In this special edition of We Mean Business, Ananya Bhargava interviews KFF Health News’ David Hilzenrath. He is a member of the 2024 Barlett and Steele Gold Award-winning team in the Regional/Local Category. Their investigative series, “Overpayment Outrage,” a collaboration of eight local TV news stations and KFF Health News, helped uncover the immense toll Social Security repayment demands have on some of the nation’s most vulnerable families. Hilzenrath discusses the behind-the-scenes of this investigation, including their biggest challenges and how they overcame them to tell this story and create a roadmap for Congress to make needed program reforms.
Transcript
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Ananya Bhargava: Welcome to a special edition of We Mean Business, where we dive into the stories behind the Barlett & Steele Award winners. Join us as we uncover the winners’ investigative processes, the challenges they conquered, and the powerful impact of their reporting. The Gold Barlett and Steele Award in the Regional/Local category goes to an outstanding collaboration that resulted in quick, significant changes in the system. The collaboration of eight local TV news stations across seven states, with the assistance of KFF Health News, helped uncover the immense toll Social Security repayment demands has on some of the nation’s most vulnerable families – the very people the Social Security system was designed to protect. I am here with David Hilzerath of KFF Health News’ to learn more about how they did it.
David Hilzenrath: My name is David Hilzenrath and I’m a reporter at KFF Health News. We’re a non-profit news organization, and we do in-depth reporting on health care and related issues. And while some of your listeners might not have heard of us, they’ve no doubt heard of many of our partners. As a public service, we make our coverage available free of charge to other news outlets, and they include local and regional publications and major networks and newspapers. And in this case, Cox Media Group, which operates television stations and produces television newscasts around the country.
We investigated a catastrophic breakdown in federal programs on which millions of Americans depend for their survival. We’re talking about devastating dysfunction in the Social Security system. The Social Security Administration has been trying to reclaim billions of dollars from many of the nation’s poorest and most vulnerable people. Payments it sent them, but now says they never should have received and to claw back the money, the government has been reducing or suspending the monthly benefit payments that serve as beneficiaries’ lifeline, and some people have been left homeless. We’re talking about people who are elderly, poor, disabled, or some combination of those. And here’s what it looks like: Justina Warrell, featured in our first story, was working part-time as a kitchen helper in an Ohio nursing home. She has cerebral palsy and other health problems. She was earning $862 a month and receiving about $1,000 in monthly Social Security disability benefits, altogether about $23,000 a year, when a letter arrived from the federal government. The Social Security Administration had been overpaying her, the letter said, and wanted money back. Within 30 days, it said, she should mail the government a check or a money order for $60,000. That’s $60,000.
And over many months, we told Justina’s story and the stories of many other people across the country who have faced similar circumstances. We’ve explained the systemic roots of these problems. In some cases, the overpayments resulted from errors on the part of the beneficiaries. They hadn’t complied with the rules for these benefits. In other cases, the overpayments were the results of errors on the part of the Social Security Administration, but the beneficiary was nonetheless held responsible for the alleged overpayment. And we explained how the system made it easy for people to run afoul of the rules, and we showed what gave rise to these overpayments. And further, we saw that the Social Security Administration was typically very slow to catch the overpayments. The overpayments could continue for years and grow to staggering proportions by the time the government got around to demanding the money back, and that made the overpayments all the more devastating for the people affected.
Since our initial stories ran, members of Congress have demanded answers from the Social Security Administration. The agency announced a top to bottom review of its policies, Congress held a hearing, and a new commissioner of Social Security announced sweeping reforms that are now in the process of being implemented.
Bhargava: So I would love to know sort of what methods you use to gather information and how you verify the credibility of all of your sources in the investigation.
Hilzenrath: Let me speak to that in a couple of ways. We faced two major challenges, and those were finding people who were affected by the problem and finding out how many people were affected by the problem. To take the first, the power of this journalism was largely in the stories of individual people struggling with overpayments and clawbacks, and a key challenge was finding and connecting with them. We cast a wide net, we scoured social media, we combed an obscure database of court cases that would actually reveal whether overpayments were a factor. We reached out to organizations that work with Social Security beneficiaries, such as legal aid bureaus and groups that advocate for people with disabilities. Some were too busy to help. Some were focused on helping their individual clients and might have had difficulty seeing how journalism could make a difference at a macro level.
I remember pressing one national organization again and again, to contact its grassroots network on our behalf. Eventually, one member of that network answered the call and delivered in a big way, connecting us with people who figured prominently in our coverage, like Justina, who I mentioned. As it turned out, this particular advocate had a personal reason to help. She was severely disabled, and she herself had experienced an overpayment. So she was motivated to tell this story, and it was in part, a matter of luck that we found her. Once we connected with beneficiaries, getting information about their cases was another challenge. Many are living precariously, they’re struggling from month-to-month, even day-to-day, and they might not have ready access to financial records or years of correspondence with the Social Security Administration. If they could find their records, they might have difficulty sharing copies with us just with the mechanics of it. They don’t have scanners or copiers. Some sent us cell phone pictures of lengthy documents one page at a time. It helped that this was a collaboration. I was doing my reporting from Washington, D.C. But as you know, we were collaborating with Cox Media Group and its journalists in D.C. and around the country. And from our offices in Washington, I interviewed Justina’s caregiver and aunt in Ohio extensively by phone, and reviewed records that she was able to convey. I introduced her to a Cox Media Group television reporter in Ohio, John Bedell. John and a videographer went to visit her and recorded an interview on camera. And Justina’s aunt, Addie Arnold, ended up distilling the story into a single sentence. She told us, “Social Security should be to help people, not to destroy them.”
So you see there, the extraordinary teamwork between our organization, an online non-profit news organization, and our partners in the broadcast news business who could contribute information from all around the country. We gathered information, we shared it with them. They found information, they shared it with us. For each round of coverage we produced a national story in Washington, and our colleagues produced localized TV stories in each of their markets, which included feeds from other markets and from the national perspective and stuff from their own backyards. Soon after we published our first story, we posted callouts on the KFF Health News website asking readers to share their overpayment stories with us, and we asked them to fill out a brief online questionnaire. At last check, more than 600 people had responded. Suddenly, we didn’t have to scrape to find people, many of them found us, and their responses showed patterns and helped guide our unfolding coverage.
Bhargava: That’s amazing. So I would love to hear sort of any stories or any highlights on any “Aha!” moments, any shocks, any surprises, anything interesting in the entire investigation.
Hilzenrath: Well, you know, I think I did not completely answer your earlier question, because a second major challenge we faced was finding out how many people were affected. One of our main questions was, “How many people are affected by overpayments and clawbacks? How widespread was this problem?” We had anecdotal evidence, but we were trying to see the big picture, and the Social Security Administration couldn’t or wouldn’t tell us. Historically, the government had focused on overpayments as a fiscal problem, not a human problem. It had focused on the dollars in trying to recover misspent taxpayer funds. When we began reporting on this, we combed federal financial records, we studied audits of the Social Security Administration and reports by the agency’s Inspector General, and we found that the government was trying to recoup more than $21 billion of accumulated overpayments. Our partners at Cox Media Group had submitted a FOIA request for every overpayment in the country. That freedom of information request didn’t work.
When we asked, it just went nowhere. The agency did not respond – as far as I know, an appeal is still pending. When the agency wouldn’t tell us how many people were affected, we asked members of Congress if they knew and if they thought the agency should tell us. They were outraged. One representative, Mike Carey of Ohio, said that if the agency wouldn’t tell us, he would ask the agency at a hearing – and he did. In the witness chair, the Acting Commissioner of Social Security, given this question, demurred. She said she had seen or heard the number, but couldn’t recall, and it seemed like we wouldn’t get the answer. But her deputy helpfully handed her a piece of paper, and she read from it at the hearing. She gave precise numbers down to the individual person for the prior two years, and they rounded to about a million people a year. A million people a year! That was astonishing, and it was a revelation. It was the answer that we had been seeking, something the government had never revealed before, but we had reason to suspect it wasn’t the whole story. The head of Social Security qualified her answer at that hearing, and when we followed up later with questions to the agency’s press office, “Were these numbers for all Social Security programs or just a subset?,” the agency wouldn’t say. We asked again and again, and they wouldn’t say. So once again, we resorted to the Freedom of Information Act.
This time, instead of making the broadest possible request, we made the narrowest possible request. We asked for a single piece of paper, the one the Acting Commissioner’s deputy handed to her at the hearing, the one she read from in her testimony. And to back up our FOIA request, we submitted a photo and a video of her being handed the page and reading from it, and weeks later, we got the document. It showed that our suspicions were well-founded. In her testimony to Congress, the Acting Commissioner had read just some of the numbers, she had left out others. For example, she had left out the Supplemental Security Income program, which was most prone to overpayments. And what we learned was that, in fact, twice as many people a year as the Commissioner had said were being hit with overpayment notices, about 2 million people a year. The Acting Commissioner ended up sending a letter of apology to members of Congress. Members of Congress wrote a letter of their own criticizing her for failing to set the record straight until our FOIA request brought the truth to light. So Ananya, when you ask about the techniques we used, I would emphasize our strategic use of the Freedom of Information Act and our use of callouts to ask our readers to help us with our reporting.
Bhargava: I really like that thing that you mentioned about how they did not realize that it was a human problem, and they viewed it as a fiscal problem. So I would love to ask sort of how you balanced reporting individual stories and then also tackling those larger systemic issues at play within the Social Security Administration?
Hilzenrath: Ananya, that is a great question, and I’m so glad you asked, because we really had two major tasks ahead of us. One was to tell the stories of the individual people affected, to show the public what was going on and how it was affecting people. And the other was to tell the systemic story to explain how and why this was happening. As a long time financial journalist, I focused heavily on the systemic issues and explaining the root causes. For example, the rules that made it so difficult for people to comply and the dysfunction at the Social Security Administration. The heavy reliance on manual, error prone systems, the chronic understaffing at the agency that made it difficult for beneficiaries to get through to government employees, by phone, by mail to get answers, to get accurate answers, to get consistent answers.
The systemic analysis ultimately provided a roadmap for reform, and members of the House and Senate and ultimately a new commissioner of Social Security began to follow. We thought that it was not enough just to tell these stories. We wanted to hold the government accountable, and so we demanded answers from members of the House and Senate. We asked them to address the information we brought to light. “What did they think about this? What were they going to do about it?” And when they didn’t respond, we persisted. We went up to Capitol Hill and interviewed lawmakers on camera, and I think that if we hadn’t persisted in doing that, the federal response might not have been as strong.
It’s possible that this story could have passed without leaving a ripple. Instead, it triggered other coverage. It was widely picked up by other news organizations with coverage of their own. It snowballed. It drew bipartisan attention. It was the rare issue on which Republicans and Democrats seem to agree, and as we speak today, the government is in the process of implementing historic reforms that could make a profound difference.
Bhargava: That actually leads me to my next question. So you mentioned how there was sort of this like almost gut feeling during the hearing where you didn’t think the entire picture was being shown when the number was mentioned on how many people are affected by overpayments. Could you talk a bit about sort of the ongoing process? A lot of people would assume that leading up to the hearing the job is sort of done, like you’ve brought the issue to light and it ends there.
Hilzenrath: Ananya, I think those are really wise words that you’ve shared for any journalist, and it’s to be relentless, to listen carefully, ask follow up questions, and to persist in seeking answers. It was, it was more than a gut feeling at that hearing, she said something that seemed odd. When she gave the precise numbers, she qualified her answer ever so subtly. She said for Social Security, and she recited the numbers. I was watching that testimony online because I was writing a daily news story about it, and my colleague, Jody Fleischer, was in the hearing room and Jody could not even hear that subtle qualifier for Social Security. But as we reflected on the testimony, the question naturally arose, “Well, what did that mean, ‘For Social Security,’ aren’t all of her numbers for Social Security? Why would she have to qualify that?” And when we dug a little bit deeper, we got the sense that perhaps she was using the term for Social Security more narrowly, to refer only to certain Social Security benefits and not to others. And that’s what led us to investigate further. And if I could sort of hearken back to something I said earlier, initially, the agency couldn’t or wouldn’t, give us the number of people affected. We in the public and members of Congress had no way of knowing that we were talking about millions of people. But as it turned out, the agency was capable of producing this number because, well it did. It was on that piece of paper.
Bhargava: Is there anything else you would like to add any other advice you would like to give aspiring young business journalists?
Hilzenrath: Several things come to mind, and the first is to make targeted use of the Freedom of Information Act. Our early, broad attempt failed, and ultimately what succeeded was a very narrowly targeted approach, but it does show what the Freedom of Information Act can do for you. Second, I would say, hold lawmakers and other government officials accountable. Demand answers. We ask members of Congress to address the information we brought to light if we hadn’t persisted in doing that, I don’t think the outcome would have been the same. I don’t think the federal response would have been as strong.
I would say, think creatively. This was a new and as far as we know, an original model of reporting. This collaborative project involved sharing information back and forth, sharing sources, all in a spirit of almost seamless teamwork. When I say seamless, I don’t mean to understate the incredible logistical challenges involved but think creatively, use teamwork, collaborate and think of ways to get the word out. Our coverage ultimately ended up in some unexpected places, including repeatedly on ABC’s Good Morning America, because some of those Cox Media television stations are affiliates of ABC News.
Next and at a much more general level, I would say talk is cheap. The web rewards opinion and rehashing information that’s already out there. As I see it, journalists add the most value when they’re bringing new information to light, when they’re showing people things they wouldn’t otherwise see, and when they’re helping people understand the world better. And I would encourage young journalists to find ways to do that. I’m not saying any of this is easy. It can be difficult, time consuming and expensive, and I count myself privileged to work at an organization, KFF Health News, that makes it a priority, and knock on wood, has the ability to support it today when so many news organizations do not. And that’s really part of our mission, to somehow pick up the slack where other news organizations have shrunk. And that leads me to my next point of advice, which is, if you’re going to make a career of this, go into it with open eyes. Ananya, from a business standpoint, the news media have been in meltdown. Many newspapers have gone out of business or have been hollowed out. Thousands of journalism jobs have been eliminated. So if you’re going into journalism, I think you have to view it as a calling, and I think it’s a worthy calling. I think I would say to journalism students, “Society needs you, news organizations need you.” We need young journalists to adapt to technological change, to changing business models, and to reinvent the delivery of news while preserving journalism’s core values.
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Bhargava: That was KFF Health News’ David Hilzerath, one of the gold winners of the Barlett and Steele regional and local category. To everyone listening, thank you for tuning in. For more information on the awards visit our website businessjournalsim.org/awards.
