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Wednesday, February 20, 2019

Reprinted with permission from Media Matters for America.

In the lead-up to the election, prime-time news shows functionally abdicated any role in questioning what President-elect Donald Trump will offer in place of the Affordable Care Act (ACA) and how it might affect the millions of Americans who gained insurance coverage as a result of the landmark law. Instead of asking pointed questions about Trump’s piecemeal policy proposals, TV personalities focused on negative stories like the 2017 premium hikes and conservative fearmongering about the potential of a so-called “death spiral.” Going forward, media figures must make “What is Trump’s replacement plan?” their first question in any discussion of health care policy and ask necessary follow-ups to pin guests to substantive proposals.

According to a Media Matters analysis of broadcast and cable evening news coverage from October 24 to November 7, TV personalities asked questions about Trump’s potential ACA replacement plans only four times amid 77 total discussions of health care. In total, TV personalities, panelists, and reporters mentioned Trump’s health care plans 13 times, and these mentions occurred exclusively on cable shows, revealing a serious deficit in broadcast coverage of health care in the last weeks of the election. Compounding the problem, nine of the 13 mentions came from either Fox News or a Trump surrogate (like Corey Lewandowski or Kellyanne Conway) on CNN, meaning right-wing media spin dominated the limited substantive discussions of Trump’s plans.

Media figures’ failure to probe politicians and surrogates on Trump’s plans kept important context out of the health care discussion. For example, during a panel segment on CNN Tonight, correspondent Corey Lewandowski insisted that “Trump has laid out a plan” to let individuals “buy health insurance across state lines,” calling it a “simple solution.” CNN host Don Lemon asked no follow-up questions — problematic given the numerous critiques of the “state lines” proposal — and instead changed the subject. Hosts must be prepared with the facts on proposed policies and hold guests accountable for explaining the impact of those policies. Permitting conservative talking points to stand unchallenged allows conservative misinformation to fill the void in a confusing policy arena that is poorly understood by the American public.

Coverage of health care in the last two weeks of the election largely focused on the news of double-digit premium increases next year on average for insurance plans sold on Obamacare’s online marketplace at As Trump used this news to make his pledge to “repeal and replace” a focus of his closing campaign, news coverage failed to ask important questions about his idea to keep the popular parts of the ACA — like prohibiting insurers from discriminating against individuals with pre-existing conditions — while getting rid of other provisions. Instead, TV personalities focused on the premium hikes and fearmongering about the potential for a “death spiral.” The focus on negative news like premium hikes makes sense — it was an important story that deserved coverage. But that coverage completely eclipsed almost any substantial discussion of what Trump’s replacement plan might include — a trend reflected in the broader failure to engage in much of any policy discussion throughout the election.

The overall lack of coverage about the specifics of Trump’s replacement plan represents a fundamental problem in media’s treatment of health care policy and must quickly change now that Trump is the president-elect. A recent study from the Urban Institute showed that 24 million people will lose health care coverage by 2021 if Congress repeals the ACA. Trump’s nominee for secretary of health and human services, Tom Price, is a known foe of the law’s birth control mandate, a regulation that has dramatically reduced out-of-pocket health care costs for women and massively expanded contraceptive coverage. Repeal could also roll back the gains made in reducing the budget deficit, extending the life of Medicare, and lowering health care costs that resulted from the implementation of the ACA.

While no concrete plan for a replacement currently exists — due to Republican infighting — repealing Obamacare remains a top priority for the incoming Trump administration. Journalists must start asking questions about what a replacement plan will look like, how it will affect millions of Americans who gained coverage under the ACA, and what its true goals are. Every interview or panel segment about health care must begin with the question, “What is Trump’s replacement plan?” and include aggressive follow-ups about how it would function in order to hold the Trump administration accountable and educate the American public on the future of health care in the United States.


Media Matters conducted a Nexis search of transcripts of weekday network broadcast evening news programs on ABC, CBS, NBC, and PBS and weekday prime-time news programming (defined as 6 p.m. through 11 p.m.) on CNN, Fox News, and MSNBC from October 24, 2016 (the day the Obama administration announced the premium hikes), through November 7, 2016. We identified and reviewed three types of segments — news reports, panel segments, and interviews. We searched for “Obamacare” or “Affordable Care Act” or “health care” and identified and reviewed all segments in which health care/ACA/Obamacare was the stated topic of discussion, or health care/ACA/Obamacare was discussed by at least two speakers in the segment (e.g., a host asking a single question about the ACA to a guest and the guest responding during a multitopic interview would count).

IMAGE: U.S. President-elect Donald Trump talks with the media at Mar-a-Lago estate where Trump attends meetings, in Palm Beach, Florida, U.S., December 21, 2016. REUTERS/Carlos Barria

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9 responses to “What Exactly Is Trump’s Replacement For Obamacare?”

  1. secondclassguy says:

    When do media outlets EVER talk about the nations healthcare system in any comprehensive way. I know why, because it’s not exciting enough. If you ask anyone what’s the most important thing in their lives they always say their health. Yet the media never covers that most important thing.

    Most people who work in the media are covered just fine, so even on a personal level it’s a big yawn. Of course you will see coverage over the next few months as reality for millions sets in that their coverage, and all the protections could be gone.

    The media coverage i hope focuses on all the neglected things that were never covered about the ACA, and that all it’s components except one are extremely popular, how republicans lied to people in every way about the ACA, and how all their ideas to replace it are highly inadequate

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  2. bobnstuff says:

    As of right now the Republican plan is DON’T GET SICK! The insurance industry has bought the party and now are going to take it for a spin. If you thought rates were bad before just watch what a deregulated insurance industry will do for you. The best case scenario is that the states that can afford to will put in place Romneycare. These are the states that voted for Clinton. Those poorer states will be left with nothing but since they voted for Trump they will be getting what they voted for. The only problem here is the 35% to 49% that didn’t vote for Trump in those states will also get the short end of the stick. Remember we have the best government money can buy.

  3. Arnie says:

    First off Mr. Trump and all the Republicans can’t come up with a new version of the ACA because the ACA (Obamacare) is a Conservative think tank Idea and approved by a truckload of Republicans in the House and Senate to start off with. It’a done with private insurance companies with a minimum standard of health coverage much like automobile liability insurance. In-fact the ACA paradigm is very much like auto liability insurance. Add to that the fact that the ACA is rather basic with little that can be cut from it. I suspect that the reason it is been disliked by the party that created it and that so much false information put out about it is because Pres. Obama put it through. The replacement for it will most likely be close to the same thing if not the same thing, because it’s so basic, and already privatized, only it will have a different name so it looks like a Republican or Trump idea.

    The idea of improving it is too much to ask for because that will require creative thinking and work. Without that it’s back to insurance companies taking our money and cutting the service and and charging more each year or two (by between 8-15%) with 40 million Americans not insured placing a heavy burden on hospital emergency rooms. What a great idea! Oh, been there, done that, didn’t work.

    An actual, checkable fact, the rise in the cost of healthcare America has flattened out some making this year the slowest rise in a decade. It’s still going up, just less so. The insurance companies still have the power to increase fees at will. Without laws that control that (like all other corporations) then what’s the point. Healthcare has been going up bigger and faster than the cost of living by allot, but like I said less so over the past decade. The ACA has helped. It needs tweaking so it can do a better job. That my good people is exactly why we elected those people to represent us, we the people. The ACA is starting to work it’s their job to make it work better for us and not the insurance companies. If they can’t, then we fire them! To borrow a phrase, “You’re fired!”.

  4. CPANY says:

    I don’t believe that Trump thinks that far ahead. He’s a “shoot from the hip” type.

    If he gets backed into a corner, he’ll probably propose expanding Medicare to cover the entire population as a face-saving device.

    Bottom line: Socialized medicine for all.

    • secondclassguy says:

      Tom Price would never accept that

      • CPANY says:

        He may not have a choice if Congress implements it.

        • secondclassguy says:

          true but if you look into how he views this issue it’s clear he was picked for a reason. If he gets ejected i see some hope. The HHS has some broad powers to make it difficult for people to get coverage even with congressional laws in place. It’s kind of like having the right to vote but making it very difficult. He could do things like require near impossible means testing of income, among other things

  5. johninPCFL says:

    Alan Grayson brilliantly summed up the two-part GOP plan in 2009: “Part One: Don’t get sick. Part Two: If you do get sick, die quickly”.

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