Health Reform: Covering the Rollout in Your State and Community
If you haven't seen this Kaiser Family Foundation health reform video yet, you should. Aside from being quite cute, it's a fairly even-handed explanation of what health reform will and won't provide.
Onward: At the recent California Endowment Health Journalism Fellowships seminar in Los Angeles, Victoria Colliver and Mary Agnes Carey, two veteran health journalists, and health policy consultant Peter Harbage provided an update on health reform's rollout at the state level and ideas for covering it in your community.
Here are some of the highlights:
1. Setting a new bar: States traditionally have regulated insurers, but health reform has propelled the federal government into a stronger, but still evolving, regulatory pressure affecting what insurers can and can't do, Harbarge said. Health reform sets national standards that states aren't accustomed to," Harbage said. "It's a real change in the state federal-relationship." That tension is likely to be the source of many a story in the coming months.
2. The evolving image of Medicaid. Created as a welfare program, Medicaid was "de-linked" from welfare during Clinton-era welfare reforms. But it still retains its stigma, Harbage said, noting that applicants are still put through a variety of potentially degrading financial asset tests, including, in California, asking whether they have burial plots. "At what point does Medicaid stop being a safety net program and start being just a way the state ensures that its residents have health care?" Harbage asked.
3. Is your state balking? Some state leaders are fighting implementing health reforms with lawsuits or general foot-dragging, while others have embraced the reforms. Where does your state stand? The constitutionality of the new reform law is largely expected to be upheld in court, but in the meantime, "Americans are already confused and this kind of stuff could really complicate things," Carey noted.
4. One size does not fit all. How health reform will affect your audience depends greatly on what kinds of insurance they have, whether they're "grandfathered" and their incomes, Colliver pointed out. Don't write as if everyone is equally affected.
6. Employer calculations. Employers are trying to figure out whether to dump their existing insurance in favor of having employees buy health insurance on exchanges starting in 2014. What calculations are employers in your region making? How do employees feel about the potential changes?
7. Explain, explain, explain. "The more explainers you do, the better," Carey said, noting lists of key points and short definitions health reform terms can be run with every story. If you're in broadcast, publish these boxes online.
8: Line up your sources early. Colliver suggests establishing relationships with insurance brokers who are independent and not tied to major firms. Brokers can serve as a kind of early warning system because they hear early from clients about issues like rising premiums and have communications with insurers that journalists traditionally don't have access to. Keep contact information for readers who contact you with their personal stories on hand for use in future stories. "It can be hard to find ‘real people' on the fly," Colliver said.
8. Electronic health records. Doctors are facing a new system of carrots and sticks prompting them to establish or upgrade electronic medical records in their practices. How are local doctors handling this issue? Are they avoiding it altogether? Click here for more ReportingonHealth tips on covering electronic health records.
9. Medical school bonanzas? If you have a medical school in your area, what federal money are they getting – or going after – to train new healthcare workers? There is a hefty amount of money in the health reform bill up for grabs.