Articles about "Health care reporting"


Journalists can learn how to use Medicare surveys of their local hospitals to develop stories about the quality of the care they provide. (Depositphotos)

How to tap into patient reviews of local hospitals

If you haven’t examined how your local hospitals performed in the latest Medicare surveys, you’re missing out on some important stories with high likely readership.

Jordan Rau of Kaiser Health News joined us for a chat on how journalists can use the surveys.

The surveys, one of the first parts of the Affordable Care Act, probe patient attitudes on such questions as how carefully doctors and nurses listened to them, how often they were treated with courtesy and respect, how well their pain was controlled and, among other things, where they’d rate the hospital on a scale from “worst hospital possible” to “best hospital possible.”

The results of the surveys are used to provide more than 2,500 hospitals nationwide with federal government bonuses or penalties, depending on the survey results.

Rau, a senior correspondent for Kaiser Health News, covered the surveys extensively last month from the national perspective, accompanied by useful charts and spreadsheets. Still largely untold are local stories exploring patient attitudes toward individual hospitals. Rau can direct you to easy-to-access databases on the Medicare website that compare individual hospitals with one another and with national and statewide averages. Interviews that you’d do with local hospital workers and officials — as well as patients and advocacy groups — could significantly advance your audiences’ understanding of healthcare in your region.

Here’s an example of how the St. Louis Post-Dispatch localized the quality-incentive story with a focus on hospitals in its region.

Here’s a pdf of the questionnaire that patients are asked to complete.

Bring your questions to our online chat and walk away with the tools to write stories that will impact your community.

Check out NewsU resources for covering Medicare. Those resources and this live chat are funded by the Robert R. McCormick Foundation as part of the McCormick Specialized Reporting Institutes program.

You can replay this chat at anytime and find the rest of our archives at www.poynter.org/chats.

 

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The performance of HealthCare.gov isn't what will count in the end, says Politico's Joanne Kenen. (AP Photo/Jon Elswick)

Health care coverage is more than numbers

We’ve heard a lot about the HealthCare.gov website and its performance metrics recently.

But the Affordable Care Act metric that really matters isn’t error rates or response time. It’s enrollment.

Furthermore, what matters isn’t just how many people enroll – although that’s part of it. It’s also who enrolls – in particular, their age and health status. A mix that includes younger and healthier people is needed for a viable insurance risk pool. And whether that mix has been achieved may not be clear until later in the six-month open-enrollment season. Read more

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How to fact-check the health care law

Before the health care law — aka Obamacare — the American health care system was a fragmented, confusing patchwork.

After the health care law, the American health care system remains a fragmented, confusing patchwork.

And there’s no sign that’s going to change anytime soon.

I’ve been fact-checking health care for PolitiFact since 2007, and I have to remind myself all the time: We don’t have one health care system, but several.

The biggest chunk of Americans get health coverage at work, through some sort of employer-provided plan. Next up is Medicare for people over age 65, along with Medicaid for the poor and other forms of government-provided health care insurance. A few people — about 6 percent of us — go out and buy health care insurance on our own, in what’s known as the individual market. It’s that relatively small chunk that has been getting cancellation notices in recent weeks, because the current plans don’t meet new standards for comprehensive coverage.

What does this mean for your reporting?

It means you have a bunch of different people to think about as you prepare your reports. People who get insurance at work, for example, may not know what’s it’s like to buy on your own. Younger people may not understand how Medicare works. Then there are veterans; the VA health care system is unlike any other. And the list goes on.

The 2010 health care law didn’t try to change the basic contours of these systems. Instead, it sought to bring the uninsured into the existing framework. Plus, it pushes and prods the health care industry toward more efficiency with tons of smaller changes and fixes.

Confusing? You bet.

So what’s a journalist to do when fact-checking claims about the health care system?

1. Call out the most ridiculous claims. The health care law does not turn the U.S. system into one like Canada or Britain. Muslims are not exempt. There are no death panels. Congress is not exempt from Obamacare, despite some members of Congress saying they are. PolitiFact has fact-checked more distorted claims about the health care law than any other piece of legislation. We published a list of 16 myths, rounding up the most absurd claims.

2. Embrace nuance. Calling out the worst of the falsehoods isn’t too hard, but other claims are trickier. Promoters of the law in particular can be a little rosy in their assessments. At PolitiFact, we found 10 things Obamacare supporters say that aren’t entirely true.

Obama said that if you liked your health care you can keep it, and the cancellation notices that have gone out to people in the individual market directly contradict his statement.

But Obama wasn’t entirely off-base, either. It was a way of letting people know that his plan wasn’t a single-payer, Canadian-style proposal. People who get their insurance through work, for example, get to keep their plans to the same extent that they did before the health care law — that is, they’re subject to changes their employers decide to make. People on Medicare are left alone, for the most part. We get regular criticism whenever we rate a statement Half True, but in a complicated world, it’s often the right call.

The health care law touched almost every part of the health care system, in ways both major and minor. It’s hard to make sweeping generalizations.

3. Look to nonpartisan sources, and talk to both sides of the partisans. We’re always looking to respected, independent sources on the health care law. When it comes to cost and economic impact, we look to the Congressional Budget Office for its regular reports and forecasts. The Congressional Research Service, an official government agency, publishes more topical reports that often find their way to the Internet. (Frustratingly, these reports are not public records.) Outside of government, the nonprofit Kaiser Family Foundation is a treasure trove of unbiased information and research.

Keep in mind, though, the people who know the details of the health care law often have strong opinions about it. We like to interview experts on one side of the debate and then run their line of thinking by the experts on the other side. That way, you find the areas where there truly is common agreement, and where the arguments are strong or weak. (If you’re looking for ideas on sources, we list our sources on the right-hand rail of each fact-check.)

4. Welcome reader reaction. Everybody needs health care, so everybody usually has opinions about health care. Brace yourself for hate mail: Because the health law is so politically polarized, passions run high. But we also get lots of good tips and feedback from readers who let us know when we haven’t considered all the angles. Readers who are willing to share their experiences  can be a rich source of interesting stories.

Angie Drobnic Holan is the editor of PolitiFact. She has been covering federal health care policy since 2007. She will be our guest at noon, ET, on Wednesday through Poynter’s News University. Learn more and sign up now.

Related: How to avoid mistakes in covering the Affordable Care Act | How reporters can localize coverage of the Affordable Care Act | 5 myths about the Affordable Health Care Act | How to weave stories of ‘real folks’ into coverage of health-care law | NPR will use term ‘Obamacare’ less | News orgs rush to quote guy who said he bought Obamacare plan

Training: Covering the Affordable Care Act – free, on-demand NewsU Poynter Conversation Read more

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How to avoid mistakes in covering the Affordable Care Act

If there’s one thing everyone can agree on about Obamacare, it’s that the law is complicated. Really complicated — especially for a reporter trying to write about it on a deadline.

I’ve spent the past four years writing about the Affordable Care Act for two different newspapers. To this day, I still run into provisions that are new to me and face the challenge of trying to understand them fast enough to turn around a blog post later that day.

Unfortunately, covering the health law is unlikely to get easier anytime soon. As the new marketplaces roll out, and readers begin researching their options, they will no doubt have lots of questions about how it all works. Here are five of the common mistakes that I’ve made before, have seen others stumble on and hope you can avoid.

1. Not keeping the size of the overhaul in perspective. The Affordable Care Act is, without a doubt, the most significant insurance expansion since Medicaid and Medicare became law in 1965. At the same time, it will only impact a small sliver of the American population. Just 7 percent of the population — or 24 million Americans — are expected to use the health insurance marketplaces by 2023. An additional 13 million people will gain access to Medicaid through the health law’s expansion of the public program.

The vast majority of Americans will continue to get health insurance the same way they do right now, either through their employer or public insurance programs. When readers ask me how the health care law will affect them, and they currently have coverage through their employer, the answer can often be pretty simple: It won’t.

2. Comparing premiums from before and after the health care law. The health care law will dramatically upend the individual insurance market beginning Jan. 1. That makes comparing premiums from before the health law to those offered afterwards a bit like comparing apples to oranges — or even apples to steak.

Here’s why: The health care law makes four big changes to the individual insurance market. First, it requires health insurance plans to cover all subscribers regardless of whether they have any pre-existing health conditions. This will likely increase premiums, as insurers will have to accept sick patients who, right now, they reject.

Second, it dramatically restricts the factors that insurance plans can use to determine the size of premiums that a subscriber will pay. Right now, they can use hundreds of different elements of an individual’s health. Starting in 2014, they can only use three factors: age, location and tobacco use. This change will likely increase premiums for the young and healthy, but decrease them for the old and sick.

Third, insurance companies are required to cover 10 categories of benefits, like maternity care and hospital visits. Known as the “essential health benefits,” this set of health care services is generally thought to be more robust than what individual market plans cover now. This policy will probably nudge up premiums just a bit.

Fourth and lastly, the health law includes subsidies for low- or middle-income people to purchase health insurance. This will likely decrease premiums, as it provides financial help for those buying their own coverage.

Taken together, these suite of four changes make the insurance market of tomorrow different than what exists right now. It’s one where insurers have to take all consumers — and will have to provide a larger suite of benefits. Many shoppers will get financial help. This makes the market very different than what exists right now, and any comparisons between premiums of the past and future extremely difficult.

3. Just focusing on the premiums when other cost-sharing matters a lot for affordability. Premiums are an easy metric when it comes to judging health care costs. They are the most stable form of payment in a health plan, the one piece where the price stays the same from month-to-month. That probably explains why they’re most often used to examine how expensive a health plan would be for consumers.

Leaving out other forms of cost-sharing, though, doesn’t give consumers the full picture of what they might actually pay. When discussing health insurance costs, three other factors could help give readers a fuller picture. The first is the deductible, which is the amount consumers owe until their health plan begins to pay. In some cases, the deductibles on the exchanges are pretty high, upwards of $6,000 for an individual policy.

The second element that can help consumers understand the cost of their health plans is the co-payment, the fixed amount that the subscriber pays when they take a trip to the doctor. Lastly, there is co-insurance, when the subscriber pays a certain percentage of a the cost of a doctor trip.

These concepts don’t squeeze easily into a one-sentence comparisons of health insurance plans. But they do help readers get a better understanding of how much health insurance costs under the Affordable Care Act — and helps them avoid the potential sticker shock of higher costs after committing to a certain premium.

4. Leaving out medical trends that pre-dated the Affordable Care Act. There are lots of changes happening in the healthcare industry, some of it due to the health law and some to completely independent factors. Tying everything to the health overhaul is easy to do, but also avoidable.

The best way to dodge this mistake is to look at how health care trends were evolving before the health care law took effect, and see if they have changed since. One great example in this space is the growth of health care costs, which has recently begun to slow. That could seem like a product of the health care law until you notice that the health cost slowdown began in 2009, while Congress was still debating whether to pass the Affordable Care Act. It’s helpful to do the same kind of research on premiums and narrow insurance networks, to get a sense of what began as part of the health law and what predated it.

5. Comparing the exchanges to “Expedia.” This is one area where, at least in my view, even the White House has been guilty of making a mistake. They’ve told voters that buying insurance on the new marketplaces will be just as easy as buying a plane ticket on Expedia.

But health insurance policies are more complicated than plane tickets, not to mention a much more significant financial commitment. We’re talking about a commitment to spend money each month. Telling readers that such a purchase will be as easy as shopping for a trip is most likely not true, even before all the technical problems the marketplaces are now experiencing.

Part of this has to do with the act of purchasing health insurance, which requires entering in information about your family size, your age and where you live. Part of it also has to do with how the federal government designed its website. Unlike most shopping websites, HealthCare.gov requires users to create an account before browsing insurance options. That has created what many technology experts see as a bottleneck that sometimes crashes the website, and makes the shopping experience more difficult than others.

Want to learn more? Sarah Kliff, who covers health policy for the Washington Post, will be our guest at noon Eastern on Wednesday through Poynter’s News University. Learn more and sign up now.

Related: How to weave the stories of ‘real folks’ into coverage of health-care law | How reporters can localize coverage of the Affordable Care Act | 5 myths about the Affordable Health Care Act | NPR will use term ‘Obamacare’ less | News orgs rush to quote guy who said he bought Obamacare plan

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How to weave the stories of ‘real folks’ into coverage of health-care law

On a hot, humid summer day it’s easy to find somebody who is uninsured — all you have to do is look for the folks on their front porches. If they can’t afford air conditioning, they can’t afford health insurance.

What’s harder is determining whether or not the people you talk to will actually get coverage under the Affordable Care Act. Here in Tennessee — as in almost all of the Southern states — just being poor and uninsured doesn’t automatically qualify you for coverage.

That’s how I wound up walking around sweating and trying to keep a piece of paper dry. The paper spelled out yearly incomes according to percentages of the federal poverty level as adjusted by family sizes. Anyone who made less than that level — about $23,500 for a family of four — was going to be a loser under the federal health law in Tennessee, where at this point Medicaid isn’t being expanded. Not only would these folks not be getting Medicaid, they would also not qualify for a subsidy toward buying private insurance on the exchange.

Which meant I was the one who had to deliver the bad news about “Obamacare.”

That’s what it takes to get the voices of real people into news coverage about the Affordable Care Act. After learning all I could about the law, I came to a few conclusions:

  • The politicians and analysts were getting too much attention;
  • I wasn’t smart enough to understand the macroeconomics behind the legislation
  • All people really wanted to know was how the law affected them.

With these conclusions in mind, editor Lisa Green and I set two basic goals. The first was to determine who the uninsured really were and explain how the law would affect them. The second was to identify the law’s winners and losers.

We kicked off our coverage with vignettes told from the perspectives of individuals representing groups falling through the coverage gaps. These short articles gave answers for each person’s situation and came with several infoboxes. The individuals chosen included a part-time job juggler, an immigrant, a ”young invincible,” a worker who makes less than the poverty level, an entrepreneur and someone with pre-existing conditions.

I didn’t find these folks on front porches — that came later. It took time to identify people who would commit to sharing their stories, having their pictures taken and appearing on video. Later in the series, we focused on the people who had to pay for the law — the high-wage earners, suntan-parlor owners, businesses that would fall under the employer mandate, and medical-device companies.  We also profiled an emergency-room “frequent flyer” — a patient who needed many such visits and had been identified for special attention by an accountable care organization.

Here are a few tips for identifying the winners and losers under the health law and then weaving these people into your coverage:

  1. As crazy as this might sound, start with the Internal Revenue Service. The agency does a pretty good job spelling out whose taxes are going up and what the penalties are for not abiding by the law.
  2. Reach out to federally qualified health clinics for uninsured people to interview, but don’t count on them to deliver a “real person” as a news source. While working on a story about two towns on either side of the Tennessee-Kentucky state line, I had commitments from two organizations to help me out, then heard nothing. That’s how I wound up driving to Portland, Tenn., and Franklin, Ky., with that sheet of paper. Now that colder weather has arrived, the uninsured are no longer sitting on front porches, but they are washing clothes at laundromats and using the free Internet at libraries.
  3. Don’t be afraid to call in a favorfrom that server/bartender you always tip generously. This is probably a young, uninsured person who already likes you and will feel comfortable sharing his or her story.
  4. Realize that this law is hitting some folks’ pocketbooks really hard. Many are getting hit with a 2 percent Medicare tax increase as well as other fees and penalties. Start out easy with the questions. Show as much empathy as you would in speaking with someone who’s sick and uninsured.
  5. Social justice organizations are a great resource. If you’re lucky, you have a local one that works one-on-one with people. They can help you find the stories that will connect with readers.
  6. Put your name and number out there in a big way. Ask people to call you with their questions. This is the only way to identify the folks who are most representative of your readers, and key to truly understanding what consumers want to know.
  7. Make a pledge not to quote a single politician, and try not to break it (even though you will). It’s inevitable that you will need politicians to explain something, but turn to them only if you have to. Don’t get caught in the political trap.
  8. Don’t assume people know things. I have made this mistake. Many Medicare recipients think they have to take action with their insurance exchange when they don’t have to do anything. I’ve received many calls and emails from Medicare recipients. My to-do list includes a story spelling out what the law does mean and does not mean for them.

Want to learn more? Wilemon will be our guest in a video interview at noon Eastern on Wednesday through Poynter’s News University. Learn more and sign up now. Read more

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How reporters can localize coverage of the Affordable Care Act

Health reporting is steeped in science and certainty. Healthcare reform is a different beast, dominated by politics and unpredictability.

Congressional battles, U.S. Supreme Court decisions and state legislative votes meant to clarify the Affordable Care Act instead produced universal frustration. Reporters are tasked with sorting through the confusion and localizing one of the most significant federal laws in decades.

I’ve written numerous “what-if” reform scenario stories the past few years. Early on, my editor and I created a mantra to focus only on our Florida and Tampa-area audience — and their ability to take care of their health and their pocketbooks. Political reporters have chopped through ideological thickets. For the most part, I’ve been able to stay focused on health.

Now, as the ACA lumbers toward its biggest milestone — the Jan. 1 health insurance requirement for nearly all Americans — more journalists want to sort the political stories from the practical. And it’s a good time, considering most of my sources, neighbors and friends all seem to be asking: “What’s this all really mean to me?”

Some important, immediate stories surrounding the 2014 changes include:

  • The new online exchange or marketplace, which primarily affects the uninsured and people who buy their own coverage
  • Expansion of Medicaid insurance for the poor (or the impact of no expansion in states opposed to it)
  • Elimination of restrictions of people with pre-existing conditions
  • Transitions businesses large and small will be making to prepare for a Jan. 1, 2015 rule change

Here are ways you can identify local issues and add community flavor.

Include local context in all your stories

The Kaiser Health Foundation’s State Health Facts lets you see who is insured and uninsured in your state. Know who will be eligible for the exchange, aided by Medicaid expansion or left out.

See if state health agencies have regional or county information. For example, Florida’s data provides basic, non-political context. The U.S. Census also has hyper-detailed data.

Don’t focus too much on one issue

The Oct. 1 launch of the online marketplace is hot, and gobs of money are being spent to attract an estimated 48 million uninsured Americans. The U.S. Department of Health and Human Services and other pro-Obamacare camps are regularly pitching stories.

But remember almost half of all Americans have insurance through an employer, and another 30 percent already are on Medicaid or Medicare, the government’s health insurance for seniors.

The Tampa Tribune and TBO.com have seen these figures reflected in an interactive Healthcare Q&A we launched this summer, designed to answer people’s questions about the law. About half the inquiries come from people with insurance. As a result, we included specific stories on the insured in our recent series and special online report – Your Health. Your Care.

Keep politics out of explanatory stories, if you can

The political battle over Obamacare won’t end for years, but regardless, the ACA is changing how most Americans get insurance. The rancor is especially toxic in states such as Florida, where Medicaid expansion remains a hot political debate.

Personally, I avoid talking to politicians or advocacy groups for explanatory stories. I’ve seen both sides share inaccurate information. Be sure to focus on how changes affect individuals and their families.

Rely on solid resources

Political groups will keep pushing agendas, so have some reliable national sources in your pocket. For daily news, go to Kaiser Health News. Reporters there focus only on health, but the site also summarizes local and state coverage, offering ideas and context you can use.

For the big picture, The Association of Health Care Journalists has a comprehensive and up-to-date section devoted to reform. And the Alliance for Health Reform offers information in its journalist resource page.

Look outside health care

The uninsured in many cases are not sick, so hanging out at community clinics doesn’t tell the whole story. Find the poor and uninsured at places such as food banks, where people are worried about food and shelter, not health care. But often a medical condition or costly trip to the hospital led to their financial crisis.

More so, a vast majority of the uninsured are employed. Nationwide, less than 40 percent of small businesses offer insurance to their employees. Look for local small businesses collaboratives, not just Chamber of Commerce organizations that may have a political agenda.

Also, try reaching out to old sources not connected to health care. They may trust you and point you in the direction of friends or colleagues who have compelling health insurance stories.

Reporters are pros at summarizing long, detailed personal anecdotes. But be careful when choosing quotes and sound bites about the Affordable Care Act.  A person’s claim about being denied coverage may be accurate and compelling journalism, but out of context it can be a disaster.

Keep asking

So much about the Affordable Care Act is unknown, and it will be fluid for years to come. Specifics about health care costs, as well as local phone numbers and resources about the online exchange will start showing up after Oct. 1.

But many of the groups with this information are small, grass-roots groups. Keep calling or emailing contacts you have. And update your audience when helpful, concrete information becomes available.

Communities will only get hungrier for information. If possible, dedicate a place on your website for local reform and update it regularly. Use this spot to educate and interact with readers up to Jan. 1 — and long after.

Want to learn more? Shedden will be our guest in a video interview at noon Eastern on Wednesday through Poynter’s News University. Learn more and sign up now.

Related: 5 myths about the Affordable Care Act
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5 myths about the Affordable Health Care Act

Let’s face it: As a reporter, there’s pretty much nothing you can write or broadcast about the Affordable Care Act that someone won’t complain about. From its inception in 2009, the bill, and later, the law, has prompted more disagreement than any law in recent memory.

As a result, less than a month before the major part of the law is set to get underway, the public remains confused. The latest monthly tracking poll from the Kaiser Family Foundation finds that 44 percent of those polled are unsure if the Affordable Care Act is even still in force or whether maybe it’s been repealed by Congress or overturned by the Supreme Court.

Part of the reason for that confusion is that the law is both large and complicated. Unless you’re an expert in health care and tax policy and economics, it’s pretty much impossible to understand everything about how all the moving parts fit together.

In fact, even if you are an expert, just about every day there’s another twist that jumps up to surprise you. That’s because the law lays a complicated structure on top of an already complicated health care system. “In fairness, how many people know how their own health insurance works?” Kaiser Foundation President and CEO Drew Altman said by phone.

But another reason for the confusion is that both supporters and opponents of the law have exaggerated and misrepresented things about the law. And reporters (including this one) have frequently fallen into some fairly easy traps that can be avoided. Here are the top five myths to avoid:

1. The law changes everything about the nation’s health care system.

Actually, the law mostly just builds on the existing system, where the majority of people will continue to get private health insurance through their or a family member’s job, or an existing government program like Medicare, Medicaid or the Department of Veterans Affairs.

A sizable minority of the population continues to support a “single payer” system (like our Medicare or the one in Canada) where tax dollars pay for care provided by private healthcare providers. But that has never mustered anywhere near majority support, nor have conservative proposals to scale back existing government involvement in the health care system, which has been substantial since the creation of Medicare and Medicaid in the 1960s, and the addition of the Children’s Health Insurance Program in the 1990s.

In fact, the Affordable Care Act is so un-sweeping in many ways it’s not even projected to eliminate the problem of the uninsured. Even before the Supreme Court made the expansion of Medicaid under the law optional, the Congressional Budget Office estimated that when the law was fully implemented in 2022, about 10 percent of the population would remain uninsured; about 27 million people.

And despite the desire of many people to purchase insurance on the new health exchanges that are about to open for enrollment, they are in fact open only to those who currently purchase coverage in the individual market, those who are uninsured, and those who do not have an offer of affordable coverage at their workplace, along with small businesses. The CBO estimates that next year the exchanges will only enroll an estimated seven million people.

2. The law won’t change anything if you already have insurance (AKA if you like what you have you can keep it).

This may be the most frustrating part of the story to cover right now. On the one hand, there are stories pretty much everywhere about employers cutting hours or cancelling coverage, and blaming it on the health law.

On the other hand, economists say that there’s no evidence that that law has caused an upsurge in involuntary part-time employment on any macro level. (See in particular this exchange with Moody’s Mark Zandi on CNBC).

But the fact is that for some substantial number of people, the president was wrong; if you like what you have, you may well not be able to keep it. It’s just that sometimes that’s because of the ACA and sometimes not.

For example, the law phases out certain types of insurance policies deemed to have insufficient coverage. People with those policies will have to buy better coverage that will also likely be more expensive. And in some cases, insurance companies may make business decisions that will force people out of policies they have and like.

But many of the changes now happening — including things like the UPS decision to end coverage for spouses who have access to other insurance — are the speeding up of trends that predated passage of the ACA. How much of that speeding up is due to the law and how much would have happened anyway is probably impossible to tease out.

“Employer coverage has been trending down for decades,” Austin Frakt, a health economist from Boston University, said by phone. “It’s just economics and rising health care costs.”

3. The law is a government takeover of the healthcare system.

Even after the law is fully implemented, “we will still be one of the most private-based health care systems in the world,” Aaron Carroll, a professor of pediatrics at Indiana University and a blogger at the Incidental Economist, said by phone.

Frakt, who is Carroll’s blogging colleague, agreed: “It’s the Heritage Plan and Mitt Romney passed it” (in Massachusetts when he was governor in 2006). “The biggest government expansion is the Medicaid expansion and it’s optional. We can just laugh this one right off the page.”

But Michael Cannon of the libertarian Cato Institute warns reporters not to take everything supporters of the law say at face value, particularly when they talk about “free” benefits like contraceptive coverage for women. “Nothing is free,” he told Poynter. “Someone is paying for it.”

4. You’ll be able to tell people how much their insurance will cost.

This is everyone’s top question: How much will I have to pay for insurance? And for the moment it remains pretty much unanswerable.

That’s partly because of the way the law is structured.

There are going to be 50 state exchanges, each with different regions within. On top of that, there are four separate “metal” categories for plan coverage (bronze, silver, gold, and platinum). Then premiums are adjusted for age and smoking status. Then, depending on your income, you may be eligible for a tax credit to defray part of the cost. It doesn’t take a rocket scientist to see that there are too many possibilities to generalize.

Right now most journalists have been covering studies looking at premiums in what’s still a minority of states that have released public figures. But while premiums in these early states have been lower than expected, many already had insurance markets that included people with pre-existing health conditions. Still, even after the Department of Health and Human Services releases information on the 30-plus exchanges it will be running, this is something that will remain difficult to generalize.

5. We know what impact the law is having on health spending.

Here’s pretty much what we know about health spending. It’s been growing at the slowest rate in the last half century — 3.9 percent in 2011. Here’s what we don’t know about health spending – why that is.

The Obama Administration would have you believe the Affordable Care Act is at least partly responsible. Most economists say that while there’s something other than the recession going on this time, it’s probably too soon for the health law to have had much of an impact.

Julie Rovner is a health policy correspondent for NPR specializing in the politics of health care.

Want to learn more? Rovner will be our guest in a video interview at noon Eastern on Wednesday through Poynter’s News University. Learn more and sign up now.
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AP stylebook adds entry on mental illness

AP Stylebook | NAB
The Associated Press has introduced guidance on how to use information about mental illness in coverage. “Do not describe an individual as mentally ill unless it is clearly pertinent to a story and the diagnosis is properly sourced,” the new Stylebook entry begins.

In the immediate aftermath of the shooting at Sandy Hook Elementary that left 20 children and 7 adults dead, there was much speculation about the mental health of shooter Adam Lanza.

By email, AP spokesperson Paul Colford acknowledged that shooting was a factor.

“Newtown was certainly among the reasons we considered this carefully, as well as the run of other mass shootings where the state of the shooter was an issue. Editors heard from and sounded out mental health experts and welcomed their input,” he said. Read more

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SCOTUSblog details in 7,000 words how CNN, Fox got Health Care ruling wrong

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In an exhaustive account, SCOTUSblog publisher and co-founder Tom Goldstein describes, minute by minute, how CNN and Fox News initially misreported the Supreme Court ruling on the health care law:

Here’s what happened at 10:07:20, Goldstein reports:

The CNN and Fox producers are scanning the syllabus. Eight lines from the bottom of page 2, they see the following language: “Chief Justice Roberts concluded in Part III-A that the individual mandate is not a valid exercise of Congress’s power under the Commerce Clause and the Necessary and Proper Clause.” They immediately and correctly recognize that sentence as fantastically important. The individual mandate is the heart of the statute, and it is clear that the Court has rejected the Administration’s principal theory – indeed the only theory that was discussed at great length in the oral arguments and debated by commentators.

Into his conference call, the CNN producer says (correctly) that the Court has held that the individual mandate cannot be sustained under the Commerce Clause, and (incorrectly) that it therefore “looks like” the mandate has been struck down. The control room asks whether they can “go with” it, and after a pause, he says yes.

The Fox producer reads the syllabus exactly the same way, and reports that the mandate has been invalidated. Asked to confirm that the mandate has been struck down, he responds: “100%.”

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Justice Ginsburg cites Washington Post reporter in health care decision

I am not gonna pretend that I’ve read today’s healthcare decision yet, but this has to be a pretty cool feeling for Sarah Kliff; Associate Justice of the Supreme Court Ruth Bader Ginsburg cited one of the Washington Post reporter’s articles in her opinion:

43-44. The extra time and resources providers spend serving the uninsured lessens the providers’ ability to care for those who do have insurance. See Kliff, High Uninsured Rates Can Kill You–Even if You Have Coverage, Washington Post (May 7, 2012) (describing a study of California’s health-care market which found that, when hospitals divert time and resources to provide uncompensated care, the quality of care the hospitals deliver to those with insurance drops significantly), available at http://www.washingtonpost.com/blogs/ezra-klein/post/ high-uninsured-rates-can-kill-you-even-if-you-have-coverage/2012/ 05/07/gIQALNHN8T_print.html.

Kliff found one word to describe how she felt when she found out:

In other Sarah Kliff news, she got one of SCOTUSblog’s #teamlyle T-shirts, the second-geekiest status symbol in Washington right now:

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