October 8, 2013

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.

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