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Reporter seeks stories of people impacted by Obamacare repeal. Things don't go as planned.

Reporter seeks stories of people impacted by Obamacare repeal. Things don't go as planned.

Picture of Julio Ochoa
[Photo by Chip Somodevilla/Getty Images]

Sometimes it’s better for the greater good when your project doesn’t come together as planned. That’s what I told myself to keep from rooting for the repeal of Obamacare so I could report on the fallout.

Looking back, my project on the free clinics in the Tampa Bay area told compelling stories of people without insurance who struggle to find health care. And what actually happened in Washington ended up being a much better outcome for the people whose stories I wanted to tell.

But last year, as I was crafting the pitch for my project, the Affordable Care Act didn’t look like it had much of a chance.

Donald Trump had just taken over the White House after campaigning for months on the promise to repeal the health law. In campaign speeches, he said it would be his first priority. Republicans had control of the U.S. Senate and House and lawmakers had already voted dozens of times since 2011 to repeal the ACA.

Our newsroom wanted to tell the stories of people who would be affected by a repeal — those who couldn’t afford health care coverage before Obamacare, then had it, only to lose it after the repeal. We spoke with leaders of places known in the Tampa Bay areas as free clinics, and they said they expected a 10 to 15 percent increase in patients if the law was repealed. The clinics, which provide care for people who have no health insurance and do not qualify for Medicaid, reported a similar dip in patients who received insurance when Obamacare became available. We thought that if we spent time at these clinics, we could tell the stories of the recently uninsured.

But as spring turned to summer, lawmakers struggled to craft a replacement for the health care law. By the time I headed to California for a week at the Center for Health Journalism in July, the repeal effort was all but defeated. Senators would fail to pass a bill to replace the ACA. An attempt to simply repeal the law would also fail. There would be more attempts, but those too would be unsuccessful.

So what do you do when the main theme of your project doesn’t materialize?

I took that question to the editor-fellow workshop portion of the fellowship that week in California and received some valuable feedback.

We identified that “uncertainty” was a major theme in the health insurance markets before efforts to repeal and replace the Affordable Care Act even began. Attempts by lawmakers to undo the law made the confusion and that uncertainty among consumers even worse.

We knew that people who had Obamacare or needed coverage had questions: Would they be able to buy health insurance on the Marketplace next year? What would changes to the ACA do to health care premiums? What would happen to Obamacare if the mandate that individuals have health insurance went away?

We decided to report on that confusion and whether it was causing more people to lose their insurance.

In order to capture the drama as it unfolded, we decided to break the project into monthly installments, rather than roll it out in one, long piece at the end of six months. That way, we could get reaction from people who were affected by changes to health care as the decisions were made.

For instance, just before open enrollment began in the federal marketplace used in the state of Florida, some patients using the free clinics were telling intake coordinators that they thought the Affordable Care Act was no longer available. And around that time, President Trump himself said, “Obamacare is finished, it’s dead, it’s gone …” 

A month or so later, the president killed the ACA’s cost-sharing subsidies, driving up premiums for marketplace plans. The Graham-Cassidy bill was also introduced in the Senate and the repeal-and-replace conversations started again.

All the while, we were gathering voices of community members who could not afford the cost of health care.

For help finding more voices, we reached out to Jesse Hardman, who shared his work on the Listening Post Collective at the fellowship. Hardman suggested posting flyers in the clinics and in communities where people who struggle to afford health care congregate. We scoured Facebook groups and broadcasted a call for listeners to contact us if they recently lost their health insurance.

That turned up voices like Kammeron Findley, a 38-year-old health care professional who dropped Obamacare after her $110 premium tripled in four years. We also heard from parents who could no longer afford to insure their families and others who were being crushed by the cost of health care.

Their stories drove home the fact that there’s a whole segment of society who can’t afford health care. The Affordable Care Act, though hampered by cuts to subsidies and the removal of the individual mandate, survived for another year. Even so, there remain people in Florida who can’t afford insurance and end up in emergency rooms and free clinics because they have no other options for care.

We’ll continue to tell their stories.

[Photo by Chip Somodevilla/Getty Images]


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