Insurers Have Remained Mysteriously Quiet About Obamacare Repeal


A reader emails with a question:

The repeal-Obamacare mania has been on for years, but I have NEVER read anything about what the insurance industry is thinking or doing about it.

Neither have I! And it’s damn mysterious. Obviously the insurance industry was heavily involved in lobbying for Obamacare back in 2009, and just as obviously there are parts of Obamacare they don’t like. The patient pools have turned out to be sicker than they projected and insurance companies have struggled to make money on Obamacare policies. This year, however, they’re finally there—or close to it. The market has shaken out, premiums have risen to CBO-projected levels, and Obamacare is probably a break-even or better prospect for the insurers who have gutted through the first three years.

What’s more, like it or not, they’ve spent years adapting the way they do business. Everything from computer systems to physician compensation now follows Obamacare’s rules. This has cost tens of millions of dollars, but now it’s done. The last thing they need is to rip it all out and start from scratch.

And yet insurance companies have been surprisingly silent about the Republican plan to kill Obamacare. Do they prefer getting rid of it even if there’s an upfront cost? Have they given up, and assume that repeal is a foregone conclusion that’s not worth fighting? Is all their lobbying behind the scenes? It’s not clear. Insurers are pretty unanimous about wanting some certainty in the rules, but aside from that, this eight-week-old story from the New York Times still describes things pretty well:

Far from reflecting the magnitude of the moment, the most prominent message from lobbyists that lawmakers saw in their first week back at work was a narrowly focused advertisement from the U.S. Chamber of Commerce….Health care professionals are not totally silent, but industries that were integral to the creation of the Affordable Care Act in 2010 are keeping their voices down as Republicans rush to dismantle it.

….Some lobbyists have tacitly accepted the likelihood that major provisions of the health law will be repealed, setting their sights instead on shaping its replacement. They fear that if they come out strongly in opposition to repealing the law, they will lose their seats at the table as congressional Republicans and the Trump administration negotiate a replacement.

Insurers spent $150 million lobbying in support of Obamacare in 2009. So far they’ve spent virtually nothing in 2017. I continue to be mystified by this.