WASHINGTON -- When given the chance to take part in the creation of the Affordable Care Act, America’s highly profitable health-insurance industry didn’t have to think twice.
Led by Karen Ignagni, the president and CEO of America’s Health Insurance Plans, the industry’s loudest voice in Washington, AHIP pulled up a chair at the White House table that eventually would slice up a pie worth hundreds of billions of dollars over the next few decades.
For this she has drawn the ire of tea party Republicans and other true believers in an unfettered free market. But unlike her counterparts in the pharmaceutical industry, she acted in the clear and evident self-interests of all Americans — not just the companies who pay her salary.
Under the Obama administration’s “pay-to-play” rules, AHIP and its members forked over more than $10 million, mostly to Democratic senators and House members.
It was a brilliant strategy that gave AHIP a seat at the high-stakes poker table and allowed them to sit in at hundreds of White House and Department of Health and Human Services’ conferences that eventually shaped the massive 2,000-plus pages of legislation that became the Affordable Care and Patient Protection Act.
By choosing to be present at the beginning rather than being a helpless bystander, Ignagni gave the nation’s health-care insurers a better-than-even shot at being allowed to sell coverage to the estimated 16 million to 20 million-plus uninsured Americans now slated for coverage under Obamacare.
Democratic House Speaker Nancy Pelosi, trying to round up a key 60th Senate vote for the sweeping legislation in May 2010, famously said: “We have to pass the bill so that you can find out what’s in it.” Unlike Pelosi, Ignagni knew exactly what was in the law; after all, she took part in all the major deliberations that led to its enactment.
Ironically, Ignagi is now coming under fire from some members of the health-insurance industry, who accuse the administration of issuing regulations that belie assurances AHIP received when it was a major player in the crafting of the legislation.
A Wall Street Journal editorial recently noted that national insurers except for the Blue Crosses and Blue Shields have sat out the actual implementation of the law “and are planning trial runs in only a few states, waiting to see how the exchanges mature in practice. Many of them pulled out of states amid regulatory abuse and some are marketing their own policies as better than exchanges, despite the lack of subsidies.
“What an irony it is,” the Journal concluded, “that the industry that first lobbied for ObamaCare to increase its market share is now unhappy with the result.”
Designed to fail?
There are some cynical whispers among health-care insurance executives, that the reform was set up to fail — thus setting the stage for progressive Democrats to argue it didn’t work because those who negotiated it tried too heavily to appease private sector kingpins like Big Insurance and Big Pharma.
There’s a possibility, of course, that the health-care insurers may have been gulled by the administration, so it could move on to its true goal — a universal, single-payer system similar to those in Canada and the United Kingdom.
That’s hardly likely, however, with such a tough negotiator as Ignagni — a longtime supporter of health-care coverage for everyone — sitting in at the bargaining that led to Obamacare. Word from the White House is that the president is deeply committed to making the necessary tweaks that will make his signature legislation effective and popular — even with progressives.
Ironically, health-care insurers did the right thing for all Americans, by backing legislation that ultimately will improve the health of everyone. In the end, the nation’s poor and previously uninsured will end up thanking Ignagni and the others who designed a workable health-care law.
Wayne Madsen is a contributing writer to www.onlinejournal.com.