June 19, 2012

What Americans Learned From the Media About the Health Care Debate

After helping define the Obama presidency for almost a year, health care reform largely disappeared as a subject in the American news media as it wended its way through the legal system to the Supreme Court.

When it was a major story, however, most of the coverage focused on the politics of the bill rather than the substance of the legislation. And the language and framing of the issue favored by the bill’s Republican critics was far more prevalent in the news coverage than the language and framing favored by Democrats supporting the bill, according to research conducted by the Pew Research Center’s Project for Excellence in Journalism.

Health care reached its heights as a news story in the summer of 2009 and early 2010, during the rise of the tea party and the battles in the House and Senate over passage of the legislation. In the third quarter of 2009, with passions fueled by angry town hall meetings, coverage of the health care debate filled 18% of the newshole, according to PEJ’s News Coverage Index, making it the No. 1 story in the news. That number fell slightly but remained high in the last quarter of 2009 (13%) and the first quarter of 2010 (14%).

But once the battle over health care shifted to the courts, largely in federal appeals court decisions, the subject received far less attention. From April 2010 through December 2011,  the subject never exceeded 2% of the overall newshole in any three months period.

That changed, some, in the first three months of 2012, with coverage rising to 5% of the newshole. The week of February 6-12, the story first made a comeback (9% of the newshole) as the debate over whether religious institutions should be forced to cover contraception in their health insurance plans emerged as a major issue. Four weeks later, Rush Limbaugh’s controversial comments about a Georgetown law student helped drive coverage (10%) the week of March 5-11.

At its peak, in 2009 and early 2010, the issue was also more of a topic in the opinion part of the media culture, on radio and cable TV talk shows, than elsewhere. But it wasn’t always Obama’s partisan opponents doing the talking, but often people from within the liberal camp who felt the law didn’t go far enough. During that period, liberal talk show hosts devoted more time to the issue than conservative hosts.

That fits with another finding in an analysis of the press coverage, particularly during the formative stages from June 1, 2009 through March 31, 2010. Most of the coverage of the health care reform bill focused on the politics as opposed to reporting on what the bill would do or the state of health care. Fully 49% of the coverage focused on politics and strategy, as well as the legislative process. Less than a quarter of the coverage (23%) outlined what the various proposals would do, and 9% of the coverage focused on the state of the health care system in the U.S.

Which side got the better of this highly politically oriented coverage? An analysis by PEJ of the language used in the media (PEJ research) reveals that opponents of the reform won the so-called “messaging war” in the coverage. Terms that were closely associated with opposition arguments, such as “government run,” were far more present in media reports than terms associated with arguments supporting the bill, such as “pre-existing conditions.”

To conduct the analysis, researchers examined and identified three of the most common concepts being pushed by opponents of the bill and the three concepts being promoted by supporters and then examined the news coverage for the presence of those concepts and language.  The concepts used by opponents were nearly twice as common as those used by supporters. See the full methodology here.

How important is health care to Obama’s presidency? Of all the stories in which Obama has been a lead newsmaker (meaning at least 50% of the story referenced him), the health care debate is the No. 3 topic during his first year in office. Fully 13% of these stories were about health care, substantially more than about the war in Afghanistan. Only the economy (the subject of 18% of Obama stories) and stories that focus directly on the operations of the Administration were larger.