How Not to Cover Coverage

From an article in yesterday’s New York Times, about the closing of the enrollment period for Obamacare health insurance policies in New Jersey. The couple, Ana Gonzalez and Celso Morales, had earlier been described as coming to a health center in Plainfield, New Jersey in order to “sign up for a subsidized health plan.”

Ms. Gonzalez and Mr. Morales, who moved to New Jersey from Puerto Rico, came to sign up for coverage on the advice of one of his co-workers after Mr. Morales was told he has diabetes. The couple — she is 54 and he is 58 — qualified for Medicaid in Puerto Rico, but in New Jersey, their income is too high. They earn about $35,000 a year between her job at Target and his work laying stones for a construction company. With the Affordable Care Act tax credit, they will pay just under $200 a month to cover the two of them, a sum that seemed to please Ms. Gonzalez.

How useful is this information if we don’t know how high their deductible is or what their coverage is like? No middle- or upper-middle class person that I know would be content to know that their health insurance premium was $200/month without knowing anything else about their policy or coverage. But for some reason, seasoned reporters for The New York Times seem to think that we’re to judge this couple’s insurance situation knowing just that.

It should be obvious–but I guess it isn’t–that a health insurance policy is not health care, and that the sheer possession of a health insurance policy doesn’t necessarily give you the access to health care that you really need. Obviously, it’s better to have a policy than not to, but having the wrong policy can also serve to enrich the insurance company at your expense–whether it’s subsidized or not. It pays to read the fine print. It also pays to report on it.

Nor can we safely infer that if the policy pleased Ms. Gonzalez, it was necessarily a good buy. A reality check: The couple just got here from Puerto Rico. It’s not clear how much English they speak or understand. They’d previously been on Medicaid. All things considered, it’s not clear whether they have the experience to judge the pros and cons of the policy they’ve just bought. Granted, they’re surrounded by people who can make those judgments, but as far as the article is concerned, none of those people is asked a single question about the merits or demerits of the policy in question.

No rational person would assume that they were better off simply because they had purchased a low-premium health insurance policy, full stop. A low-premium policy with a high deductible could in principle be indistinguishable from a high-premium policy. A low premium policy with a high deductible and bad coverage could be an outright waste of money. Do the couple know this? Did the reporters ask? Or is there simply a “premium” here on telling us that low-income people are being insured under Obamacare, and that we should leave matters there? (Oddly, we aren’t told whether Mr. Morales was pleased by the purchase, even though his condition was the reason for buying the policy in the first place.)

Elsewhere, the same authors take a shot at “the news media,” i.e., their right-wing competitors, as follows:

Without many television ads, Ms. English said, people seem to be getting their information about the Affordable Care Act from the news, where Republicans are repeatedly threatening to repeal the law and warning that insurance markets are collapsing.

“The cuts to advertising, and the media, have put it in people’s head that it’s going to be too high and they can’t afford it,” Ms. English said. “Then when we do tell them what it’s going to cost, they would just be shocked. ‘Oh, the media said it was going to be expensive.’ We say, No, no, you just need to do it.”

Well, a deductible is surely part of the “cost” of an insurance policy, and the nature of the coverage one gets is part of any rational deliberation of the pros and cons of buying one. I don’t doubt that the right-wing media’s coverage of health care issues is mostly crap. What I’m not sure about is whether the Times is all that much better.

People interested in writing journalism rather than propaganda would skip the gratuitous rhetorical jabs, and descend to real-world details about premiums, deductibles, networks, and coverage. If you went to HR and were told that your company offered a great health insurance policy with a $200 monthly premium, but they refused to tell you more, you’d either leave in a huff or laugh in their faces. It’s an interesting question how we’re supposed to respond to news coverage with about the same concern for facticity and detail. But apparently, that’s the kind of coverage we’ve got.

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