Wendell Potter: The Behind-the-Scenes Battle That Could Subvert Obamacare (IMPORTANT!!) [View all]

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http://wendellpotter.com/2012/12/the-behind-the-scenes-battle-that-could-subvert-obamacare/

And now, insurers have turned once again to the Chamber, this time to wage a behind-the-scenes campaign aimed at state insurance commissioners. If they succeed, insurers will be able to sell a highly profitable insurance product to a highly targeted group of small employers—those with mostly young and healthy workers. By buying this product—stop-loss insurance—those small employers would be able to avoid using the planned state insurance exchanges to obtain coverage for their workers.

Here’s why that’s important. Because of the way the Affordable Care Act is written, by avoiding the exchanges those small businesses would be exempt from having to comply with many of the most important consumer protections in the health law.

It’s complicated—so complicated that unless you are a reader of obscure insurance industry newsletters, you’ve probably never heard about this, even though it has the potential to cause the collapse of the exchanges and completely circumvent to intent of Congress. The intent of Congress was to make coverage more affordable and available to all of us, not just the young and healthy.

The key to this fight are those state insurance commissioners. Their organization, the National Association of Insurance Commissioners, just wrapped up its fall meeting in Washington, where consumer advocates were pitted against lobbyists for big insurers and their old friend, the Chamber of Commerce. The Chamber has taken the lead in pressuring the NAIC to make it easy for insurers to sell stop-loss coverage to small businesses wanting to avoid many of the ACA’s consumer protections. Those protections aren’t a small matter; they would, among other things, prohibit insurers from charging people higher premiums because of their gender, age and health status. Buying stop-loss coverage would also allow employers to largely side-step any regulation at the state level.