For nearly four years, poll after poll has shown that the majority of Americans remain flummoxed by Obamacare. Many are confused; some are afraid. They don’t know what the Affordable Care Act (ACA) says, and they don’t know how it will affect their lives
From the beginning, many in the media have blamed the White House.
Early in 2011, when a CBS poll showed that only 56% of Americans said the bill’s impact had not been explained well—or even “somewhat well”– CBS senior producer Ward Sloane summed up the prevailing view: “To me, that is a Monumental Failure by the Obama Administration. . . . [my emphasis] And it opens up a big hole for the Republicans which they have driven through with, you know, several tanks.”
Because Democrats had botched explaining the legislation, Sloane argued, Republicans “can say whatever they want about the healthcare bill … whether it’s true or not, and . . . it will resonate . . . People are afraid. People are afraid of things that they don’t understand and they don’t know. . . The Republicans are playing to this fear and they’re doing a masterful job.”
Sloane slid over the role that reporters might play in helping the public understand an enormous—and enormously important– piece of legislation. If Republicans were spreading disinformation, shouldn’t news organizations like CBS try to separate fact from fiction?
Network and cable news shows are in our living rooms every evening. President Barack Obama and Health and Human Services Secretary Kathleen Sebelius are not. In speeches and in press conferences Obama and Sebelius can address a handful of questions, but they cannot explain the hundreds of interlocking details that will benefit millions of Americans. The public needs an independent, informed press that will dig into the major provisions of Obamacare and explain them, not once, but again and again.
There was just one problem: As Sloane suggested, the Republicans were doing “a masterful job” of misleading the public. What he didn’t take into account is that journalists are part of “the public.”
Fast forward two years to the fall of 2013.
Little has changed; most Americans still don’t understand the Affordable Care Act, and many are convinced that they have been betrayed by the president they elected.
Millions are now receiving letters from their insurers, telling them that they cannot renew their policies. The media blames the White House. According to NBC, CNN, CBS and Fox News, not only did the administration fail to warn the public that under Obamacare, some insurance that didn’t meet the ACA’s standards would have to be replaced, it deliberately concealed this fact. http://mediamatters.org/research/2013/10/29/media-surprised-by-obamacares-effect-on-insuran/196652
NBC broke the story: “The administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans,” yet Fox hissed, “they didn’t say a word.
This is simply not true. Back in June of 2010, Health and Human Services Secretary Kathleen Sebelius held a press conference to announce that, under Obamacare, millions would be moving to new plans. As I point out in this post, a HHS press release spelled out the numbers: “roughly 42 million people insured through small businesses . . . along with “17 million who are covered in the individual health insurance market.”
Even Fox covered the press conference, complete with a video of Sebelius’ speech. But somehow, by 2013, amnesia had set in.
But what about the president’s promise that “if you like your plan, you can keep it”? Wasn’t this proof that Obama had tried to hide the fact that millions of Americans would lose their insurance?
Obama first made that pledge in 2008, while debating John McCain. The context is crucial: Obama was addressing “the majority” of Americans (roughly 66% ) who worked for large companies that paid 75% to 80% of their premiums –not the minority who purchased their own insurance in the individual marketplace (5%), nor the 17% who were insured by small business owners.
As I have explained, at the time, Obama was trying to reassure Americans who worked for large corporations that they would be able to keep the generous benefits they enjoyed. Reform would not mean dismantling employer-based insurance, and moving everyone into a single-pay system. But over time, Obama made a critical error; he let his pledge become a one-liner, making it easy for his opponents to rip that line out of context.
Meanwhile, few in the media seemed to feel that it was their job to put the president’s words in context, or to help clarify why certain policies could not be renewed.
“Explaining”–that was the administration’s job. The media’s job was to stir emotions and assign blame. Or, at least, that’s what many journalists seemed to think.
Before long, the news about “policies cancelled” inspired portraits of “Obamacare’s victims,” people like Debra Fishericks, a Virginia Beach grandmother who was losing her insurance.
After a CBS reporter interviewed Fishericks, the network’s Washington Bureau put together a video, headlined “Woman Battling Kidney Cancer Losing Company Health Plan Due To Obamacare.” The Bureau then sent it to CBS affiliates nationwide.
WDBJ7, a CBS station in Roanoke, Virginia was among the first to run the video on November 24, 2013.
“We’ve heard about the computer glitches associated with the Affordable Care Act website.” observed WDBJ anchor Susan Bahorich. “Now, some are saying, you can add broken promises to the list of problems.
“CBS reporter Susan McGinnis visited a Virginia Beach woman who says her work insurance was fine –until ACA came along.”
McGinnis, a CBS Washington Bureau correspondent, narrates the tale:
“At her office in Virginia Beach, Debra Fishericks often sneaks a peek at her 3 year old grandson.”
“That’s my guy,” says Fishericks.
McGinnis sets up the story: “Debra is battling kidney cancer. During the 10 years she’s worked at Atkinson Realty, the company has provided group health insurance with manageable premiums.”
Betsy Atkinson, the owner of the real estate business, appears on the screen: “We had great insurance. We had continuing care for our employees.”
“’Great’” McGinnis adds, “until owner Betsy Atkinson learned the policy would be terminated because it doesn’t meet the requirements of the Affordable Care Act.”
“On June 30, 2014, I will probably not be offering company insurance to my employees. I just can’t afford it’.
“Debra has scoured the website looking for a new policy,” McGinnis reports, referring to Healthcare.gov. “So far,” she adds, “she cannot afford the premiums. “They just keep going up higher and higher when there is a pre-existing condition,” Fishericks explains
McGinnis wraps up the piece: “Debra hopes that eventually she will find a plan that fits her budget so that she can still makes trips to Indiana –to visit her grandson.”
“If I can’t go to see him—that’s the worst,” says Fishericks.
She begins to cry.
Watching the video, I thought: “Oh no, not again.”
A month ago I wrote about Whitney Johnson, a 26-year old suffering from MS who claimed that under Obamacare, she would have to pay $1,000 a month—or more—for insurance. http://www.cwalac.org/cwblog/
When I read her story in the Ft. Worth Star-Telegram, I knew it couldn’t be true. Under the Affordable Care Act) insurers can no longer charge more because a customer suffers from a chronic disease. I had thought that this was one part of the ACA that everyone understood.
Apparently not. In Fishericks’ video, the CBS correspondent tells viewers that a cancer patient who “has scoured the website . . . cannot afford the premiums” because, as the patient explains, “they just keep going up higher and higher when there is a pre-existing condition.”
I was stunned. The reporter, Susan McGinnis, who later told me that she oversaw the piece, has been a Washington Correspondent at CBS News for three years–following an eight-year stint as an anchor on CBS Morning News. She is a seasoned journalist; yet she didn’t flag the fact that what Fishericks said couldn’t possibly be true.
Granted, McGinnis didn’t actually interview Fishericks; she just did the “stand up” narration in D.C. Another CBS reporter from the Washington Bureau went down to Virginia Beach. And apparently that reporter didn’t realize that under the ACA, insurers cannot jack up premiums because the customer has been diagnosed the cancer.
Finally, someone at CBS’ Washington Bureau must have edited the video.
I can understand why any one person might not have spotted the problem. We all make mistakes. But no one?
Let me be clear: Fishericks had shopped the Exchange and honestly believed what she was saying. The problem is that no one at CBS corrected her.
Perhaps this was because after four years, the debate over health care reform had dissolved into sound bites, creating what Nancy Pelosi rightly called a “fog of controversy,” obscuring the facts about health care reform. Reporters were printing and parroting the fictions and half-truths that conservatives fed to the media. And in an era of cut-and-paste journalism, the myths became memes, iterated over and over again. Little wonder that many people—including journalists—didn’t know what to believe. This, I think, is one reason why no one at CBS caught the glaring error in Fisherwicks’s story.
Thus the network left viewers with the false impression that under the “Patient Protection and Affordable Care Act” a cancer patient may not be able to afford care.
In late November, 50 CBS stations aired Fishericks story. (Hat tip to the Franklin Forum for this information) Within 48 hours, it began showing up in newspapers like Investors’ Business Daily and The Weekly Standard .
Fishericks’ tale then was picked up by thousands of blogs. “Living Under Obamacare” (paid for by the National Republican Congressional Committee) and “republicansenate.gov” both featured it.
Google “Debra Fishericks,” and you will get over 13,000 results. In other words, the story got around.
Trouble is, it wasn’t true. As Fishericks herself would tell me: “they got the whole story wrong.”
When I began fact-checking this story, I wanted to talk to the CBS reporter who went down to Virginia Beach and interviewed Fishericks. Only she would know what questions she asked, and exactly what her source said. I phoned McGinnis and asked for the name and phone number of the reporter who actually interviewed
McGinnis explained that while several reporters were involved in the project, she had been in charge. She wanted to take a look at the transcript, “talk to my bosses,” and look into the problem herself.
I asked if I could see the transcript of the full interview.
No, that wouldn’t be possible.
McGinnis and I then exchanged e-mails, and I spelled out what I found misleading:
McGinnis’ reply was cordial:
“I understand your point regarding the ACA and pre-existing conditions.”
“Our piece was aimed at illustrating a small business’ experience with the law . . . We were trying to illustrate what Debra was going through, what she understood, and how she felt. She was having trouble with the website, was getting no help, and her impression was that having a pre-existing condition could make insurance more costly for her.
“Nowhere did we report that she would be denied coverage for a pre-existing condition, she was only worried about it. [my emphasis]
McGinnis was right– CBS didn’t say that Fishericks was denied coverage. But that was not my complaint.
Fishericks had suggested that, in the Exchange, she would have to pay far more than she could afford because she was a cancer patient.
McGinnis still didn’t seem to understand that by leaving Fisherwick’s comment in the piece CBS was misleading its audience. Viewers would believe that, under Obamacare, if you’re sick, insurers can gouge you.
In her e-mail McGinnis also insisted that reporters still have time to fact-check. Yet no one checked this piece. If they had, someone would have discovered another error: Fishericks was not “battling”cancer.
But I wouldn’t find that out until I talked to Fishericks for a third time at the end of the week.
On January 8 I received a final email from McGinnis, conceding that: “the Affordable Care Act does indeed specify, in Section 1201, that . . . a health plan cannot deny enrollment, or the plan’s benefits, to someone based on that person’s preexisting condition.
“However,” McGinnis argued, “that certainly does not mean a plan has to include coverage for ongoing treatment that a patient started before obtaining coverage in an exchange plan on January 1, 2014.”
“Key to understanding this distinction” she added, “is that having ‘health coverage’ is not the same as actually obtaining ‘health care.’ The insurance plan has to take anyone who wants to enroll, regardless of their health status or health history – but they don’t have to provide the same treatments, the same doctors, or the same medications that a patient has been receiving.”
McGinnis seemed to have swallowed a rumor spread by so many “concerned trolls”: Just because a carrier sells insurance to someone who is sick, that doesn’t mean that the insurer must continue the treatment the patient needs.
I understand that few reporters had time to actually read the 2000-page law. But ideally, reporters would have dug into the in-depth briefs published by groups such as the Kaiser Family Foundation, the Commonwealth Fund, or the Robert Wood Johnson Foundation. Concise and well-researched, these briefs corrected most of the misinformation about Obamacare floating around in what had become an increasingly toxic atmosphere.
But rather than concentrating on the policy, reporters tended to focus on the politics of health care reform.
I responded to McGinnis with the facts:
The ACA stipulates that insures must cover all “essential benefits.” As the American Cancer Society (ACS) explains, this includes “cancer treatment and follow-up.” The ACS also points out that the law bans “dollar limits on how much the insurer will pay out for care,” and “gives patients “new rights to appeal claims that are denied by the insurer.”
That last point is important.
While the law does not guarantee that a patient can continue to see the same provider, if a patient or her doctor believe that only a particular hospital or specialist can provide the needed care, Obamacare strengthens the patient’s right to appeal.
Under the ACA, if the case is urgent, the insurer must respond to the appeal within 72 hours. If the carrier says “No,” the patient then has a right to an “external review” by an independent reviewer, and once again, the law calls for a speedy decision.
Similar regulations apply if an insurer doesn’t cover a needed medication..
How likely is it that a patient will win an appeal? A 2011 GAO study shows that even before Obamacare “between 39 and 59 percent of denials were reversed on internal appeal and an additional 23 to 54 percent were reversed or revised on external appeal.” Today, a patient’s odds are significantly better. ht
McGinnis probably wasn’t aware of the new rules and, even if she has heard about them, she may have had doubts as to whether they would be effective. Fear-mongers on both the left and the right had planted seeds of suspicion, and by the fall of 2013, mainstream journalists were increasingly skeptical as to whether Obamacare would force insurers to do the right thing.
After swapping e-mails with McGinnnis I wanted to talk to Fishericks; I called her at the Atkinson Real Estate Agency where she works as a receptionist.
No surprise, she wasn’t terribly enthusiastic about talking to me. She was at work, she explained, covering seven phone lines. But in a brief conversation she did convey a critical piece of information: the story that CBS aired was wrong—form beginning to end.
“I wrote them a letter” Fishericks told me. “And do you know what I got in return? Two words: ‘Thank you.’”
Clearly she was angry.
But I could tell she didn’t want to continue the conversation. And I didn’t want to press my luck. I thanked her, and hung up.
I planned to call her again—when I had more information.
In part 2 of this post, I will discuss how and why the media wasn’t able to do a better job of lifting “the fog” of disinformation.
For one, our sound-bite culture makes it difficult to explain something as complicated as the ACA to the public. As one observer notes: “Americans aren’t into nuance.”,
In the second part of this post, I’ll also report what CBS’ producers (including Ward Sloane, who now is Deputy Director of CBS’s Washington Bureau) had to say about Fishericks’ story, why the Bureau ultimately removed the video from its server, and most importantly, what Debra Fishericks revealed in our final interview.