Yesterday I asked “Why are Americans against Obamacare?”, and today I learned another reason. Health insurance companies, which said they were for the Affordable Care Act, were actually (and secretly) giving money to groups that were fighting against it.

Rick Unger at Forbes.com writes :

At the very same time the American Health Insurance Plans (AHIP)—the health insurance industry super lobby—was cutting a deal with the White House leading to its stated support of the proposed Obamacare legislation, they were secretly funneling huge amounts money to the Chamber of Commerce to be spent on advertising designed to convince the public that the legislation should be defeated.

Why would health insurance companies conspire against a law that would bring them 30 million new customers?

The reason is the “MLR” (medical loss ratio) which requires health insurance companies to spend 85% of premiums on claims. The MLR for small group and individual health plans is 80%.  You see, insurance companies don’t want limits put on their profits (or the million dollar salaries they pay their top management).

The MLR rule is in effect already, and health insurance companies are sending rebates to their customers. For 2011, these rebates totaled around $1.1 billion.

Medicare Advantage MLR

Medicare Advantage companies must meet an 85% MLR starting in 2014.  Last year, at a training held by a Medicare Advantage company in Tucson, the company rep boasted that their MLR was 70%. Wow!

The rep was boasting about how his company manages the care of its members – and many of them have chronic illnesses. The company model is successful because their proactive care keeps people stable and out of the hospital. This is a very good thing for their members and for the company profit margin. But is it good for Medicare?

All of this company’s revenue comes from Medicare. The company has a great model. The company makes big profits. But Medicare actually pays them more money for their chronically ill members than for healthy patients – and Medicare is saving no money from this business deal. Starting in 2014, when the 85% MLR requirement kicks in, maybe Medicare will save some money on this deal.

The original premise for Medicare Advantage was that turning Medicare beneficiaries over to insurance companies would save Medicare money. Turns out it was really about making profits (unlimited) for the insurance companies. The Affordable Care Act is one step towards saving money for Medicare . Given the dire forecasts for Medicare’s financial future, who could argue against this? And will the billions of dollars in savings be lost if the Supreme Court throws out all of the Affordable Care Act?

I have complained for two years that Democrats and the Obama Administration barely bothered to promote the Affordable Care Act once it was passed.  I suppose that was because in 2010, with the Tea Party rising, they thought it was probably best to not talk about it -  even while many parts of the law were being put in place.

Opinion surveys show that most Americans actually like many parts of Obamacare – when they are informed about them. But most people are against the mandate. The trouble is that very few Americans know about the parts of Obamacare they would probably like.

Media Matters for America has an article that shows why people are so misinformed on the Affordable Care Act. Here are some snippets from the article and a link to the entire piece, which can be read in full here:

The individual mandate was invented by the conservative Heritage Foundation and supported by Republicans. The idea of a mandate was introduced in a 1989 Heritage Foundation brief titled “Assuring Affordable Health Care for All Americans,” as a counterpoint to the single-payer system and the employer mandate, which were favored by Democrats.

Law professors are unable to find even a hint of the constitutional objection before Obama’s election. Andrew Koppelman, a law professor at Northwestern University wrote in Salon:  “The constitutional limits that the bill supposedly disregarded could not have been anticipated because they did not exist while the bill was being written. They were invented only in the fall of 2009, quite late in the legislative process.”

More courts have upheld the law than overturned it, but 84% of broadcast and cable segments reported on rulings striking down the law. In contrast, 10 percent of segments (just 3) reported on rulings that upheld the law.

With very little messaging from those who support Obamacare, the negative news has molded Americans’ opinions on the law – even me.  According to the New York Times, $235 million has been spent on ads attacking the law since its passage in March 2010.  Only $69 million has been spent on advertising supporting it.

I hear how The Affordable Care Act is a “job killing bill” and “it’s a government takeover of health care”, and it makes me question my support.  I don’t really know what “job killing bill” means, since I think it will help create jobs and allow more people to retire early because they can get health insurance on their own. I know it is not a “government takeover” because it leaves insurance companies in charge of paying people’s medical bills  – and collecting billions of dollars in premiums – and making very good profits.

The battle over messaging around Obamacare wasn’t lost – it was never even fought. I guess those in favor of the Affordable Care Act thought the Supreme Court would put aside politics, and rule based on the precedents established around similar issues in the case. Too bad that’s probably not going to happen. We’ll see on Thursday.

The Supreme Court will meet again on Thursday, so that is when they will announce their decision on the constitutionality of the Affordable Care Act.

If you want to be the first to know how the Supreme Court rules on this case, you can go to scotusblog.com and get live minute-by-minute breaking news provided by reporters who are in the building.  The Supreme Court session begins at 10 am eastern, 7 am in Arizona.

I was on the SCOTUS blog site this morning and they are several minutes ahead of tv news.