Health plans aren't supporting efforts to repeal health reform

Executives say moving forward makes sense for the industry, which has spent considerable time and money adapting to the law.

By Emily Berry — Posted Nov. 29, 2010

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The man who will become speaker of the House in January 2011, Ohio Republican John Boehner, has pledged to repeal the health system reform law. However, health insurers said they are not pushing for a repeal of the Patient Protection and Affordable Care Act, despite some of the problems they have with the legislation that they hope will be addressed in the new Congress.

One reason was summed up by Jeff Goldsmith, PhD, professor of public health sciences at the University of Virginia and president of Health Futures Inc., speaking Nov. 8 to the fall meeting of the trade group America's Health Insurance Plans in Chicago.

"Repeal the legislation, and 15 or 20 million new customers for your product go away," he said. "We really don't want that. We really want more people to have access to health insurance."

Health plan executives say they recognize that moving forward with the new law makes sense for the industry, whose companies have spent considerable time and money adjusting to health system reform.

"I don't think it is in our society's best interest to expend energy on repealing the law," Cigna CEO David Cordani said Nov. 9 at a Reuters health care conference in New York.

Officially, he said, Cigna won't be on either side of the debate.

"We are not and will not get into that dialogue, because I think it is a futile exchange," Cordani said. "This conversation needs to get back to what are the principles that need to support a sustainable policy for our society. ... We believe in access expansion for affordable care for all, a sustainable cost equation and improvements in clinical quality. There are means with which to achieve that. So just a blatant repeal is not necessarily solving what our country needs."

Looking for changes

Insurers have said they hope to see some changes in the health reform law, though they mostly have stayed away from discussing the specific tweaks they would like.

When pressed at the Reuters conference, Cordani said that "in a vacuum" he would oppose a provision that places a tax on the most generous health benefits, often referred to as "Cadillac plans." Generally, insurers have been critical of the health reform law's expansion of coverage without addressing costs in a way they believe will really change the system.

Insurers' lack of a call for a repeal comes even though a recent report detailed how much they spent lobbying against health reform, at least as it was originally proposed by President Obama.

According to a Nov. 17 report from Bloomberg, the trade group America's Health Insurance Plans gave the U.S. Chamber of Commerce $86.2 million in 2009 to lobby against a public insurance option and advocate for a "market-based health care system."

The bill that Obama signed March 23 did not contain a public option and will require states to create or participate in health insurance exchanges so that millions of uninsured people can buy their own coverage to comply with a federal mandate beginning in 2014.

Repeal chances low

There appears to be little chance that a repeal of the health reform law will happen, Molly Voris, program director of the Health Division of the Center for Best Practices at the National Governors Assn., said Nov. 10 at the AHIP fall forum in Chicago. Even if House members manage to pass a repeal, the Democratic Senate majority wouldn't pass it, and the president wouldn't sign it.

That means the bill is likely to remain in place in the short term, Voris said, "What happens in the long term, I don't think anyone can say."

Some have wondered if the reform law might be stripped of its funding through a legislative mechanism that doesn't require Democrats' cooperation. Speaking to investors at a conference Nov. 11, Aetna Chief Financial Officer Joe Zubretsky said the company expects to see opponents take an incremental approach.

"We all have our own speculations, but the way we like to characterize it for our investors are three words in the way the Republicans are going to approach this, and that's amend, appropriate and influence. That's the impact they can have before they have either a supermajority or the White House. But they can do a lot. And there's a lot still that's unknown, a lot still to be decided by [the Dept. of Health and Human Services]," he said.

Aetna isn't counting on any rollback of the law, but is expecting a "dialogue" that is helpful to business now that Republicans have the majority of the House and a bigger portion of the Senate.

"We believe Republicans will engage in a more balanced dialogue and engage the private sector more on this solution," Zubretsky said. "The Republicans believe that private sector can be the solution to solve some of these fundamental issues and not solely rely on government intrusion, and we think that balance is quite healthy."

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