Health insurance under a President Hillary Clinton would likely see the strengthening and expansion of the Affordable Care Act, including the creation of a public option to compete with private insurers on the exchanges, the Democratic presidential nominee said during a recent campaign speech.
Days after Republican Donald Trump outlined his economic plans in Detroit – a temporary ban on new financial regulations, for one – Clinton shared her own vision with audiences in Warren, Michigan. Part of her priorities include further health reform.
“Giving Americans in every state the choice of a public-option health insurance plan won’t just help those who struggle to afford coverage,” Clinton said. “It will strengthen competition and drive down costs for everyone.”
The former Secretary of State also slammed Trump’s proposals for a moratorium on financial regulation and the repeal of the ACA, saying his plans would “let insurance companies write their own rules again.”
“I’ll do the opposite – we should strengthen those rules so that Wall Street can never wreck Main Street again,” she said.
Clinton on health insurance
Clinton has a long record of support for federal involvement in health insurance, including for a government-run program. In 1993, she headed the Bill Clinton administration’s task force on reforming health insurance, delivering a 1,000-page plan later dubbed “Hillary Care” that included provisions for a public option. She reaffirmed that support in July, after criticizing rival Bernie Sanders’ plans for universal Medicare as costly and impractical.
Clinton has also publicly scrutinized recent major health insurance merger proposals, including Anthem’s takeover of Cigna and the acquisition of Humana by Aetna. Together, she said, the two deals comprise nearly $100 billion and could undermine competition the health insurance space – violating one of the major tenets of the ACA.
“These mergers should be scrutinized very closely with an eye to preventing the undue concentration that they appear to create,” she said in a statement. “I am very skeptical of the claim that consumers will benefit from them because the evidence from careful studies shows that too often the companies end up pocketing profits rather than passing savings to consumers.”
Clinton further vowed to increase regulatory scrutiny if elected president.
"I would strengthen the antitrust enforcement arms of the Department of Justice and the Federal Trade Commission and appoint aggressive regulators to take on troubling concentration wherever it occurs in the healthcare industry," she said.
“A roadblock to reform”
The health insurance industry has been largely silent on the “Big 5” mergers, but is adamantly opposed to the creation of a public option. Insurers famously spent more than $173 million in defeating the public option provision in the original iteration of the Affordable Care Act, and AHIP – the industry’s lobbying arm – called the public option “a roadblock to reform.”
“A government-run plan would underpay doctors and hospitals rather than driving real reforms that bring down costs and improve quality,” the group said. “It’s time we focus instead on broad-based reforms that will ensure the affordability and sustainability of our healthcare system.”
Health insurance agents have also been outspoken in their opposition to a public option, saying it would hinder their ability to assist consumers with coverage choice and even force them out of the market altogether.
“This will further squeeze compensation,” Michael Keegan, senior vice president with Health Agents for America, said last month. “There is an assumption by some in the state and federal government that agents are just salespeople. Certainly when you look at what goes into servicing clients, it’s much greater than that.”
The future of the health insurance agent
Clinton’s controversial proposal comes at a time when agents are already contemplating exiting the ACA business. High costs and poor financial performance has caused many health insurers to seriously limit and sometimes axe commissions paid to agents.
Such cost-cutting techniques are being implemented even among the nation’s largest insurers. Anthem and ConnectiCare made headlines last week by saying they may stop offering commissions to brokers next year, and UnitedHealth made the same move several months ago.
With a public option also in the mix, agents say they are unsure how long they will continue to sell plans on the exchanges.
“At what point will agents and brokers even want to stay in this business?” Keegan said. “If agents and brokers leave, consumers will be hurt.”
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