As you read this, rest assured that the people who were largely responsible for the individual mandate in Obamacare—and certainly for the constitutional challenge that the Supreme Court just rejected —are at work conspiring with their friends in politics and the media to strip out the consumer protections in the law that benefit Americans most.
I'm talking about the health insurance industry, of course. It was the insurers that led the drive on Capitol Hill and at the White House to include the individual mandate in the reform law in the first place.
The industry had two objectives going into the debate on reform: making sure there was an “enforceable” requirement that all Americans obtain coverage, and making sure there was no public option created.
As the former head of communications for Cigna, I was privy to the industry’s strategy to influence the reform debate. I knew that insurance company executives and the industry’s biggest trade association—America’s Health Insurance Plans—would be working behind the scenes to achieve their policy victories.
But although the industry achieved its two big policy goals, it was not able to keep the Democrats from including many new regulations on the industry and numerous consumer protections, including the one that will make it illegal for them to refuse to sell coverage to Americans with pre-existing conditions. It also was not happy with the fact that the penalties for not buying coverage are not as severe as it had hoped. So, since the law was enacted two years ago, insurers have been trying to get their friends in Congress to weaken or remove those consumer protections. And they have tried to influence the Obama administration to delay or weaken the new regulations and to influence how the law is implemented at the state level.
But industry executives have not been nearly as successful as they thought they could be. So what happens now? After making a temporary alliance of convenience with the Obama administration over the health care law, they clearly have decided the best strategy to get what they want is to get back fully in bed with the GOP. Expect health insurers to funnel millions of dollars to campaigns and front groups in the months ahead to help Mitt Romney defeat President Obama as well as to keep control of the House and flip the Senate to GOP control.
Undoubtedly, the industry is helping shape the GOP’s new strategy of just calling for repeal of the law now that the Court has upheld it—not repeal and replace it, as Republican leaders promised until recently. Why? Because the industry knows—as do Republican leaders—that the industry’s favorite “solutions”—allowing insurers to sell policies across state lines, tort reform and deregulation of the industry in general—have proven to be completely ineffective in expanding coverage and controlling costs (although they would benefit insurers’ bottom lines) and cannot be enacted as long as Obama is in the White House.
In short, the health insurance industry is now with Team Romney.
So what we can expect to hear beginning immediately from both Republicans and the industry's allies in media and business is that the consumer protections and regulations in Obamacare will result in higher insurance premiums and that, despite what the Court decided, Americans should not be forced to buy insurance if they don’t want to.
The White House dodged a bullet today, to almost everyone’s surprise, partly because it and Congressional Democrats have done such a lousy job since the Affordable Care Act became law of explaining why it is a good law, and why it should go forward. If the Democrats want to have a prayer of holding on to the Senate and White House, they will have to figure out how to win the coming messaging war—which will be funded, to a large extent, by the insurance industry. Which means that they will be using a big chunk of what we pay in premiums to help the GOP wage a propaganda campaign to get us to vote against our own best interests.
Wendell Potter, a former head of communications for one of the nation’s largest health insurers, is a senior analyst at The Center for Public Integrity. He is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans .