CALPIRG Blog

The health insurers' trade group has finally said they're willing to accept a health care reform that stops them from discriminating against the sick.

Right now, if you're sick, or likely to get sick, and trying to get health insurance, HMOs have carte blanche to refuse to cover you, or jack up the price they quote to stratospheric levels (if you get coverage through your job, things are a little better -- they only jack up prices when the whole office, on average, gets a little sicker).

But the insurers know that that power is going to be one of the first things to go when health care reform legislation is written in Congress.  After all, sick people need care to get healthy -- and people at high risk of getting sick need care to keep them well.  The insurers' discrimination raises costs for everyone, too, since if sick people can't get coverage for preventive care, they'll be forced to get treated in the emergency room, turning what could have been a minor, cheap treatment into a full-bore crisis. 

They're not giving up this lucrative-for-them but disastrous-for-us business model because they've finally seen the light, of course. 

It's because they see the forces aligning in favor of reform, and know that they risk getting trampled if they try to stand in the way.  And so, per Winston Churchill, they're doing the right thing after exhausting all other options. 

That's good news.  When the opposition is making compromises before legislation even gets drafted, you know that they're feeling vulnerable. 

This isn't the first time insurers have made this calculation.  When Governor Schwarzenegger's comprehensive health care reform proposal came up in the California legislature last year, some insurers ultimately wound up supporting the plan, even though it did end their ability to discriminate against the sick. 

There are many lessons for the national reform effort in what we did in California -- even though it was ultimately unsuccessful, the policy ideas and political currents of that fight have a lot of parallels to what's unfolding now on Capitol Hill.  Our D.C.-based advocates, among others, are working there to make sure that the lessons of California don't get ignored.