Earlier this week, former President Bill Clinton visited the group that almost single-handedly brought down his health care bill in 1993 with their infamous Harry and Louise ads. Clinton delivered the keynote address at the America’s Health Insurance Plans (AHIP) conference in Las Vegas, where he thanked them for supporting reform the second time around:
“I want to thank you for your support of the healthcare reform movement,” Clinton said numerous times during his lengthy, largely economics-oriented speech, which dealt with everything from the BP oil spill, to a new bus system in Lima, Peru.
“You deserve credit for taking a different position on this healthcare reform debate than the last one,” he said. The Health Insurance Association of America, an earlier incarnation of AHIP, was largely credited with torpedoing Clinton’s reform plans with their multimillion dollar “Harry and Louise” ad campaign.[…]
“I agree with you that we should have done more on cost-control,” he said, but he added that the law’s new insurance exchanges — which will begin operations in 2014 — will spur competition between insurance companies and lower costs.
“Americans tend to blame insurance companies for things that are really probably providers’ faults,” he said.
Clinton certainly isn’t wrong in suggesting that under the leadership of Karen Ignagni, the insurers adopted a more conciliatory tone towards reform. But he’s overstating the intensity of their support. In December 2008, the health insurers issued their own health care plan and announced that they were willing to accept new market regulations in return for a strong individual mandate, a concession they had already made 16 years earlier.
Recall that in December of 1992, the insurance lobby, then known as Health Insurance Association of American (HIAA), called for “a new Federal law that would require coverage for all Americans, define the basic set of benefits, and try to contain health care costs by limiting tax breaks for the purchase of insurance.” Under their proposal, everyone would have to buy ‘an essential package’ of benefits and could receive coverage “regardless of a person’s medical history.”
The industry ultimately rejected reform because it feared that Clinton’s regional alliances would bar some smaller insurers from the marketplace, and it opposed the President’s premium growth constraints and the community rating provisions. The lobby went on to “plant seeds of doubt” about Clinton’s reforms and organized countless grassroots campaigns, hired field operatives in six states whose lawmakers were expected to be swing votes, and recruited ground troops from members companies’ networks of employees, managers, and agents. By the end of its effort, HIAA had generated more than 450,000 phone calls, visits, and letters to Congress.
In 2009/2010, industry support for reform may have certainly been more vocal and sustained, but it followed a very similar trajectory. From September to December 2009 — while publicly embracing the idea of universal coverage — six of the nation’s biggest health insurers began quietly “pumping big money into third-party television ads aimed at killing or significantly modifying the major health reform bills moving through Congress.” Watch a compilation of some of these ads:
In October of 2009, the industry released several studies arguing that the weak personal responsibility requirement, taxes on health care providers, spending reductions in Medicare and taxes on high-value health plans will increase “the cost of coverage for both single and family policies in the individual, small group, large group, and self-funded insurance markets.”
Despite all these efforts, however, health insurers are now promising to work alongside federal and state regulators to implement the new reform law and hold off efforts by progressives to re-introduce the public option or single-payer proposals.