Aetna Gets Caught


img_0888Today we have proof of what we’ve suspected all along. Insurance companies lie and hide the truth about their profits.

Deep pocketed insurance providers have squealed like pigs about the healthcare exchanges. Not because they were not making fair profits but because the regulations imposed through healthcare reform made it more difficult to earn obscene profits and injected too much control into the marketplace.

From day one, the insurance providers have been fighting the Affordable Care Act by giving quite generously to the Republican Party who also oppose it. And why do the Republicans oppose it? We know many self serving reasons but mostly it was because achieving universal healthcare coverage would have been a huge victory for Obama and the Democratic Party.

Couldn’t have that now could they? Can’t let a little thing like the welfare of the constituents interfere with the Great War between the left and right because after all, the great prize is not a better, more perfect society, it’s power and money. We all know that, right?

Throughout the process of reform, the insurance companies and the Republicans kicked and screamed, and stirred up fear (Republicans love love love fear… fave tool ever) by telling people they would be at the mercy of death panels and other nonsense. They were as uncooperative as humanly possible, doing everything they could to make sure IF healthcare reform was passed it would be left with crippling shortcomings. In other words, they figured out a way to make it work for them, not the citizens.

Think of the ACA as a new car. A car America badly needed because the old one just didn’t work for everyone. It left too many people sitting on the curb and feeling poorly. The Dems wanted to forego the expensive chrome and leather seats and instead order enhanced safety features and better performance. They wanted carrying capacity and dependable service.

The toadies and their check writers were saying, “Bullshit, ain’t nobody gonna get rich off this minivan of a health plan” so they promptly started cutting brake lines and loosened lug nuts, generally removing things which would likely allow the car to move forward in a safe and efficient way. Because they knew once that baby came to a standstill, victory would be theirs and the passengers would all be pissed. Oh, and let’s call that car ObamaCar because we want to make sure that wreck forever has his name attached to it. (Nice touch!)

What would be the happy result of the predictable breakdown for the toadies and their check writers? We would all have to go back to the way it used to be and more importantly, the big corporations and the toadies could get back to the business of getting paid. ‘Merica.

For the ACA, the cut brake line was the removal of the public option. The public option would have provided low cost barebones policies similar to medicare and therefore would have immunized citizens from the high rates of the private insurers and their threats to leave the exchanges. It would have helped control costs and allowed for negotiation with healthcare providers.

The public option was included in the bill by the House but later ditched in a backroom deal in the Senate. Why? Maybe as a payoff for an unrelated matter. Maybe to get them to shut up about the death panels. We’ll never know.

That was a huge win for the insurance companies and their toadies. Without it, citizens are forced to pay whatever rates are offered by whichever providers decide to participate in the exchanges. The tax bill for subsidizing those jacked up rates for the poor grew and we lost the ability to negotiate with healthcare providers. With the removal of the public option, we put the insurance providers right back into the drivers seat.

I’m pretty sure they took the rest of the day off to celebrate that one. Double martinis for everyone. Now lets go play some golf.

So the next thing that happened is the insurance providers did join the exchanges and promptly began cranking up those premiums as early and often as possible, citing increased risks due to “uncertainty” of the system and the increased burden of having to actually cover those who had serious, longstanding illness. (Not to mention losing the essential ability to cherry pick their policy holders and drop them when arbitrarily set caps were reached).

So up went the rates and the insurance providers went back to making a shit ton of money with the added bonus of knowing the high rates would cripple the middle class, who vote in large numbers, allowing them to pay off their debt to the toadies who needed those votes in order to stay in office and get that socialist POS legislation repealed.

See how that works?

Without the public option, the providers have all the leverage. They can also pull out of exchanges, leaving citizens with few or no providers (and very pissed off so even more votes for the toadies… yayyyy).

Which is where we are now. Except this time a judge caught one of them. Aetna got a little too brazen and tried to use their leverage to force approval of a merger with Humana. That merger would have further decreased competition and driven up rates.

In other words, Aetna wanted to use their participation in the ACA created exchanges to further increase their control of the insurance marketplace by merging with another corporate giant. To force the issue, Aetna threatened to pull out of markets altogether if the merger with Humana was not given the green light.

When the merger was not approved, Aetna promptly pulled out of five states citing “losses which made their participation unsustainable”. Poor them, right? Except they lied. And despite the Republicans citing those losses as proof of the failure of the ACA, justifying their effort to repeal the ACA, we now know it was all total bullshit. We know because the Honorable Judge John D. Bates caught them.

I don’t play golf but I’ll have that martini now. Just a small one befitting a small victory. It’s all we got.

You may read more about the court case HERE.

Lynn may also be followed via Twitter handle @lynnmcmorris and you are invited to join her on Facebook via the Blue On The Bayou group.