Reporting on Health Reform: Bringing it Home

On Monday, I listened in on a telephone press briefing on the impact of national health reform on Californians. The briefing, sponsored by the California advocacy group Health Access, highlighted new research from the UCLA Center for Health Policy Research, the UC-Berkeley Center for Labor Research and Education and the labor-backed advocacy group Health Care For America Now (HCAN).

You should take the HCAN report with the usual grain of salt you reserve for research from interest groups. Same with the UC-Berkeley report, which was prepared for left-leaning think tank The Institute for America's Future. There are interesting tidbits in both, and the UCLA report offers particularly good background for California journalists trying to localize what's still very much a national political story.

UCLA's analysis, presented in a fact sheet and based on 2007 California Health Interview Survey data, found that about four million of California's 6.4 million adults and children under 65 who were uninsured in 2007 would benefit from the health reform proposals now being considered in Congress. That means that 93 percent of California legal residents under age 65 would have access to health insurance, a nearly 13 percent jump from the approximately 80 percent that are insured now.

The numbers were even more striking in Los Angeles County, which the researchers called the state's "epicenter" of the uninsured: 1.2 million uninsured adults and children could benefit from the current health reform proposals. (Full disclosure: the UCLA analysis was supported by The California Endowment, which also funds ReportingonHealth and The California Endowment Health Journalism Fellowships.)

So, California reporters have a good start for localizing the impact of health reform in their communities. Now, how do you get beyond the political maneuverings in Congress to come up with compelling stories that will still be relevant whether the public option comes in a trigger, opt-in or opt-out flavor?

After the press briefing, Health Access executive director Anthony Wright, Ken Jacobs, chair of the UC-Berkeley Center for Labor Research and Education and Shana Alex Lavarreda, Director of Health Insurance Studies, UCLA Center for Health Policy Research, were kind enough to share their ideas for reporters.

1. What small health reforms are percolating in your state while the national debate plays out? California tried to come up with its own version of health reform in 2007 and failed. Now, the state's budget crisis means a bit of nibbling around the edges, says Anthony Wright. For example, California Gov. Arnold Schwarzenegger recently signed a bill preventing gender discrimination in the cost of health insurance policies.

When health reform passes, however, "there will be an explosion of activity at the state level, whether it's insurance regulation or management of Medicaid, (issues) that are the purview of states," Wright said.

2. When writing about health reform, don't forget to include the impact of doing nothing. A good resource is "The Cost of Failure to Enact Health Reform: Implications for States," a report for the Robert Wood Johnson Foundation and the (again, left-leaning) Urban Institute.

3. Focus on employer-based coverage, not just the public option. " I've been amazed how little attention is paid to what employer requirements (for health coverage) are in future bills," said Ken Jacobs of the UC-Berkeley Center for Labor Research and Education. What are small and larger employers in your area saying about the proposed reforms from a business perspective?

4. Keep it simple (as much as you can). "There's a lot of talk about health care that gets unnecessarily complicated," Wright said. Wright would like to see basic stories that identify groups of people and examine what health reform means for each of these groups. He explains: "Most people get coverage from work. If you do, this is what it means to you: there would be more security in what employers are required to provide to you. If you get health coverage through Medicare, the doughnut hole would close. More people would get on Medicaid. Finally, the individual health insurance market is the place where the world fundamentally changes. You break it down in terms of how the consumer experiences it. It's sort of like an iPod: we want (health reform) to be simple on the outside even though it's going to be complex on the inside."

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