An informative piece in Politico Magazine:
So when the law actually came into effect on Oct. 1, Americans were by and large not prepared—not for the website when it froze up and not for the millions of cancellation notices that went out to Americans in the individual insurance market. The news hit like a bomb—and the political impact hit that much harder for the Obama administration. Why hadn’t the media caught wind of HealthCare.gov’s troubles? Had President Obama lied when he promised, “If you like your health care plan, you can keep your health care plan.” And if so, why didn’t the media call him on it at the time?
One obvious reason: Health policy is tough stuff. Since 2007, I have written more than 700 posts for the Columbia Journalism Review examining the coverage of health reform, starting with the debates of the 2008 election and long beyond. From this perch, I’ve seen most of what the press has sent out to the public during the debate over the Affordable Care Act through its implementation last month. And I have to say: With a few exceptions, much of it has been dismal. ….
But it’s more than that. Although the media spoke or wrote zillions of words about the ACA, relatively few explained in meaningful ways what the law was all about, who would be affected by it and how—in short, how would it affect peoples’ lives and why they should care. The media, for the most part, fell down on the job when it came to dissecting the promises made by supporters (for example, that people could keep their insurance and their doctors); who would pay for the subsidies; why essential benefits were important; and why there had to be an individual mandate with penalties for not buying insurance. And there’s no question most of us failed to dig into the most basic question of all: Would the darn thing work?
What the press delivered instead was mostly a conversation among policy wonks and Beltway political elites without letting in the people who would be most affected by the nostrums they were prescribing. The public was the victim of a messaging war, with much of the conversation shaped by spin and talking points. And as in all wars, truth is the first casualty. Americans needed clear, direct explanations, honesty, dot connection and a probe of the carefully crafted words that came to define the debate. Yes, there were plenty of fact-checkers keeping watch, but as press critic and political scientist Brendan Nyhan has pointed out, these services can fall short. Their one-the-one hand, on-the-other hand format often confuses more than illuminates. Against this backdrop, the backlash of the last few weeks was probably inevitable.
I will confess error here too. When writing Unprecedented, I spoke to just about everyone who knew anything about Obamacare, and the problems we witnesses in the past two months were not on anyone’s radar screens. Remember, even during Ted Cruz’s filibuster, none of the issues we face now were mentioned.
Everyone fell down here.
The issues we should have been talking about are the problems we now see:
It took two things—the failure of the website and the turmoil in the individual insurance market—to ignite public awareness of what the Affordable Care Act will and will not do. Suddenly, many journalists were realizing that the real story was not the stuff of far-right paranoia—like the false “death panels” claims or the canards about “socialized medicine” that dominated the early coverage; it was the law’s messy tradeoffs, its power to create new classes of winners and losers as it tried to bring insurance to more Americans.
Plus, the Administration had to “oversell” the law:
Because of its patchwork nature, the president’s health reform offered most Americans nothing that would tie them to the law and give them a stake in its success the way they are tied to Medicare and Social Security. So the sales pitch was targeted more narrowly: Young adults could stay on their parents’ policies, and there would be no more caps on the amount insurers could pay in claims and no more denials of coverage for those with preexisting conditions who applied for insurance in the individual market. Although important to the relatively few numbers of Americans affected by them—roughly between 10 and 15 percent of the population—such measures didn’t mean much to most people. “Unless you have already been denied coverage, it would not necessarily be something you would know about,” admitted Democratic strategist Chris Lehane. The law was a tough sell. Perhaps fearing that its various provisions would scare off the public and produce a backlash, reform advocates oversold the law. The backlash happened anyway.
Very good read. Read it.