HALLOWELL, Maine — The Obama administration’s heath care overhaul isn’t making everyone happy, but health insurance industry whistle-blower Wendell Potter says it’s an important step in the right direction.
Potter told a coalition of liberal-leaning advocacy groups and policy organizations on Wednesday that supporters of the Affordable Care Act must be well informed and speak with one voice in defending it against powerful groups that seek to overturn it or undo the key consumer protections it contains.
The ACA “is far from perfect but it is a strong start and already making improvements in the lives of Americans,” Potter said, speaking to the first formal meeting of a group known as the Health Care for Maine Alliance. The group met at the Maple Hill Farm conference center in Hallowell.
For example, Potter said insurance companies can no longer refuse to cover children with pre-existing medical conditions, small businesses get new tax breaks for offering coverage to their workers, young adults can stay on their parents’ policies until they turn 26, and the infamous “donut hole” coverage gap in the Medicare Part D prescription gap is closing.
In 2014, health insurance market places known as “exchanges” will help consumers choose affordable coverage that works for them, just in time to comply with the ACA’s “individual mandate” that requires most Americans to have health coverage or pay a penalty.
In 2007, Potter walked away from a lucrative public communications career with Cigna insurance company after having what he terms “an epiphany” about the industry’s profit-making priorities. Since then, Potter has been in demand as a speaker and has written a book about the insurance industry titled “Deadly Spin.”
Companies such as Cigna are “enormously rich monopolies” that “comprise a cartel that has assumed the power to decide who lives and who dies,” Potter said on Wednesday. By constantly raising the cost of insurance and developing new reasons to deny coverage, Potter said insurance companies are engaged in a systematic effort to “get the old and the sick off their books.”
Insurance companies, he said, support the ACA because the individual mandate guarantees them millions of new customers. In part because of the industry’s support, Potter expects the ACA to be upheld by the “very political” U.S. Supreme Court, despite challenges from conservative Republicans and business groups that have questioned its constitutionality.
But he cautioned that the powerful, organized and well-funded insurance lobby is hard at work trying to erode certain ACA consumer protections, such as one provision that requires insurers to spend 80 cents of every premium dollar on actual health care services, and another that subjects proposed rate increases to approval by state insurance superintendents.
Americans who want to ensure the overhaul gets implemented as enacted must “have a well thought out strategy and work as a well coordinated team, or we’re going to get slaughtered by these guys,” Potter said during his lunchtime address.
Potter said the American health care system is in a crisis and headed toward collapse if major changes are not adopted.
In a conversation before his lunchtime talk, Potter said he has been speaking to church groups about the Affordable Care Act and the need to overhaul the nation’s health care system.
“I believe people of faith have been misled in devious ways … in an effort to get them to vote against their own interests,” he said.
Potter said the administration of Gov. Paul LePage and the new Republican majority in Augusta were heavily influenced by insurance lobbyists in their support for LD 1333, a contentious bill passed during the last legislative session that significantly lightened the regulation of health insurers in Maine.
“I have no doubt [the lobbyists] were doing high-fives when LePage was elected and the Legislature flipped,” he said. “I can’t imagine there was anything they wanted that they didn’t get” in the new law.
Potter’s visit to Maine was funded by the Health Care for Maine Alliance, whose steering committee includes representation by the American Cancer Society, AARP, the Maine Center for Economic Policy, the Maine Medical Association, Consumers for Affordable Health Care and other groups.