Health insurers press to exempt millions from ACA

You would think that with the latest news that the health insurance lobby is still laundering money for attack ads against Democrats who supported ObamaCare, the Democratic leadership would slam the door on any requests from the industry. But no. Democrats in the Senate are seriously considering passing a health insurance industry bill that would weaken Affordable Care Act (ACA) consumer protections for 13 million people.

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The New York Times reported that AHIP, the health industry trade association, laundered $1.6 million through a fund controlled by the National Federation of Independent Business to run ads against Arkansas Democratic Senator Mark Pryor this past December. Pryor faces a tough reelection fight this fall. AHIP, which stands for the warm and fuzzy name America's Health Insurance Plans, has a long history of laundering money through business front groups to finance anti-ACA attack ads, including at least $86 million through the U.S. Chamber of Commerce.

Now, at the behest of major AHIP members including CIGNA, MetLife and Aetna, the Senate is looking at a bill passed by the House, the Expatriate Health Coverage Clarification Act of 2014 (H.R. 4414 as amended or "EHCCA"), which would exempt 13 million people from ACA consumer protections.

The legislation, which the National Immigration Law Center has correctly called "using a bat to swat a fly," is supposed to deal with a narrow issue: health inurance polices sold to 330,000 Americans who work abroad for more than six months per year. But the bill enacted by the House would actually exclude 13 million people, including green-card holders who have made the U.S. their permanent home and low-wage immigrant workers, such as farmworkers and caregivers.

The health insurance industry has never liked ACA provisions that set coverage standards, including benefits like preventive care, prohibitions against lifetime and annual caps, and limits on administrative costs. All of these would be waived by the EHCCA legislation. Insurers make the most money when they can sell substandard policies, shifting more cost to consumers. By pressing to dramatically expand such exemptions in the EHCCA legislation, the industry aims to gain a precedent, which it will then argue should be applied to other Americans. It's the long game, which they continue to play.

The EHCCA would also exempt policies from the premium fee, which insurers must pay to the help fund coverage under the ACA. Eliminating the fee is another top item on the industry wish list. The ACA's employer responsibility provisions would also be waived, creating a set of perverse incentives that would lead to higher costs for consumers and inferior coverage, as the Georgetown University Health Policy Institute has pointed out.

Why would Democrats, who should see the health insurance industry for what it is — an enemy to providing good coverage for American families and businesses — even consider the legislation? The excuse — as with every single argument made by businesses who want to get out of regulations — is that it will cost jobs. The insurers argue that they will move overseas to cover ex-pats, to avoid having to comply with the ACA rules that would be waived by the EHCCA. By now, Congress should have woken up to the industry game of blaming regulations on job loss. There's even an entire website, the Cry Wolf Project, which exposes industry scare tactics about awful economic impacts that never materialize.

Democrats have no excuses not to be fully cognizant of the double game being played by the health insurance industry. The industry is profiting by covering millions more Americans under the ACA. At the same time, it secretly finances political attacks on ACA supporters in Congress, with the goal of a compliant Congress that will gut the law's consumer protections. If Democrats go along with this gambit, they will prove themselves to be the suckers that the health insurance industry believes them to be. And American consumers will be the biggest losers. 

Kirsch is a senior fellow at the Roosevelt Institute and a senior adviser to USAction. Follow him @_RichardKirsch.

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