Will anger against health insurers spur action? Pessimistic Democrats

Democrats are pessimistic that Congress will enact new rules around the health insurance industry, even as they try to appear sensitive to growing calls for reform after the killing of UnitedHealthcare CEO Brian Thompson.

Luigi Mangione faces murder charges in the Dec. 4 killing of Thompson. His death unleashed a torrent of anger on social media against America’s health care system and insurance companies specifically.

It also opened an uncomfortable national discourse about whether the health care executive deserves sympathy, given the profits his company made while denying a relatively high percentage of claims.

“We cannot remain indifferent at this time when there is so much anger with private insurance companies, where we are hearing story after story of people with cancer, heart disease or diabetes or their claims being denied,” he said. say deputy Ro. Khanna (D-California).

While politicians have roundly condemned the violence, the apparent killing has exposed the deep cynicism with which much of the public, on the right and the left, views the insurance industry.

Sen. Rafael Warnock (D-Ga.) said the incident was a “flash point,” but he wasn’t sure how much impact it would have in spurring any change.

“I think if we listen to the people in our states, we will focus on that,” Warnock said, but “I don’t know” whether the incident will spark talks about reform.

Criticism of the insurance industry dates back to before the Affordable Care Act introduced major changes.

As a result of the 2010 law, young people can stay on their parents’ insurance until the age of 26. Health insurers are now required to cover a defined list of essential health benefits, such as hospitalizations, maternal and newborn care, and prescription drugs. They also can’t charge people more or deny coverage if they have pre-existing conditions.

But while the law dramatically expanded health care coverage, it wasn’t a remake of the entire health care system. It didn’t fully address the underlying reasons why care is so expensive, which include prescription drug prices and provider reimbursements, said Cynthia Cox, vice president of health policy research at the nonprofit KFF .

Health care spending has continued to rise, and individual consumers are often stuck with large out-of-pocket costs on top of what they can pay monthly for their insurance premiums.

“The entire American health care system is to blame, certainly not just the insurance companies,” Cox said. “When you look at health care spending, it’s because we spend a lot more on inpatient and outpatient care than we do on drugs, general expenses, or insurance.”

However, a consensus on what to do about it remains difficult in Congress.

“You can get bipartisan consensus if you’re willing to do the work,” said Sen. Tim Kaine (D-Va.), pointing to efforts to reform the pharmacy benefit manager (PBM) industry. “We got a very nice bipartisan consensus in the HELP Committee on PBM reform … and then nobody ever did the work to get them in line on the floor.”

Progressives say the answer is single payer, effectively consolidating the insurance market into a government agency. Some centrists want more government regulation, while some rightly question whether health coverage is necessary.

“I’m open to seeing if there’s a Republican who supports at least bipartisan legislation to not deny your claims if a doctor prescribes something that Medicare covers,” said Khanna, a progressive supporter of Medicare for All.

While insurance companies may only be part of the cost equation, public resentment against them has never been higher. And it’s not just the prices that people are angry about.

“We’re at a point where the discontent has been exposed and is being exposed for all to see,” said Sachin H. Jain, CEO of SCAN Group, a not-for-profit Medicare Advantage insurer . “I think there’s a degree of awareness of what many of us have observed for a long time about American health care, which is that we’ve normalized a lot of practices that are frankly abnormal.”

Critics point to policies like prior authorization, where insurers require doctors and patients to get permission before undergoing a procedure, or step therapy, which requires patients to try a lower-cost drug or treatment before “upgrade” to a more expensive one.

Health plans argue that they are saving consumers money and reducing unnecessary procedures. But critics point out that insurance companies are only denying the cure to increase their own profits.

A Gallup poll released last week showed that Americans’ positive view of the quality of health care in the US “is now at its lowest point” since 2001.

Police are still looking for a motive for Thompson’s alleged shooter, although a short, handwritten document found on Mangione at the time of his arrest made it clear he was furious with the health care industry.

While the lawmakers denounced violence as a solution to any problem, they said the public anger and desire for change is understandable.

“I have been saying for some time that violence, murder, are always unacceptable, always. But I think there’s a context, you know, here that’s very important,” said Sen. Ron Wyden (D-Ore.), chairman of the Senate Finance Committee.

“People who have coverage, who have a good package from employers feel like they’re kind of a serious illness to find themselves in very difficult circumstances,” Wyden added.

Rep. Alexandria Ocasio-Cortez (DN.Y.)he saidCBS News that Americans view a denied insurance claim as an “act of violence.”

“That’s not to say that an act of violence is justified, but I think anyone who is confused or shocked or appalled should understand that people interpret and feel and experience denied claims as an act of violence against them.” Ocasio said. said Cortes.

However, Mangione did not have an insurance policy through UnitedHealthcare, the company said, and it is unclear if he was ever denied an insurance claim.

Source link