Time to Hold Hearings on Medicare for All

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One of the reasons—arguably the biggest reason—Republicans lost control of the U.S. House of Representatives Tuesday was their years-long effort to repeal the Affordable Care Act and, make it possible for insurance companies to once again pad their bottom lines by denying coverage to people with preexisting conditions.

Voters were clearly smarter and less gullible than many Republican candidates expected. Having seen polls showing that health care was voters’ top concern, many of the very same members of Congress who voted dozens of times to get rid of the ACA claimed in their campaign ads that they were fighting to protect people with preexisting conditions. Voters from coast to coast weren’t buying it.

For years—in fact, until this year—polls have shown that a majority of Americans were not happy with the ACA. But what Republican members of Congress ignored, at their peril, was that many of those folks were unhappy because the ACA did not go far enough to protect them from unscrupulous, profit-obsessive health insurance companies. They wanted Congress to go much further than the ACA, which kept our expensive and hugely complicated multi-payer system of health care financing in place. More and more Americans wanted private health insurances out of their lives. Forever.

As the former head of PR for two of the biggest for-profit health insurers—Cigna and Humana—I can assure you that health insurance executives have known for years that the companies they lead are among the most despised of all companies the world.

In an article earlier this year about America’s most-hated companies, USA Today noted that “few industries are as widely detested as the insurance industry.” Reading the list, I wasn’t the least bit surprised to see that one of my former employers—Cigna—came in at number 10, and they’re certainly not along in being reviled. I left my job there because of the numerous anti-consumer, anti-patient practices that had been common throughout the industry for years. Before the ACA was passed, for-profit and nonprofit insurers alike charged people with preexisting conditions exorbitant amounts of money for their coverage. Worse, they even refused to sell coverage to as many as one in three applicants because of a preexisting condition. That is why almost 50 million people in the U.S. were uninsured when the ACA became law.

But as I said at the time, the ACA was just the end of the beginning for healthcare reform in this country. Insurers have simply found other ways to please Wall Street, which is constantly breathing down their necks to meet short-term earnings goals. To make up for profits lost from being unable to shun people with preexisting conditions, insurers have herded most of us into plans with “skinny” networks of doctors and hospitals and with such high deductibles that a growing number of Americans can’t even afford to pick up their prescription medications.

Even with employer sponsored insurance, workers are often getting a raw deal. A recent Commonwealth Fund report found that nearly 25% of people with employer-sponsored coverage had such high out-of-pocket costs and deductibles relative to their income they were effectively “underinsured.”

It’s little wonder that pre-election polls indicated that 70 percent of Americans supported Medicare for All. People are simply fed up with private, profit-obsessed health insurers. And despite the industry’s current propaganda campaign to convince lawmakers that our employer-based system of coverage needs to be kept in place, both employers and their workers are increasingly inclined to ditch it.

Now that Democrats control the House, it’s time to do something with it. Even candidates who didn’t explicitly support Medicare for All were elected by voters who overwhelmingly do (recent polling indicates 85% of Democrats support Medicare for All). If they take their responsibility to represent their constituents seriously, they will keep the promises they made to hold hearings, hammer out the details of Medicare for All, and lay the groundwork we’ll need once we have a White House that isn’t openly hostile to healthcare reform. That work needs to start now.