A day after formally delaying a vote on a healthcare bill and having to accept a further weakening of a public option to compete with private insurers, House Speaker Nancy Pelosi (D-Calif.) lashed out at the health insurance industry and urged her members to do the same during the August recess.
“They are the villains in this,” Pelosi said of private insurers. “They have been part of the problem in a major way. They are doing everything in their power to stop a public option from happening. And the public has to know that. They can disguise their arguments any way they want, but the fact is that they don’t want the competition.”
“The more the public knows about what we’re doing, the more they support it, and especially if you’re talking about a public option, because that’s where the insurance companies are making their attack,” Pelosi said. “Our members have to go out there ready to take on a big special interest that has not made our country healthier, has made costs spiral upward, and for whom that is coming to an end.
“It’s almost immoral what they are doing,” added Pelosi, who stood outside her office long after her press conference ended to continue speaking to reporters, even as aides tried in vain to usher her inside. “Of course they’ve been immoral all along in how they have treated the people that they insure with pre-existing conditions, you know, the litany of it all.”
Just as Pelosi was speaking, House Majority Leader Steny Hoyer (D-Md.), the No. 2 Democrat in the House, was also meeting with reporters and acknowledging that Democrats have been losing the message war "a little bit" with Republicans.
He said that Republicans have exploited confusion about the bill as it changed in the legislative process.
"We're responsible for putting together a plan. We've been focused on that," Hoyer said. "Republicans have been free to conjure up whatever they want."
In stark contrast to the healthcare reform debate in the 1990s, the health insurance industry has refrained from launching attacks on Obama or the plans working their way through Congress. Insurance lobbyists have been very active on both ends of Pennsylvania Avenue trying to shape the legislation, but so far the industry has not used its considerable resources to stop the process, despite numerous Democratic proposals it opposes.
Moreover, the insurance industry's biggest trade association, America's Health Insurance Plans (AHIP), has already agreed to new regulations key to the Democratic proposals, such as no longer denying coverage because of pre-existing conditions and no longer using health status or gender to establish insurance premiums. The industry's support for these concessions is contingent upon the final healthcare reform legislation including a requirement that all individuals obtain coverage, a provision that has been included in each of the Democratic bills.
"Health plans have been working in support of bipartisan health care reform for three years," America’s Health Insurance Plans spokesman Robert Zirkelbach said Thursday. "Our community has proposed guaranteed coverage for pre-existing conditions, discontinuing rating based on a person’s health status or gender, and a personal coverage requirement to get everyone into the system. We have proposed far-reaching administrative reforms to slash paperwork, reduce medical errors, and ensure doctors and hospitals can focus on patient care.
“Countless physicians, hospitals and employers, and millions of concerned citizens agree that a government-run health care plan will dismantle employer-based coverage, bankrupt local hospitals, and break the promise made to the American people that those who like their health plan can keep it," Zirkelbach said.
But the insurers' concessions are not enough for many Democrats who are aggressively pushing policies the industry strongly opposes. Liberals insist on the creation of a government-run public option insurance program that would compete with private plans. Senate Democrats and the bipartisan Senate Finance Committee group working on a compromise deal are seeking to levy taxes on insurance companies. Democrats also want to slash funding for private Medicare Advantage health plans by as much as $177 billion.
In recent days, Obama has also ratcheted up his rhetoric against the insurance industry.
“The truth is we have a system today that works well for the insurance industry, but it doesn't always work well for you,” Obama said at a Wednesday town hall meeting in Raleigh, N.C. “What we need, and what we will have when we pass these reforms, are health insurance consumer protections to make sure that those who have insurance are treated fairly and insurance companies are held accountable.”
But, at the same time, the Speaker said she could swallow what the Blue Dogs successfully demanded, noting that it resembles the legislation offered by Sen. Edward Kenndy (D-Mass.) and guided through his committee by Sen. Chris Dodd (D-Conn.), which represents the Senate’s more liberal approach to healthcare reform.
“I am for the strongest possible public option, because, as the president said, that’s the way to keep the private sector honest, that’s how you have true competition, and achieve true universal, quality, accessible healthcare for all Americans,” Pelosi said.
Speaking of the Kennedy-Dodd bill and the current state of the Energy and Commerce agreement, Pelosi said the approach “is one that I think would be OK.”
"It’s not my preference,” she said. “My preference is a stronger bill. But it meets the test of having an effective public option.”
This story was updated at 3:10 p.m.