The insurers' odd play 

The health insurers may not have intended to make such a splash in its criticism of the Baucus bill today.

For months, America's Health Insurance Plans, the HMO lobby, has carefully supported the vague notion of "reform" while pushing hard for its favored policies and gently critiquing those proposals that would hurt the industry.

In basic terms, AHIP has called for the individual mandate and subsidies, while opposing Medicare cuts and a government option. But it's been something of a soft sell. In part, Obama--on the advice of pollsters--has shown willingness to use the insurers as the whipping boy, and if Pelosi and Obama wanted to spend the effort, they could make people hate the insurers even more. 

But also, soft-selling and a gentle touch is the modus operandi of AHIP President Karen Ignagni. I met her at a breakfast organized by the Christian Science Monitor, and despite the efforts of all the reporters, she simply wouldn't say a bad word about any proposal or any politcian. You ask her about a government option, and her reply is along the lines of, "we think there's a better way to accomplish those same goals." You ask her about Nancy Pelosi calling her members a "villains," and she says something like, "we're glad the conversation has mostly been more productive than that."

So, did AHIP mean to smack down the Baucus health-insurance bill? It's out of character, for one thing. The bill is also very friendly to the industry--no government option, yes individual mandate, yes subsidies for private insurance--even if it has some provisions they might not like.

The risk here: Democrats decide the insurers are simply an enemy, and they pass a final bill that hurts the insurers for real.

The potential upside: the media swallow the line that this bill hurts insurers, taking away the Democratic impulse to really stick it to the insurers.

As of now, I'm scratching my head.

 

[update: My friend Peter Suderman at Reason sheds some light on the situation. His take--and I agree--is that the insurers are objecting to what they see as a weak individual mandate. The fine for not buying insurance is too law, they say, and so those with low health-risk (young, healthy folk) may not buy health insurance. Without the healthiest paying premiums, the insurers can't lower premiums for the sicker folks.]

[update 2: Ezra Klein at the Washington Post goes through the insurers' complaints in a clear post.]

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Timothy P. Carney

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