Annually, the Shorenstein Center on Media, Politics and Public Policy awards the Goldsmith Prize for Investigative Reporting to a stellar investigative report that has had a direct impact on government, politics and policy at the national, state or local levels. Six reporting teams were chosen as finalists for the 2021 prize, which carries a $10,000 award for finalists and $25,000 for the winner. The Journalist’s Resource is interviewing many of the finalists to offer a behind-the-scenes look at the processes, tools and legwork it takes to create an important piece of investigative journalism. The entry discussed here, “Restoring Health Care for Pacific Islanders After Decades of Unfilled Promises,” was published in POLITICO. The Journalist’s Resource is a project of the Shorenstein Center, but was not involved in judging the Goldsmith Prize. The winner of the $25,000 will be announced on April 13.
On a chilly February day in 2019, journalist Dan Diamond ventured out to the U.S. Capitol and stopped by a rally — a typical scene in Washington before the COVID-19 pandemic. This one was about Medicare for All.
He struck up a conversation with two health care workers from Iowa who had stopped by the rally because they thought their uninsured patients from the Republic of the Marshall Islands could benefit from expanded health coverage.
“I think I asked them another question or two, like how they would benefit, and that’s when they started unspooling the story,” says Diamond, who was a health care reporter at POLITICO at the time and is now a national health reporter at The Washington Post.
The conversation prompted a series of stories about the plight of the citizens of the Marshall Islands who have been moving to states like Iowa, after the U.S. used their homeland to conduct nuclear weapons tests in the 1940s and 1950s. He brought to light this nearly-invisible population who were promised health insurance coverage in the U.S. but lost it later in a legislative oversight in the 1990s. His stories eventually played a role in the U.S. restoring health coverage for tens of thousands of Marshallese who currently live here.
“I had never heard there were people living on the islands that the U.S. tested nuclear weapons on,” says Diamond. “I remember the footage from high school, watching the black and white footage of Bikini Atoll and these big [hydrogen bombs] in the Pacific, but I never realized that there were people caught in the nuclear fallout. That was a shocking moment and it overshadowed a lot of the day for me.”
Lawmakers and health advocates have credited Diamond’s stories for the restoration of Medicaid for the islanders after 24 years of failed attempts. In a letter, the Marshall Islands’ ambassador to the United States thanked POLITICO for the role its reporting played in Congress’ decision, according to Diamond.
We asked Diamond how he went about reporting the stories and narrowed down our telephone and email conversations to the following seven tips. We have lightly edited some of his comments to reflect JR’s editorial style.
1. As much as COVID-19 restrictions allow, look for opportunities to talk — and listen — to people.
“My job at POLITICO was writing the newsletter about health policy and politics every day,” Diamond says. “My job was very much to know the stories that were shaping health care in Washington and being discussed in health policy and that meant having an open mind and listening. Doing a lot of listening.”
He keeps his ears open for tips and rallies were among the places that gave him that opportunity before the pandemic stopped large gatherings.
“I find that deliberately prospecting for stories can be less productive than just going out and listening to what people have to say,” he says.
2. When possible, capture audio.
Diamond says he records a lot of audio, with permission from sources.
“I do find that recording a conversation helps me actually focus on it, rather than trying to furiously transcribe it in the moment,” he wrote in an email to JR.
In February 2019, when he met the two Iowa health care workers at the Capitol, he was recording the sound of the rally to potentially use on POLITICO’s “Pulse Check” podcast or for another project. The recording memorialized the moment Diamond learned about the plight of the Marshallese and used parts of it in the podcast. To listen to parts of that conversation, go to min. 22:30 of the Jan. 14 episode of “Pulse Check.”
3. Read and research as much as you can and talk to experts.
“I’m probably a completist when doing a project: I try to read as much historic coverage as possible before starting my interviews, and then I try to get as many perspectives as possible, from advocates to officials on all sides of the issue,” Diamond wrote in an email.
After meeting the Iowa health workers, Diamond began speaking with advocates, including leaders at the Asian & Pacific Islander American Health Forum. He met with lawmakers and members of their staffs, including U.S. Sen. Mazie Hirono, a Democrat from Hawaii, and U.S. Rep. Tony Cárdenas, a Democrat from California, both of whom had tried to restore Medicaid for the islanders. In addition, Diamond interviewed current and former Medicaid officials, who helped explain the issue.
He also read books on the Marshall Islands and nuclear testing and talked to national experts to better understand the issue.
“I went to the DC library and checked out Dan Zak’s Almighty: Courage, Resistance, and Existential Peril in the Nuclear Age. I also picked up a copy of Fred Kaplan’s The Bomb, among other books that I remember reading and consulting,” Diamond wrote.
When in Dubuque for the first time, he went to the local library looking for books on the Marshallese population and found Bravo for the Marshallese: Regaining Control in a Post-Nuclear, Post-Colonial World, written by Holly Barker, a University of Washington lecturer and a former official in the Marshall Islands.
“Although I couldn’t get a library card, I thought the book was fascinating and read as much of it as I could (and took photos of key pages) while sitting in the library over several days,” Diamond wrote. “I then reached out to Holly, who offered many tips and context in the subsequent months.”
4. Ask advocates to help you establish trust within a community, including communicating in culturally appropriate ways.
The toughest part of the project for Diamond was getting members of Dubuque’s Marshallese community to talk to him — a reporter they’d never heard of who was not from the area and worked for an unfamiliar publication. There was a language barrier, too. Many islanders in Dubuque don’t speak English or don’t speak it well.
He asked health care advocates working in the area to help him gain the community’s trust.
The two workers he met in Washington connected him with a coordinator of a local community health program for the Marshallese. And she connected him with members of the community.
He talked to these individuals several times before taking his first trip to Iowa in October 2019. Once there, he spent nearly a week at a community health center where islanders sought care.
The local health providers also helped arrange a gathering where islanders could meet Diamond in a causal setting.
“The evening became a springboard that helped me identify some community members to follow up with,” wrote Diamond in an email.
Local advocates showed him how to interact with the community in a culturally respectful way, like when not to make eye contact.
“I just feel very lucky that the health workers on the ground were motivated to help me. Otherwise, I would have been really at a loss,” says Diamond.
5. Show sources examples of your previous work.
His first story, published in January 2020, detailed how being ousted from the Medicaid program had affected the Marshallese, many of whom were not able to get health insurance and wrestled with chronic conditions such as diabetes, heart disease and obesity.
For his reporting, Diamond wanted to spend time in Iowa shadowing the health workers at the local community health center that cares for the Marshallese. To gain the trust of his sources, he showed them examples of his previous work, including his story about a large population of vulnerable people outside of the Cleveland Clinic and his reporting on the challenges Native Americans have faced getting Medicaid coverage.
“I tried to show that I was a reporter who could understand the needs of the populations that have historically had problems getting health care,” says Diamond. “There was some nervousness among some patients, just having a reporter hanging around. But I tried to be transparent with them about where I thought the reporting was headed.”
The Iowa health workers were welcoming and allowed him to hang around the health center for a few days. As patients came in, they asked them if they wanted to go on the record with Diamond.
“I just feel like I was lucky to meet so many devoted folks at the health center who wanted the story told, who felt that a spotlight would be a good thing,” says Diamond.
6. Look for policy angles; spotlight the problems and solutions.
“I wasn’t the first person to write about how the Marshallese have been historically screwed by the United States, but I was, as far as I can tell, the first person to really drill in on the health insurance issue and spend as much time on it,” says Diamond. “That framed all of the stories.”
In another example, Diamond found out in February that members of the U.S. Public Health Service, made up of 6,000 government health workers that were helping with COVID-19 vaccinations, were not vaccinated themselves and there was no plan in place to get them vaccinated.
“To me, that felt like the kind of story that I like to do, because it’s a problem. It’s a public health problem with a clear solution and that solution can be fixed by policymakers,” says Diamond.
As a result of his reporting, as the story went to press, the first batch of vaccines was secured for the members of the Public Health Service corps, Diamond says.
“I believe that reporters should spotlight problems, but we should also spotlight potential solutions,” says Diamond. “Looking along the policy lens, it can make for a very rewarding reporting project if you not only spot the policy problem, but show the policymakers how they can fix it.”
7. No matter how busy you get with other work, find ways to keep following the story.
Weeks after his first story ran, Democratic presidential candidates vowed to restore Medicaid for the islanders, Diamond reported.
Diamond had planned to report on the Marshallese community in Springdale, Arkansas, home to one of the largest Marshallese communities in the U.S. but the trip coincided with the arrival of COVID-19 and that story was put on hold.
As the months passed, it became clear he couldn’t report the story as planned. Travel restrictions prevented him from flying. He couldn’t embed with the communities. And his plate was full — he was POLITICO’s lead reporter on the pandemic and was putting out a daily newsletter with his colleague Adam Cancryn.
But he didn’t let go of the story. In 2020, he won a Dennis Hunt Fund for Health Journalism fellowship at the University of Southern California’s Annenberg School for Communication and Journalism. The fellowship allowed him to continue reporting while focusing on his broader beat, health care and politics.
Diamond says the fellowship helped him in three ways:
“First, and to be totally frank, it was a forcing function,” he wrote via email. “Margie Freivogel, my adviser, kept me accountable in regular check-ins and made sure that I was thinking about my project, even when I wasn’t able to do much reporting or writing. Second, it was productive to have virtual fellowship sessions and kick ideas around with other reporters in my small group, like New Jersey-based reporter Spencer Kent and Dan Levin of The New York Times, who were working on their own projects about vulnerable populations. Third, the fellowship helped the stories stand out in a POLITICO newsroom where editors had occasionally been asking, ‘Why is Diamond writing about these Pacific Islanders?’ and not, say, digging in on another Scott Atlas piece or more traditional Washington stories — the fellowship legitimized the work and got buy-in from senior POLITICO leaders for the rest of the year.”
He stayed in touch with his sources and wrote about lawmakers who were trying to restore coverage for the islanders. As COVID-19 spread across the nation, he learned how it was having a disproportionate impact on the Marshallese communities.
When one of the Marshall Islanders he had befriended in Iowa died from COVID-19, he changed the image on his phone’s lock screen to a photo of that man and his family — so he wouldn’t forget people were being devastated by the pandemic.
“I kept up that photo for months, until the story was done,” says Diamond. “I care about all the problems that I write about, but [the pandemic] was a real threat affecting real people.”
He decided to document the impact of the pandemic on the Marshallese community in Dubuque and in October 2020, a year after his first visit, he drove back there at a time when federal lawmakers were debating whether to include this provision in Congress’ end-of-the-year financial bill.
Because Iowa was a COVID hot spot at the time, he took safety precautions.
“I made a plan for how to maximize my time in Dubuque, mapping out where to be and when,” he noted. “I did all my interviews outside — walking around parking lots or up and down streets to stay warm — which also led to fortuitous encounters, like bumping into Dubuque’s mayor when I was interviewing the city’s top health official.”
In December, he wrote his second in-depth story about the spread of the virus among the Marshallese, many of whom worked frontline jobs and lacked health insurance.
Finally, in what advocates hailed as a Christmas miracle, Congress’ end-of-year spending package, later signed by former President Donald Trump, included language that restored Medicaid for the islanders, Diamond reported.
When Diamond set out to tell the story, he didn’t know whether it would lead to change. His goal was to do everything possible to highlight the issues that were affecting the Marshallese.
“Personally, I don’t think my role is to be an advocate. My job as a journalist is to lay out the facts, spotlight problems and hope they get fixed. All I knew was that I wanted to make sure I was emptying my notebook and showing the policymakers, showing the world, why this was such a problem,” he says.
But even after Medicaid was restored for the islanders, Diamond didn’t stop.
“I immediately followed up to hear how Medicaid enrollment was going. I’ve been keeping up on how the vaccine uptake [among the Marshallese] has been,” he says. “I’m delighted for the people who now have health care, but I don’t see my job as done.”