Tag Archives: Affordable Care Act

Covering ACA numbers? The semantics matter

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

Kyle Cheney

Kyle Cheney

With big new sign-up numbers coming out of the state and federal exchanges, Politico health care reporter Kyle Cheney reports on what the numbers mean. Enrolled? Selected? Covered? The differences matter. 

Loose characterizations by allies and enemies of how many people have signed up, (more than 7 million as of April 1) have led to rampant – often verifiably incorrect – interpretations in the press. That matters.  The way news reports characterize enrollment could  tilt the national narrative about the health law in a tense election year.

There are subtle but significant differences between the number of people “signed up” for ACA plans and the number actually “enrolled.” And there’s an even greater difference,  for the short term, between the number of enrollees and the number of people who have “coverage.”

Here’s a tip sheet with some help in avoiding getting caught up in the enrollment spin.

A deeper look at the employer mandate and the work week

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

The employer mandate was pushed back for 2014 and is being phased in more gradually in 2015-16. What portion of the workforce does this affect?

And what’s going on with that “30-hour” work week? That’s how the Affordable Care Act defines full time, and the GOP has legislation (likely to pass the House in early March – far less likely in the Democratic-led Senate) that would change the definition to the more standard 40-hour week.

As we’ve pointed out before, you hear a lot of talk about how the Affordable Care Act will hurt small business. But if you report those claims, be careful of the definitions. Small businesses with fewer than 50 full time equivalent (FTE) workers are and have always been exempt from the employer mandate. They can, if they wish, get coverage through the new (but still fairly underdeveloped) SHOP exchanges. But whether they choose to and how much they contribute to their workers’ coverage is up to them. Continue reading

Blame game: Obamacare becomes scapegoat for all that’s wrong with health care

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

obamaBlame it on Obamacare.

That’s what you hear, over and over again. Anything in the health care system that someone doesn’t like, it’s Obamacare.

Sam Baker of the National Journal took a look at some of the things people are blaming on Obamacare – high deductibles, narrow networks, employers cutting benefits – and reminds us that they were already part of the health care landscape, before the Affordable Care Act. He writes:

Welcome to the Obamacare era. Continue reading

Find out if lack of health literacy keeps people from ACA benefits

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Wordle-health-literacyYet another study tells us how little the public knows about the Affordable Care Act, and how even the people most likely to benefit from it are often unaware. The study, from The Robert Wood Johnson Foundation and The Urban Institute, found that fewer than four in 10 uninsured adults thought they would get insurance this year. Most don’t realize they may be eligible for subsidies or expanded Medicaid.

We all know that the Affordable Care Act is complicated, and the intense political fighting about it has added to the confusion and the challenges of getting simple apolitical messages across.

But is it all about politics and messaging? How much of a role does “health literacy” – or more specifically “health insurance literacy” play? Continue reading

Comparing U.S., Canadian health care systems

Trudy Lieberman

About Trudy Lieberman

Trudy Lieberman, a former president of AHCJ, is a contributing editor to the Columbia Journalism Review, where she blogs about health care and income security issues. She is a fellow at the Center for Advancing Health where she blogs about paying for health care. At Consumer Reports, she specialized in health care and health care financing. She has won more than 25 awards and five major fellowships.

Lieberman recently returned from a monthlong visit to Canada as a Fulbright Senior Specialist, where she lectured on the American health care system and learned much about how Canadians get their medical care. She interviewed hospital executives, physicians, academic experts, former health ministers, reporters covering health care, and ordinary citizens. Lieberman also toured hospitals and long-term care facilities. This is the first of four posts reporting on that visit.

canada-flagOne thing Americans and Canadians can agree on is that we don’t want each other’s health care systems. In truth, most Americans don’t know how Canada’s system works and Canadians don’t know much about the U.S. system.

What Americans know has come mainly from the negative talking points of politicians and others who have argued for years against national health insurance. Two decades ago The New York Times reported that Canadian women had to wait for Pap smears, a point vigorously refuted by the Canadian ambassador who shot back in a letter to the Times editor: “You, and Americans generally, are free to decide whatever health care system to choose, avoid or adapt, but the choice is not assisted by opinions unrelated to fact.”

Yes, there are waiting lists for some services – as I will explain in another post – but, no, Canadians are not coming across the border in droves to get American care.

There’s misinformation among Canadians, too. Wherever I went, Canadians told me they thought, mostly based on what they said they heard on CNN and Fox, that Obamacare meant America was getting universal health coverage like their country has.

Continue reading

Star-Telegram incident is a cautionary tale about ‘Obamacare horror stories’

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

In November, the Fort Worth Star Telegram wrote about several people who were “losing” under the Affordable Care Act. A month later it ended up having to do a pretty significant mea culpa by executive editor Jim Witt.

The flaws in the story caught the attention of health care blogger and author Maggie Mahar. Some of the accounts of people who lost their old policies and were facing stupendous prices for lousy new Obamacare policies didn’t ring true. A 26-year-old woman, even one with multiple sclerosis, wasn’t going to have to pay up to $1,800 a month for coverage that was inferior to what she had before.

So Mahar did a bit of reporting of her own. Continue reading

Understand role of catastrophic health plans and who’s eligible

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

ambulanceSo did the Obama administration let potentially millions of Americans buy the same kind of “junk” insurance policies that were being canceled because they didn’t meet new requirements of the health law? Not exactly.

In late December the White House said that anyone who had their plan canceled could, if they wished, get a “hardship exemption” from the individual mandate and purchase a catastrophic health plan (if such plans are available in their region).

These plans are far from generous. They aren’t designed to be. But they do have certain basic consumer protections that may meet the needs of some families. A big surge of individuals or families taking up this option could, however, hurt the overall exchanges if lots of healthy people take them. People covered under these plans could “count” toward the goal of getting 7 million Americans covered by the end of March 2014. But they don’t count as part of the exchange risk pools. They are apart. And the insurers fear that they will siphon off some of the healthier people that they need in the pool to keep costs sustainable. Continue reading

National look reveals gap in access to pediatric dental care

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Dental hygenist

Image by The National Guard via flickr.

Catherine Saint Louis of The New York Times took a hard national look at the pediatric dental benefits being offered on the state exchanges under the Affordable Care Act.

Her reporting led her to the troubling gulf that oral health advocates have been warning about.

While kids’ dental coverage is included as one of the 10 essential health benefits under the nation’s health care reform law, “pediatric dental care is handled differently” from other coverage on the federal and state exchanges, she wrote in her Dec. 16 story, “A Gap In the Affordable Care Act.”

Dental plans “are often sold separately from medical insurance, and dental coverage for children is optional,” she noted. “People shopping on the exchanges are not required to buy it and do not receive financial support for buying it.”

Experts have cautioned that the problems could leave millions of children without access to dental care. Continue reading

Lieberman: Media didn’t prepare public for website meltdown, cancellations

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

(Full disclosure: Kenen is Politico’s health care editor.)

Former AHCJ president and Columbia Journalism Review contributor Trudy Lieberman – in a wonderfully titled piece called “Dropped Coverage” – analyzed media coverage of the Affordable Care Act for the new Politico magazine.

She found that plenty was … dropped. Continue reading

Survey: Employers expect health benefits to cost more; small companies consider dropping coverage

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Image courtesy of Mercer

Image courtesy of Mercer
Click to enlarge.

Here are two issues to watch in the coming year: How many employers will drop health insurance coverage in the next five years and how much will employers’ health benefit costs rise in 2014?

These issues jumped out from the results of the annual survey by benefits consultant Mercer. Within five years, 31 percent of small employers believe they will drop health insurance coverage, the survey showed. Mercer defines small employers as having 10 to 499 workers. The 31 percent level is up from the 22 percent of responding small employers who said last year they planned to drop health insurance coverage and up from the 19 percent who said they would drop health benefits in 2011, Mercer said.

Beth Umland, Mercer’s director of research for health and benefits, offered more detail. “While 31 percent of employers with 10 to 499 employees say it’s likely they will terminate, when we look at just those companies with 50 to 499 employees, that number falls to 21 percent,” she said. “The smaller the employer, the more likely they are to say they will drop. Continue reading