Kaiser Health News flags this story from the Richmond Times Dispatch about how Anthem Blue Cross and Blue Shield in Virginia (a WellPoint subsidiary) is positioning itself to influence the implementation of health reform in the state. As I’ve argued previously, despite spending millions on trying to undermine the process of passing reform, insurers aren’t interested in repealing the health law as much as they’re invested in weakening its regulations. And in Virginia, BC/BS — which is a member on an advisory board to Gov. Bob McDonnell that will provide recommendations — is well positioned to do just that:
“First, to make sure that the new insurance reforms that are already in place are properly applied to their customers, and second, to see that the implementation we are expecting over the next few years happens very smoothly with consumers in mind.”
Asked whether there were aspects of the law he would like to see changed, King said it is “not productive” to debate the reform now. “The law is the law, and we are focused on implementing it,” he said. [...]
“One of our top priorities for the health-insurance exchange is that we want to make sure it enables competition and promotes consumer choice instead of limiting consumer choice,” he said. “There are some exchange models that really restrict consumer choice, and we hope that Virginia will steer away from those.
“The way to maximize consumer choice in the exchange is to have some base criteria that all health plans must meet to participate in the exchange,” he said. “But provided that any health plan meets those requirements, then it should be allowed to participate in the exchange.”
That last half is particularly important. Like insurers in California who unsuccessfully lobbied Gov. Arnold Schwarzenegger to adopt an industry-friendly less regulated Exchange structure, BC/BS will be pushing the state to adopt a model that, as the company’s president put it, “enables competition and promotes consumer choice instead of limiting consumer choice.” That’s spin for a loosely regulated flea market in which the exchange authority is not able to weed out inefficient issuers or use its bargaining power to secure better deals for beneficieires. Consumer advocates are urging states to avoid this kind of weak system, but we’re likely to see red states take up just this kind of approach.
In fact, the industry’s talking points are already amplified by conservative editorial pages. In a recent piece for the Wall Street Journal, Scott Gottlieb and Tom Miller of the American Enterprise Institute urged red states to undermine the Affordable Care Act by offering “their own market-friendly versions of exchanges” in which “any willing insurers already licensed to operate in a state should be able to offer plans.”
Real world experiences suggest that this kind of system is highly inefficient and ineffective in holding down costs, but expect conservative think tanks and insurers to wrap this exchange model in the rhetoric of “choice” and “freedom” and market it to conservative governors as an alternative for weakening or stopping health reform.