Wendell Potter: Health Insurance Industry Lacks Unified Opinion on Reform

Cheryl Clark, June 20, 2012

Wendell Potter is former vice president of corporate communications for CIGNA. He became a whistleblower in 2009 when he testified before the U.S. Senate about insurance company practices that limited coverage for policyholders. He is now a senior analyst for the Center for Public Integrity in Washington, D.C. and the author of "Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans."

HLM: What do insurance companies want out of the Supreme Court's ruling on the constitutionality of the Patient Protection and Affordable Care Act?

WP: Their preference would be for the whole law to be upheld, because it would keep in place the individual mandate. The worst scenario for the industry is for the court to declare just the individual mandate unconstitutional, because then the industry would have to devote even more time and resources to get Congress to get rid of the consumer protections in the law than they already are doing.

They're already mounting a campaign to persuade policy makers and the public that the law just will not work without the individual mandate...and that will go into high gear. And ever since the law was enacted, they?ve been working behind the scenes to weaken the new consumer protections and regulations.

HLM: Some have said that the insurance industry is most concerned about regulatory oversight, and they don't like the funding the ACA has authorized for states to do that.

WP: The insurance industry is not of one mind. Blue Cross and Blue Shield of California is on the record [saying it would be] supporting the ACA. And many companies have begun to implement many aspects of the ACA, and expect it will be the law of the land.  I don't think there is one opinion. But what I think you'll see is that the big companies are okay with the law, as long as there continues to be a way to enforce the individual mandate and they are able to weaken or get rid of the consumer protections.

Many companies realize that their business models are just not sustainable over the long haul without some kind of external means to get more people into coverage.

HLM: You mentioned that the insurance industry in general doesn't like consumer protections. There are a lot of them in the law. Which ones is the industry targeting for removal?

WP: They don't like the requirements that restrict them from refusing to sell coverage to people because of pre-existing conditions. That prohibits them from charging older individuals more than three times as much as younger people, and they don't like the inability to use health status to base premium rates on. They don't like having to spend 80% of premiums on healthcare. And they don't like the limits placed on high deductible plans. Those are the things that will have more of an impact on the bottom lines for these companies.

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