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Social movements are messy, so it is often difficult to know, in the midst of the battle, which side is winning.

But in the past month, momentum on healthcare reform has unmistakably shifted as liberals and progressives have taken to the streets, the Internet, the airwaves and the halls of Congress to push for a bold public option, strong regulations on insurance abuses and a progressive tax plan to finance reform.The Obama administration and its allies in Congress now understand that permitting the unholy alliance of insurance industry muscle, conservative Democratic obfuscation and right-wing mob tactics to defeat the president's healthcare proposal would write the conservative playbook for blocking other key components of his agenda--including action on climate change, immigration reform and labor laws. So in just the past few weeks, we've seen a change in strategy, a strong grassroots movement and markedly firmer resolve by the White House and liberal Democrats in Congress.

Targeting Insurance Industry Giants

Health Care for America Now (HCAN), a coalition of unions, community organizations, consumer groups, environmentalists and netroots groups such as MoveOn, has been spearheading the reform campaign since the group was launched in July 2008. In Pennsylvania, a combination of HCAN activism and Representative Joe Sestak's primary challenge to the newly Democratic Senator Arlen Specter pushed the incumbent to become a reluctant reformer. (Specter first voiced support for a public option at an HCAN rally in June.) During the summer, as healthcare reform bills moved through Congress, HCAN, MoveOn, the Service Employees International Union (SEIU) and the American Federation of State, County and Municipal Employees (AFSCME) launched television advertising campaigns, costing several million dollars, that asked Senate and House members in key states to support bold legislation that included a public option. The decision to target the insurance industry as the major culprit for the nation's healthcare crisis and as the major lobbying force trying to thwart reform was critical. Most Americans don't like their insurance companies. But the industry had been virtually invisible since Obama took office. For months the Obama administration and Senate Democrats coddled insurance industry giants, hoping to enlist their support for insurance reform. Karen Ignagni, president of America's Health Insurance Plans (AHIP), had orchestrated the industry's apparent cooperation with the Democrats drafting healthcare legislation, particularly with Baucus. Glowing mainstream media profiles of Ignagni admire her skill at coaxing the big insurance companies to try to co-opt, rather than confront, the Democrats, drawing a contrast to the industry's combative stance during the early 1990s.

On October 22 HCAN activists surrounded the hotel hosting AHIP's annual convention at the Capital Hilton in Washington, DC, with signs that read, "It's a crime to deny care." HCAN brought seven families from across the country to tell their stories of denied care and egregious mistreatment by the private health insurance industry. The families sent a letter to Karen Ignagni challenging her to face them in person and hear what they've endured. Reform advocates have not only highlighted the plight of insurance industry victims but also identified former industry employees, like former CIGNA executive Wendell Potter and former Humana physician Linda Peeno, to blow the whistle on the industry's abuse of its customers. Documentary filmmaker Robert Greenwald's Brave New Films has created a series of short videos documenting the outrageous compensation and lavish lifestyles of industry CEOs (UnitedHealth's Hemsley made $57,000 per day last year) while millions of Americans go without insurance or bankrupt themselves with medical bills.

America's Healthcare Crisis

The focus on the insurance industry has brought into relief the tragic realities of America's healthcare crisis. In the past decade, the number of Americans without any health insurance and the number who face bankruptcy due to insurance bills have both increased significantly. And over the past decade, premiums have gone up 138 percent, 3.5 times the growth in family incomes. In addition, insurance deductibles, co-pays and co-insurance have been skyrocketing, to thousands of dollars a year for families, especially for those with the cheaper insurance plans. Despite rising premiums, insurance companies continue to refuse to pay claims or delay payments, both of which result in increased revenues for them. Last year, even in the midst of a recession, UnitedHealth raked in $2.9 billion in profits; WellPoint, $2.5 billion; Aetna, $1.4 billion; Humana, $647 million; and Cigna, $292 million. In September a number of OFA staffers and key volunteer leaders threatened to quit if OFA didn't use its potential influence by encouraging members to challenge Democrats who refused to support Obama's healthcare plan. In response, OFA directed its members to participate in the protest rallies across the country, and it began targeting conservative and moderate Democrats. On October 20, local OFA groups generated 315,023 calls to Congress pushing healthcare overhaul, tripling the original goal of 100,000.

The Insurance Lobby Miscalculates

In response to escalating criticism, the insurance industry miscalculated. After pretending to cooperate with the Obama administration and Democrats, the industry's CEOs and lobbyists double-crossed their onetime political allies by publicly attacking a compromise bill crafted by Baucus. So AHIP threw a temper tantrum, releasing a report warning that average family premiums will increase to $21,300 if the Finance Committee bill is adopted. But the AHIP report neglects to take into account the Finance Committee bill's premium subsidies for families with incomes below $88,000. The White House and the Democratic leadership in Congress were taken by surprise. Said Scott Mulhauser, a spokesman for Baucus and the other Democrats on the Finance Committee: "This report is untrue, disingenuous and bought and paid for by the same health insurance companies that have been gouging consumers for too long. Now that healthcare reform grows ever closer, these health insurers are breaking out the same tired playbook of deception. It's a health insurance company hatchet job." Soon the chorus in favor of the public option was getting louder. At a press conference this past Monday, Senator Harry Reid, the Senate majority leader, said, "We're leaning towards talking about a public option," stronger language than he's used in the past. On October 20 Pelosi said that she intends to push a more liberal version of a public option plan that would link reimbursement rates to Medicare. She explained that she has more than 200 votes for the plan and wants to see "if we can find the remaining votes," according to Politico.

On October 21 the House Judiciary Committee voted to strip the health insurance industry of its sixty-four-year-old anti-trust exemption, enabling the government to force more competition into the industry. Senators Reid, Patrick Leahy and Charles Schumer announced they would file similar legislation. Public support for a public option has recovered after taking a tumble over the summer. This week a Washington Post/ABC poll found that 57 percent favor a public insurance option, while 40 percent oppose it. If a public plan were run by the states and available only to those who lack affordable private options, support for it jumps to 76 percent. Under those circumstances, even a majority of Republicans, 56 percent, favor it.

Conclusion

There is still no guarantee that a progressive bill will make it out of conference committee and end up on Obama's desk. There is still wiggle room on all three major fronts of the escalating battle for health reform: the public option, pre-existing condition reform and financing. As part of its health reform bill, the House has recommended a tax surcharge on the richest 1.3 percent of Americans--families with incomes of more than $350,000. This approach is much more progressive and efficient than the Finance Committee's plan to tax so-called Cadillac insurance policies. And there is still the question of who will be eligible for the government subsidies to help them buy insurance. The insurance industry and its allies are still trying to weaken any legislation that threatens its profits and power. But it is on the defensive, and the Democrats seem to have rediscovered their backbone. Genuine healthcare reform which seemed probable in January and impossible in August now seems possible.

Source: The Nation

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