Health insurers avoided their worst case scenario last week — the prospect of the Supreme Court striking down the individual mandate but letting the rest of the health care law, especially profit-threatening consumer protections, go forward. Now the industry can focus on a goal it has had all along: getting rid of those pesky consumer protections.
That goal was clear to me from the reaction statement issued by America’s Health Insurance Plans. The statement was jam-packed with feel-good phrases like “secure and affordable,” “peace of mind,” and “choice and competition.” Allow me to provide an interpretation of what AHIP, the industry’s biggest PR and lobbying group, was really saying and really planning. After twenty years as an industry PR guy, I’m all too familiar with prose written to obscure intentions.
Sentence by sentence, here’s what AHIP’s communications people crafted as soon as they realized the industry would not have to go nuclear to wipe out ObamaCare — that instead, it could conduct a stealth ground war to get rid of everything in the law that might threaten profits.
“Individuals and families need secure, affordable coverage choices. Maintaining the link between market reforms and universal coverage is essential to avoiding significant cost increases and loss of choice for consumers and employers.”
Translation: “Whew! Thank you, Chief Justice Roberts. We can now shelve the campaign we were poised to launch to convince people why the consumer protections in the law won’t work without the mandate. We won’t have to squander resources on that effort. Now we can devote our war chest to helping elect candidates willing to use our talking points and vote the way we tell them to vote — and to persuading people to believe the consumer protections are not in their best interests after all. The mandate will work best for us when they’re all gone.”
Next sentence: “As the reform law is implemented, health plans will continue to focus on promoting affordability and peace of mind for their beneficiaries.”
Translation: “We are masters at stringing together words that test especially well in focus groups, even if they have little or nothing to do with the way we really conduct business. ‘Affordability and peace of mind’ sound great, don’t they? So trust us. Just don’t look at our track record.”
And so on: “The law expands coverage to millions of Americans, a goal health plans have long supported, but major provisions, such as the premium tax, will have the unintended consequences of raising costs and disrupting coverage unless they are addressed.”
Translation: “First off, we want you to suspend disbelief for a moment and forget that if health plans really cared a whit about expanding coverage, they would have ended their routine practices of refusing to sell coverage to people with preexisting conditions and charging exorbitant rates years ago. That’s why 50 million Americans are uninsured. As for that premium tax, even though we stand to gain billions every year because of the individual mandate and the subsidies the government will provide to help low-income families pay their premiums, we don’t want to give up a dime of those billions to help the government pay for the expanded coverage we’ve been in favor of for so long. So we’ll have a campaign designed to mislead people into thinking that their premiums will have to increase and that their coverage might somehow have to be disrupted as a result of the tax. We’d love to be able to say that we are so grateful for the billions in new revenue that we will agree not to pass the tax along to our customers. We’d love to say that, we’d even consider doing it — if only our shareholders would let us.”
Wait, there’s more: “Health plans will continue to work with policymakers on both sides of the aisle to make coverage more affordable, give families and employers peace of mind, and promote choice and competition. Health plans also will continue to lead efforts to reform the payment and delivery system to promote prevention and wellness, help patients and physicians manage chronic disease, and reward quality care.”
Translation: “We have Democrats as well as Republicans in our pocket. And look how we’ve worked in ‘affordable’ and ‘peace of mind’ into our little statement again. Aren’t we good at this? And we know ‘choice’ and ‘competition’ are two words that test especially well. So well, in fact, that we and our allies named one of the front groups we set up a few months ago, the one we’re using to try to control how the state health insurance exchanges operate, the ‘Choice and Competition Coalition.’ And instead of focusing on how we can — and do — get between you and your doctor whenever we want to, please suspend disbelief once again and just think of us as your doctor’s helper. Doctors don’t know best, silly. We do. So trust us.”
Expect to hear all of these buzzwords and phrases coming out of the mouths of the industry’s friends in politics, business and the media in the coming months — over and over and over again. The coming war will be a war of words, a war of messaging.
Next week I’ll provide a more detailed list of the other provisions of the law the insurers have their sights on, along with some of the talking points they’ll be deploying to try to take them out.
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