Coverage of insurance exchanges needs context

During the past few days, I have read quite a bit of local coverage about health insurance exchanges from about  10 different  states (some “blue,” more “red.”) I was looking for good stories to hold up as an example of what’s at stake here.

New tip sheet

Affordable Care Act: The politics of health care, year two

The Affordable Care Act just hit the one-year mark, but that’s not likely to change the political dynamic in D.C. and many state capitals. Indeed, it may intensify as the 2012 campaign approaches. Following the complex legislative and budgetary procedures in Congress from a distance can be daunting. Joanne Kenen, AHCJ’s health care reform topic leader, has written a brief guide to some of what’s unfolding and likely to unfold in the next year or two.

I did not read every single state story from the whole country so maybe I missed something great. But I did read enough to conclude that most of the stories, unfortunately,  were awfully heavy on  process.  They described political finger pointing: Republicans say no, Democrats say yes,  the state legislature equivalent of he-said, she-said . There was  very little explanation to readers about what exchanges are, and what kind of decisions states have to make about  them , what’s at stake or why the heck the reader should care.

In case you are tempted to say it’s too complicated to explain in a short daily story: Look at Felice Freyer’s  March 31 story in The (R.I.)  Providence Journal. That is a short daily story, not a big takeout. But see how much context and explanation she was able to weave in with a deft clause here and there.

Sarah Kliff, of Politico, takes a slightly different tack that is also useful. It’s not a policy story, but politics, a state roundup. She makes two good points, which might help some of you covering the politics of implementation in your own state.  First, how successful the Tea Party has been in driving the state-level implementation conversation to the right, and second “a widening rift within the Republican party, between those who say states should implement the law, retaining more power as it moves forward, and others who favor completely opting out of a law they because they believe it to be unconstitutional.”

I pulled together some resources about exchanges for the tip sheet on covering the first anniversary of reform.  I’ll gather some more for a future update. If you see more good articles on the exchange, let me know by sending a note to joanne@healthjournalism.org.

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