political convention

political convention

Monday, April 7, 2014

60 Minutes and the Missing Facts on Medicaid

60 Minutes is the most widely viewed and respected public affairs program on television.  But after one recent edition (4/6/14) its reputation for incisive reporting may have earned the kind of steely look Mike Wallace once turned on interview subjects.   

The lead report tells the engaging story of two registered nurses who travel the back roads of Virginia’s Appalachia in an old RV bringing medical care to some of the poorest people in America. The two women fight a nearly hopeless battle against disease, poverty, and ignorance. And, oh yes, the other thing they encounter is government indifference, and 60 Minutes leaves the impression that one of the main culprits is Obamacare.
The story begins with President Obama’s exuberant announcement that 7 million people have signed up for the government plan, a significant victory.  But the President has left something out, correspondent Scott Pelley tells us. Another 5 million people aren’t getting covered and are at risk because of it.

It turns out that most of the uninsured in Appalachia, like those being served by the traveling nurses, as well as thousands of others across the country, don’t earn enough to pay for insurance under the new government exchanges.  But they earn too much to qualify for Medicaid, the longstanding government program that covers the poorest people. 

To address this problem, Obamacare required the states to expand Medicaid, a system they partly fund.  By widening the Medicaid umbrella, millions of the working poor would receive health care. However, the Supreme Court in its review of the new health care law ruled that states could not be compelled to participate. Twenty-four states have now declined--and for good reason, 60 Minutes leads us to believe. 

Pelley notes that Obamacare imposes extra costs to the states that expand Medicaid coverage. The federal government picks up the bill for three years, but after that the state pays. According to Pelley, “Virginia and other states that opted out fear that the cost in the future could bankrupt them.” 

Perhaps all of this sounds reasonable if you want your state to manage its fiscal affairs without breaking the budget. However, what Pelley fails to report is that after those first three years when the federal government pays the full cost of expanding Medicaid, it continues to fund at least 90 percent from then on.*  It is hard to believe that a state such as Virginia, with its burgeoning high tech industries and large numbers of federal government workers, won’t be able to afford the tab in the future.  Is there another reason?

The answer is yes, but Pelley doesn't say so. He neglects to tell viewers that all of the 24 rejectionist states are controlled by Republicans—either by gubernatorial or legislative power, or both. And the reason for opposing Medicaid expansion is hardly about balancing the budget. It stems from a deep-seated hatred of Obamacare because it has the potential to be a popular and successful government program and it was created by a president they loathe.  In Texas, for example, not only have the legislature and governor refused to accept Medicaid funding, but they have actively sought to prevent Obamacare insurance exchanges from signing up clients.  (Virginia has now elected a Democratic governor, but the Republican-dominated legislature is preventing him from taking the state into expanded Medicaid.)

The 60 Minutes story is captivating as it portrays the saintly work of the two nurses traveling Appalachia in their RV. But the story is marred by the factual omissions.  Most important, the report obfuscates the real reason thousands of poor people in  Appalachian Virginia and elsewhere lack health care under Medicaid. It is that Republican governors and legislators have chosen to disregard the health needs of fellow citizens for reasons of right-wing political ideology. They are the ones being indifferent to the needy people served by the nurses in the RV.

Mike Wallace
Scott Pelley

*See:  http://www.commonwealthfund.org/News/News-Releases/2013/Dec/States-Rejecting-Medicaid-Expansion-Costing-Taxpayers.aspx

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