How the Affordable Care Act will help people with disabilities

President Obama signs the Affordable Care Act. Photo is in the public domain.

Now that congressional Republicans are shamefully dismantling the Affordable Care Act, I thought I would reprise this 2010 piece that I wrote for The Guardian shortly after President Obama signed the bill into law. (I have left the Britishisms intact.) The death of Obamacare is going to have a huge, negative effect on millions, including people with disabilities.

Previously published by The Guardian.

It was some years ago that my wife and I learned a crucial fact about living in America with a disability.

Our daughter, Rebecca, now 17, had been diagnosed at birth with achondroplasia, a genetic condition that is the most common form of dwarfism. At five months she ran into dwarfism-related breathing complications that required a tracheostomy, oxygen and home nurses for a good part of the day and night. It was a harrowing time in our lives — not to mention hers. But by the time she was three years old she was fully recovered.

One day when Becky was still a baby we found ourselves at a gathering of Little People of America, an organisation akin to Britain’s Restricted Growth Association. We were looking down — way, way down — at our soon-to-be-friend Ruth, the local LPA director. Ruth told us that Becky should focus on a career at either a large corporation or the federal government. That way, she said, Becky would never have to worry about having health insurance.

We were appalled. It’s not that working for a big company or a government agency is such a terrible fate. Ruth herself is a federal bureaucrat, and a good one. So, for that matter, was my father. But the idea that our daughter should shy away from launching a business or joining a small start-up company lest she lose her health coverage was offensive to us.

Those days are now behind us — and her. After Sunday night’s historic vote in the House of Representatives, we count Becky among the tens of millions of Americans who have been liberated. It’s long overdue.

Much of the attention over the past few days has rightly focused on the 32 million uninsured Americans who will be covered, and on new regulations that will prohibit insurance companies from denying benefits to people with pre-existing conditions.

What hasn’t been emphasised enough is that many of those folks with pre-existing conditions, like Ruth, have good jobs and great coverage — but that some of them might like to do something else with their lives. Maybe an accountant who’s recovered from cancer wants to try his hand at consulting. Maybe a mother with an autistic child has a killer idea for a restaurant. Maybe a wheelchair-using lawyer at a large firm would like to hang out her own shingle. Now there’s nothing to stop them.

It is the release of this pent-up entrepreneurialism that is among the most exciting aspects of healthcare reform. When Barack Obama has spoken about healthcare in the context of the economy, he has stressed the high cost of insuring employees. For instance, in the president’s address to a joint session of Congress last September, he described cost as the reason that “so many aspiring entrepreneurs cannot afford to open a business in the first place”. Obama was right, but he overlooked what happens when entrepreneurs themselves have medical conditions that prevent them from taking risks that could benefit society as a whole.

There are other reasons, of course, to get excited about healthcare reform, even if you’re a middle-class family with good coverage and no health issues. For many families, the ability to insure your adult children under your own plan until they are 26 is a change of enormous importance. Sticking with the personal theme of this commentary, our 19-year-old son, Tim, plans to spend the next several years establishing himself as a commercial photographer. Now he – and we – have one less thing to worry about.

We are hardly unusual. Across the country, in red states and blue, in households that voted for Obama and those who think he’s a “socialist”, folks are going to discover their lives have been made better in measurable ways. The idea that Republicans will repeal the healthcare law is laughable. Instead, as Republican strategist David Frum, a speechwriter for the second president Bush, wrote on Sunday, the GOP’s just-say-no strategy has led to a “disaster” for the party’s prospects.

What happened on Sunday restored some faith that our political leaders can work on behalf of the people who elected them. It was a great moment for Obama and House speaker Nancy Pelosi, who overcame odds that seemed insurmountable following Republican Scott Brown’s surprise election to the US Senate in January.

It was also a great moment for all of us.

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Myths and realities about Obamacare premium increases

If you’re trying to figure out what’s going on regarding claims that Obamacare costs are spiraling out of control, I recommend this piece by Jonathan Chait of New York magazine. Chait really understands this stuff. The key takeaways:

The premiums announced for next year are about what had been predicted when the Affordable Care Act first went into effect. The reason the jump is so high now is that insurance companies initially underpriced their policies in order to get more people to sign up. And the premiums are still lower than they would have been without the ACA.
There are 50 insurance exchanges—one in each state. They are working well in states that supported the law and accepted federal assistance to expand Medicaid, and not well at all in states that didn’t. So it’s ongoing Republican resistance to the law, not the law itself, that is the source of some of the problems.
Complex legislation like the ACA often need fixes every now and again because there’s no way officials can predict with absolute certainty what’s going to happen. Unfortunately the ACA can’t be amended or fixed in the current political environment because the Republicans in Congress won’t allow it.

And thanks to Jonathan Cohn, a health-care expert in his own right, for flagging Chait’s article.

Headlines distort CBO report on Obamacare

The reaction to a Congressional Budget Office report released Tuesday demonstrated how easily politicians are able to game the media system.

The CBO, a respected source of nonpartisan data, found that the Affordable Care Act would lead to the disappearance of more than 2 million jobs — nearly all of them because people will choose to stop working or cut back on their hours now that their health insurance is no longer dependent on their continued employment. CBO director Douglas Elmendorf put it this way:

I want to emphasize that that reduction doesn’t mean that that many people precisely will choose to leave the labor force. We think that some people will chose to work fewer hours. Other people will choose to leave the labor force.

Of course, that didn’t stop Republican opponents from claiming that the CBO report proves the ACA is a job-killer. And why not? The media are so quick to go along. Let’s consider that this is Elmendorf’s report, and he said at a news conference precisely what it meant. Yet the very NPR story in which his remarks are quoted is headlined “Is Obamacare A Job Killer? New Estimates Suggest It Might Be.” Gah.

This morning I looked at the front pages of four major dailies. Here’s how they stack up, in order of disingenuousness.

1. The Boston Globe. “Health law projected to put a dent in workforce; GOP calls analysis proof of act’s failings.” The clear impression is that people are going to lose their jobs because of the ACA. If you would like to believe that, go right ahead — but it’s not what the CBO said. The Globe headline is slapped atop a New York Times story (below) that isn’t nearly that bad.

2. The New York Times. “Health Care Law Projected to Cut the Labor Force; Choosing Not to Work; G.O.P. Seizes On Data — Drop May Equal 2.5 Million Jobs.” Whew! Try saying it all without taking a breath. The Times’ headlines is slightly better than the Globe’s: the second deck, “Choosing Not to Work,” gets at the gist of the CBO report. But the rest of it makes it sound like Tuesday was a very bad day for the ACA. You’ve got to read the story to find out what’s really going on.

3. The Washington Post. “New fuel for the health-law fight; CBO: More will quit jobs, cut hours; Estimates revive debate over economic effects.” Not bad. The impression given by the headline is that the fight is over the economic effect of people quitting their jobs. Not quite right, but we’re getting closer. Here’s the story.

4. The Wall Street Journal. “Health Law to Cut Into Labor Force; Report Forecasts More People Will Opt to Work Less as They Seek Coverage Through Affordable Care Act.” Folks, we have a winner — a headline that accurately reflects what the CBO actually said. Good story, too. (To get around the Journal’s paywall, enter the headline at Google News. Don’t worry. Rupert knows about it and says it’s OK.)

The problem with deceptive or incomplete headlines is that few people get past them or the partisan attacks they reflect. What House Speaker John Boehner (quoted in the Times story) said is simply flat-out wrong: “The middle class is getting squeezed in this economy, and this CBO report confirms that Obamacare is making it worse.”

As U.S. Sen. Jeanne Shaheen, D-N.H., put it in a conversation with reporters (also quoted in the Times): “You guys are going to politicize it no matter what happens.”

Journalists need to resist the urge.

Headline images via the Newseum’s “Today’s Front Pages.”

Media Nation’s top 10 posts of 2012

Work-force reductions at The Boston Globe. The end of WFNX as an over-the-air radio station. “Local” news from the Philippines. Possible bankruptcy at GateHouse Media.

These were a few of the top 10 Media Nation posts of 2012 as determined by Google Analytics and WordPress’ own internal statistics.

Most people who read Media Nation come in via the home page, which means that any notion of a “top 10” is dubious. Usually it means that a particular post got retweeted a lot on Twitter or was linked to by a popular media website such as JimRomenesko.com.

But the list isn’t entirely without meaning — and one takeaway for me is that Media Nation’s role as an aggregator and a curator may be its most important. I’ll keep that in mind in the year ahead.

Here is my top 10 for 2012.

1. The Boston Globe keeps on shrinking (July 23). Despite some encouraging signs in the form of rising digital-subscription numbers and a continued commitment to first-rate journalism, The Boston Globe, like nearly all daily newspapers, continues to struggle financially. Last summer Media Nation obtained a memo from Globe publisher Christopher Mayer announcing another wave of downsizing at the Globe and its sister paper, the Telegram & Gazette of Worcester.

2. Donna Halper on the future of radio (May 17). Friend of Media Nation Donna Halper was kind enough to write a guest commentary, and her post turned out to be the second most popular of 2012. Halper wrote following an announcement by the Phoenix Media/Communications Group that it would sell WFNX’s broadcast frequency, 101.7 FM, to Clear Channel. Fortunately for local music fans, by the end of 2012 WFNX and the Globe’s RadioBDC were engaged in a spirited competition of online-only local music stations — the real future of radio.

3. Long-distance “local” journalism (July 5). The public radio program “This American Life” and the journalist Anna Tarkov reported extensively on Journatic, which helps community newspapers cuts costs by outsourcing some of their local coverage. At its worst, news was being compiled by underpaid Filipino workers writing under fake bylines. Dubbed “pink slime” journalism by one former practitioner, Journatic underscored what debt-ridden corporate chains will do to survive — and thus demonstrated the importance of independent local journalism.

4. And Joe Scarborough thinks “Morning Joe” is awesome (Jan. 1). A full-page ad in The New York Times for the wretched MSNBC program “Morning Joe” started the gears whirring when I noticed one of its celebrity endorsers was Tom Brokaw. Who, uh, appears on “Morning Joe.” I got to work, and soon found that Politico, which was quoted as praising the program, had an undisclosed partnership. The ad even stooped to using seemingly positive quotes from two reviewers who actually didn’t like it much at all. Disingenuous, to say the least.

5. More bad news for GateHouse Media (March 19). By now it’s not exactly news when executives at GateHouse Media, struggling with $1.2 billion in debt, pay themselves handsome bonuses. (Nor is that unusual at newspaper companies.) In 2012, though, there was a wrinkle at the chain, which owns some 100 community newspapers in Eastern Massachusetts. Jack Sullivan of CommonWealth Magazine paged through the company’s financial disclosures and discovered that officials were openly raising the possibility of a bankruptcy filing.

6. David Gregory debates himself (Oct. 1). The host of “Meet the Press” was brought in to moderate the second televised debate between Republican Sen. Scott Brown and his Democratic opponent, Elizabeth Warren. Unfortunately, it was all about David Gregory. Good thing the candidates were forced to weigh in on whether Bobby Valentine deserved a second year as Red Sox manager. Warren blew the question but won the election.

7. From Newtown, a plea for media restraint (Dec. 17). I republished an open letter from John Voket, associate editor of The Newtown Bee, to his colleagues at the New England Newspaper & Press Association following the massacre at Sandy Hook Elementary School. Voket wrote about “reporters and media crews invading the yards and space of grieving survivors, school staff and responders,” and asked editors “to remind your correspondents that most are still requesting to be left alone.” A heartfelt message from ground zero.

8. Calling foul on politicians who lie (Aug. 30). It would be hard to come up with a more falsehood-laden performance than U.S. Rep. Paul Ryan’s speech at the Republican National Convention. Ryan’s lies prompted me to wonder how far the balance-obsessed media would be willing to go in labeling them for what they were.

9. At CNN, getting it first and getting it wrong (June 28). My instant reaction to CNN’s false report that the U.S. Supreme Court had overturned the individual mandate in the Affordable Care Act. At least CNN executives flogged themselves in the public square. As we later learned, Fox News made the same mistake — and refused to apologize.

10. An unconscionable vote against the disabled (Dec. 5). My reaction to Senate Republicans’ rejection of a United Nations treaty on the rights of the disabled — a treaty modeled after the Americans with Disabilities Act, championed by President George H.W. Bush, a Republican.

Ghosts of 2011. Oddly enough, the single most popular post of 2012 was one I wrote in 2011 — a fairly terse item on Jay Severin’s return to the Boston airwaves, a comeback that proved to be brief. As I wrote last year, I’ve put up several Severin posts that have generated huge traffic, and I have no idea why.

Tierney, Tisei and a defense of party-line voting

We all live in Nate Silver’s world, so there were no real surprises on Election Day. Except one: Republican congressional candidate Richard Tisei’s failure to topple U.S. Rep. John Tierney, a Salem Democrat who was up to his neck in family trouble.

I was stunned that Tierney had prevailed. So, apparently, was Tisei, who was confident enough of victory to run a non-ad ad toward the end of the campaign showing nothing but a tranquil seascape. “That was lovely, but ultimately a waste of money,” writes Marjorie Arons-Barron. “Better he told voters why in a Republican-held Congress he could do more for them.”

Maybe better he didn’t.

As for whether Libertarian Party candidate Dan Fishman cost Tisei the election, I agree with Arons-Barron that Fishman probably drew a lot of support from Democrats who were turned off by the ethics cloud enveloping Tierney and who otherwise would have blanked it.

So what happened? Clearly Tierney benefitted from a party-line vote. You will find a lot of people who think that’s mindless. I think it’s pretty smart.

The culture on Capitol Hill these days does not encourage independence. Tisei, whom I first met in the 1980s when I was a reporter for The Daily Times Chronicle of Woburn, is a great guy and a true moderate, despite Democratic efforts to tag him as a tea party ally. But if he’d been elected, his first act would have been to vote for John Boehner as speaker. And you can be sure he would have voted with the Republican House majority most of the time on the issues that really matter — principally taxes and spending.

Tierney, who lacks Tisei’s personal warmth, has nevertheless been a reliable ally of the Democratic House minority. He voted for the Affordable Care Act, which Tisei said he opposed, even though as a state senator he supported Gov. Mitt Romney’s nearly identical Massachusetts version. And Tierney is a traditional Democrat when it comes to taxing the wealthy and preserving the social safety net. Those are values that voters in Massachusetts and across the country upheld this week.

It should also not go unmentioned that Tierney himself has not been credibly tied to his in-laws’ illegal gambling activities, even though his wife, Patrice Tierney, served a month in prison for her role. (I think the tale of Tierney and his in-laws is sufficiently convoluted to warrant the triple negative.)

People should vote their values and their interests. In the case of Tierney and Tisei, that’s what they did this week.

Photo (cc) by the Center for American Progress and republished under a Creative Commons license. Some rights reserved.

Will heads roll after CNN meltdown? Should they?

Three quick items on the Supreme Court’s decision to (mostly) uphold the Affordable Care Act:

1. I was watching CNN while waiting for the ruling in the mistaken belief that the other cable nets would only be worse. I must admit, listening to Wolf Blitzer and John King trying to backtrack from their whopper made for riveting television. Will heads roll? Should they? People make mistakes, but good grief.

2. Wish I could remember who wrote this, but yesterday I read an analysis that attempted to prove Justice Anthony Kennedy would vote against the individual mandate. So far, so good. But the writer went on to argue that since it was unimaginable Chief Justice John Roberts would come out on Kennedy’s left, that was the end of Obamacare. Personally, I think Roberts looked into the abyss and saw there was no bottom.

3. I thought this was a good time to recycle what I wrote about garcinia cambogia extract for the Guardian after the ACA was approved in 2010. The law isn’t perfect, but it’s an enormous improvement over the status quo. It was — and is — a BFD.

Image via JimRomenesko.com.