Health Insurance Industry Supports GOP Attempt to Repeal Obamacare Protections

After several failed attempts, President Trump and the Republican-controlled House of Representatives narrowly passed legislation known as the American Health Care Act to repeal and replace President Obama’s signature Affordable Care Act, or Obamacare. The measure, which carried by a 217 to 213 vote, was rushed through the House on May 4 before the Congressional Budget Office could score the bill to assess its cost and impact on national healthcare. But a previous CBO evaluation on a less severe version of the bill found that at least 24 million Americans would lose their health insurance coverage if the AHCA were ever signed into law.

Negotiations with the GOP’s right-wing “House Freedom Caucus” faction secured sufficient votes for passage, but their members extracted concessions that undoubtedly will make the bill even less popular than the previously debated version. Key provisions include the loss of protections for those with pre-existing conditions, mandated employer insurance plans are now in jeopardy, Medicaid expansion is ended with an $800 billion budget cut, Planned Parenthood is defunded and the wealthiest Americans receive a $765 billion tax cut over 10 years.

The AHCA bill now moves to the U.S. Senate, where many Republicans open criticized the measure, and say they’ll draft new reform legislation from scratch, which then must be sent back to the House. Between The Lines’ Scott Harris spoke with Wendell Potter, a former health insurance industry executive and whistleblower. Here, he assesses the provisions in the GOP House bill, prospects for action in the U.S. Senate, and the role of the insurance industry in eroding key benefits in the ACA.

WENDELL POTTER: It is awful, awful legislation. It is about some of the worst I've ever seen and it is something that would take us back to what life was like for many people before the Affordable Care Act was passed. In fact, make it worse. It's estimated that at least almost 25 million people would lose their health insurance. Just as bad, a lot of people who have pre-existing conditions – and quite frankly, that is almost a majority of us these days – would face higher premiums and in some cases, wouldn't be able to afford coverage at all. It would allow insurance companies essentially to do what they used to do, which is to declare some uninsurable. Blackball them and not enable people to get not only the insurance they need, but access to care that they need. In so many ways, it would put the insurance industry much more in the driver's seat once again, of our health care system than they already are. And would lift and engage some of the most egregious practices that needed to end.

BETWEEN THE LINES: Wendell, the insurance industry in the United States helped write the Affordable Care Act, Obamacare. And they reaped a lot of profits because of the expanded pool of customers for their insurance with the subsidies that came online and all that. What was the role as you understand it, of the insurance industry in working with Republicans on this piece of legislation that has passed the House of Representatives. It's not law yet, it still needs to go through the Senate and back to the House. There's a whole long process ahead.

WENDELL POTTER: You're exactly right. The insurance companies have done very very well since the Affordable Care Act went into effect. They've been reporting record profits. So they've done well. But what they don't like is that can't engage in some of these practices that they once did. They think that there's a chance they might even be more profitable if they got rid of some of these restrictions on them. They would like to go back to the time when they could pick and choose who to insure so that they could weed out people who really need coverage. And definitely, they're working behind the scenes to help lawmakers' message, if you will, what they're trying to do here in ways that they think can be sold to the American public, but they're selling them a bill a goods.

On the other hand, the insurance companies don't like that the Republicans would change the Medicaid program to what's essentially referred to as a block grant program. In other words, the federal program just would provide a certain amount of money to the states. The effect would be to reduce the Medicaid payments almost a trillion dollars over the next several years. Insurance companies don't like that because many states have largely turned over their Medicaid programs to insurance companies. So insurance companies would see a significant decline in revenues if that part of the bill goes through.

BETWEEN THE LINES: There are many listeners who have heard about a universal single-payer health care bill that's going through the California legislature. And I'm wondering if you think there's a chance that we could see an example of universal health care in one of our largest states – California – that could be an example for the federal system much in the way that Saskatchewan, a province in Canada, was the first to adopt a universal single-payer system in that country, in Canada and was later adopted by the federal government in Ottawa. 

WENDELL POTTER: I think it's entirely possible. And there is strong support for single-payer healthcare in California, and also in Oregon and Washington, too. And other states. California would be especially significant if it were to pass a single-payer bill. There is a bill that is before the California legislature now that has been introduced that would create a single-payer system. It may not get approved this year, but there is strong support for it, growing support for it. And I think what you're going to see is that business leaders are going to wake up and start embracing this. And business leaders in particular are, I think, waking up to understanding that a multi-payer system in which we have all these insurance companies that really cannot control cost and that add cost to the system – it just doesn't make sense for them or the country. Health care for those employers that provide coverage – it's an expense they can't predict year after year, and like I said, insurance companies are demonstrating that they cannot control health care costs. And I think the gig is up for them, or will be in a few years because employers who are very politically active I think may be ultimately, be the death knell for the system that we have now.

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