The Senate healthcare bill: Finding the facts amid the drama
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The Senate healthcare bill: Finding the facts amid the drama

June 22, 2017

The Raw Data

Unspun and unbiased. These are the facts.

US Senate releases new healthcare bill draft

On Thursday, U.S. Senate Majority Leader Mitch McConnell released a draft of a new healthcare bill. After a briefing of Republican senators at 9:30 a.m. local time, the 142-page “discussion draft” was published online by the Senate Budget Committee.

The bill proposes to maintain current subsidies on insurance premiums for low-income Americans. Under current law — the Affordable Care Act — people earning between 100 and 400 percent of the federal poverty level are eligible for these subsidies. Starting in 2020, the upper limit would be reduced to 350 percent. The proposed bill would allow subsidies for people living under the poverty level who are not eligible for Medicaid.

Under the bill, the federal government would continue granting federal money for enhanced Medicaid programs for three years, and then would phase out this funding. The government would also distribute federal funding to states for Medicare on a per capita basis instead of the current “open-ended entitlement” system, according to The New York Times. Starting in 2025, the annual growth rate of these funds would be tied to the general inflation rate, instead of the medical inflation rate.

The bill also proposes to repeal most ACA tax increases — except the tax on high cost health plans, the so-called “Cadillac tax.” It would also give states the option to not provide benefits that are currently required — such as emergency services, maternity care and mental health treatment. The bill would keep the ACA measure that prevents insurers from charging customers with pre-existing conditions a higher premium than those without.

Two other ACA measures would be eliminated under this bill: one that which requires companies with more than 50 employees to provide healthcare for them, and another which requires individuals to provide proof of health insurance when filling out tax returns. The bill also plans to eliminate Medicaid reimbursements to Planned Parenthood, an organization that provides reproductive health and family planning services, for one year.

Republicans hold a 52-48 majority in the Senate. In the event of a tie when the bill comes to a vote, Vice President Mike Pence would cast the deciding vote. Media reports say Majority Leader McConnell may call for a vote on the bill before the Senate’s July 4 recess. Before a vote, the Congressional Budget Office plans to publish an analysis of the bill’s cost and how many people would be covered under it. Once the bill is taken to the Senate floor, senators may propose amendments to it before the vote.

Read the full draft text here.

Sources used in this analysis: Breitbart, CNN, The New York Times, The Washington Post


Note from the Editors: This analysis was created during beta testing, which may account for minor imprecisions. Past rating standards may have also applied.

Distortion Highlights

  • Spin and slant distort information about proposed changes to healthcare—an issue that directly impacts Americans’ lives.
  • Using our formula to identify distortion, you can focus on the facts that matter most, rather than the reported Washington drama.

Show Me Everything

The Distortion

Read between the lines. Learn how news outlets distort the information.

Top Spin Words

  • Looming

    If the repeal bill is still looming over the Senate, Republicans are certain to face intense pressure from constituents who wish to see the Affordable Care Act remain in place. (The New York Times)

  • Blessing

    The Senate appears to have President Donald Trump’s blessing, as he told senators this week that the House’s AHCA was “mean,” urging them to create a “more generous” bill. (Breitbart)

  • Difficult to overcome

    But Republican leaders still must contend with internal divisions that will be difficult to overcome. (The New York Times)

  • Drastically

    A draft circulating late Wednesday showed the Senate legislation would still make major changes to the nation’s health care system, drastically cut back on federal support of Medicaid, and eliminate Obamacare’s taxes on the wealthy, insurers and others. (CNN)

  • Infuriated

    McConnell’s decision to keep the details tightly under wraps until Thursday was intentional and aimed at winning over his colleagues out of the public spotlight, but the secretive process has infuriated Democrats — and aggravated plenty of Republicans, too. (CNN)

    Still, the similarities to Obamacare will likely infuriate conservatives such as Kentucky Senator Rand Paul, who decried the House version as “Obamacare Lite.” (CNN)

  • Open revolt

    But McConnell faces the prospect of an open revolt from key conservative and moderate GOP senators, whose concerns he has struggled to balance in recent weeks. (The Washington Post)

  • Frustration

    Sen. Lisa Murkowski (R-AK) vented her frustration with the Senate’s lack of transparency. (Breitbart)

  • Finally

    Senate finally unveils secret health care bill (CNN)

The four outlets we examined present a similar perspective: namely, that the proposed Senate healthcare bill is polemical because it was written “behind closed doors,” and that its passage is questionable as it may not satisfy competing interests, which exist in and between Republicans and Democrats.

We found that CNN, The New York Times and The Washington Post included a higher number of spin terms that are dramatic and vague, while Breitbart included fewer. In all cases, the spin may give the aforementioned perspective. Additionally, an absence of context or precise information also supports the slant.

Find below the strategies these outlets use to present these perspectives. In doing so, the facts are convoluted with opinions, potentially distracting readers from critical evaluation.

Dramatic spin

Dramatic spin refers to terms that appeal to emotions or exaggerate what is observed. For instance, CNN says the way Republicans wrote this bill, without hearings and without consideration by pertinent committees, has “infuriated” Democrats. Whether you are a Republican or a Democrat, sympathetic to their response or opposed to it, to say that a group is “infuriated” is a matter of opinion, not fact.

Vague terms

Vague terms fall under spin in our analysis, as they keep things imprecise, relative or simply immeasurable. After the CNN example above, the outlet then refers to “plenty” of Republicans. Out of a possible 52 Republican senators, how many exactly is “plenty”? Your guess is as good as ours.

Is it fact or fiction? Which outlet presents the most spin?

  • 23% Spun

  • 47% Spun

  • 69% Spun

  • 82% Spun

Drama + vagueness

Vague terms alone may seem innocuous, but when coupled with dramatic words, such as in the phrase, “aggravated plenty of Republicans,” they may encourage the imagination to stretch the information any which way.

Let’s return to the original CNN sentence we’ve been analyzing: “…but the secretive process has infuriated Democrats — and aggravated plenty of Republicans, too.” Now, imagine a more neutral version: “Democrats and Republicans responded to the process Republicans used to draft the bill.”

Missing information

It may be possible that some lawmakers felt “infuriated” when Republicans announced the bill. (For the record, none of the lawmakers quoted across the four outlets said they were.) Yet, opinionated speculation about emotional responses is not ideal. It’s easy for readers to get caught up in the drama and reactions. The spin obscures the fact that there are holes in the script, so to speak. The readers are less likely to notice the missing information.

In this example, the issue some lawmakers are reportedly reacting to is the “secretive process” Republicans employed to craft the bill. Why is it problematic? What specifically is bad about it? Is this process used often?

These are questions that outlets can answer for readers, rather than favoring drama that, although entertaining, ultimately provides little useful information. They might inform readers of things like:

  • This way of drafting legislation is somewhat unusual historically, and Republicans have criticized Democrats for drafting legislation in secret in the past, including portions of the ACA.
  • In this case, the bill can go to the Senate floor, where the process of “reconciliation” may be used to pass the bill with 51 votes. (None of the outlets explain the process and how it differs from traditional Senate proceedings.)
  • The Republicans’ behind-closed-doors approach gives Democrats less time to analyze the bill, should it be sent to the Senate floor next week.
  • As The Washington Post notes, if it goes to the floor, all senators will be able to introduce amendments, and “draw attention to the causes they have championed and potentially change the final bill.”

Together, drama, vagueness and missing information can distract readers from the real issues and the information that might inform people better and diffuse unwarranted alarm. As we identify these mechanisms of data distortion, we can see past the bias and focus on the facts.

Fiction
or
Fact

CNN

“The closely guarded Senate healthcare bill written entirely behind closed doors finally became public Thursday in a do-or-die moment for the Republican Party’s winding efforts to repeal Obamacare.”

Republicans released their healthcare draft bill on Thursday.

CNN

“McConnell’s decision to keep the details tightly under wraps until Thursday was intentional and aimed at winning over his colleagues out of the public spotlight, but the secretive process has infuriated Democrats — and aggravated plenty of Republicans, too.”

Republicans drafted the bill without hearings or committee consideration.

Fact Comparison

  • Facts included in all sources
  • Facts in 3 sources
  • Facts in 2 sources
  • Facts in only 1 source

The Senate [bill] features more generous tax credits for low-income and older Americans, a slower rollback of Obamacare’s Medicaid expansion, and retains many of Obamacare’s taxes. (Breitbart)


The other articles analyzed say the bill repeals most of “Obamacare’s” taxes. According to the bill, it repeals nine types of taxes and amends two. Those repealed include taxes on items such as employee health insurance premiums and health plan benefits, over-the-counter medications, health savings accounts, prescription medications, medical devices, health insurance, “chronic care,” tanning and “net investments.” It also repeals the Medicare tax increase, but retains taxes related to hospital insurance. Taxes relating to insurance providers remain, but have been adjusted. The bill doesn’t include any other taxes. (For more details, see the link above)

The Senate [bill] features more generous tax credits for low-income and older Americans, a slower rollback of Obamacare’s Medicaid expansion, and retains many of Obamacare’s taxes. (Breitbart)


The above statement is also the only information Breitbart’s article includes about the bill. The outlet doesn’t specify what the “generous” tax credits are or explain the adjusted Medicaid expansion timeline, and this vagueness may inspire an inaccurate understanding of the bill’s potential effects. It also doesn’t mention the taxes the bill repeals (see the inaccurate data point), the one-year moratorium on funding for Planned Parenthood’s Medicaid reimbursements, the subsidy adjustments to middle-class earners or the other items mentioned in The Knife’s Raw Data.

The article later uses the phrase “more generous” two more times to describe the bill, including an unsourced statement that President Trump’s reportedly approves of the bill: “The Senate appears to have President Donald Trump’s blessing, as he told senators this week that the House’s AHCA was ‘mean,’ urging them to create a ‘more generous’ bill.” Without providing specific information about the bill that may illustrate its potential effects, readers may assume it is, as the article states, “more generous.”

Headlines

An article’s headline can direct how the news is understood. Compare and contrast how different outlets present the story through their headlines.

The above was an earlier version of the Times headline. It was later changed to: “Senate Healthcare Bill Includes Deep Cuts to Medicaid.”

Dramatizes: When the Times first published its article, the headline was factual although not entirely precise (not all of the ACA would be repealed by this bill). Later, the headline was updated to note that, under the new bill, Medicaid would sustain “deep cuts,” which is both vague and dramatic (read the Distortion section for more on this). The change in versions shows how a headline can go from informative to potentially inspiring alarm.

Assumes: The bill is a done deal.

Doesn’t say: Affect the coverage how?

Assumptions aside (it’s yet to be seen if this proposal will become law), this headline might be a bit of a teaser. It says something will happen that’ll affect millions, but omits  the what, where or when. The headline might make good clickbait, but isn’t very informative.

Balance

Get the full picture! Don’t buy into cherry-picked information.

The media’s slant:
  • The Senate healthcare bill is a big deal and is characterized as a “do-or-die moment” for the Republican party, as well as a possible “titanic political clash” in Congress. (CNN and The New York Times, respectively.)  
  • The bill is unpopular among Republican and Democratic senators because it was created with secrecy and non-inclusiveness.
  • With so many competing interests to satisfy, it’s likely the bill may not pass.
What the media doesn’t explore:
  • The outlets speculate that lawmakers may lose support from their constituents, depending on this legislation. And sure, people oppose the current healthcare policy, just as people oppose the proposed bill. What the outlets don’t point out is that, in this respect, this piece of legislation is like most that go through Congress. A useful comparison might be how the current policy was received when the Obama administration first introduced it.   
  • As noted in the Distortion section, although drafting a bill in secrecy may not be the norm, the outlets don’t indicate what advantages or disadvantages said approach poses.
  • It’s too early to tell; If the bill goes to the Senate floor, the process of amending it could satisfy differing interests.