Interview With AHIP's Karen Ignagni: We Won't Take Bait

I spoke this morning to Karen Ignagni, the president of the America' Health Insurance Plans, the industry's lobby, about the new Democratic Party strategy to cast insurers as the enemies of reform. What follows is an edited version of the interview.

So, you're the enemy now. You've been working with the White House for months. What do you do now?

We're going to continue to work with the White House and continue to work with members of Congress. ... It's what the voters told us when we launched a listening tour all around the country. They told us they wanted these problems addressed. We made a commitment, and so we submitted our proposals. They're the essential building block of the reform bills....The strategy is being adopted in the Congress and elsewhere is the same old politics. Find a target, go to work. The problems are much too great for that old style strategy to be followed. At the same time, we're going comment on where we think the rhetoric is going.

Your proposals are now part of the House and Senate bills.

Guaranteed issue, no pre-existing conditions, no healthy status ratings, no gender ratings, everybody gets coverage, everybody is part of the system. That's the reason why we have the market that we have today. Until Massachusetts did what it did, we had no state where everyone was part of the system. Health insurance grew up the way life insurance and disability insurance and auto insurance did. We did the hard work.

Your concessions include an end to the practice of rescissions.

I think that's what changed now that the American people are expecting more from industry and that's the lesson of what we see in this economy. This is an industry that listened.

... Our industry supports third party review now, but on rescissions ... we're not about advocating for the continuation of that. Entirely the opposite of that. By getting everybody in, that would not happen.

If you hadn't made all these accommodations, wouldn't health care reform have hurt the industry a lot more than it will?

I look it it another way ... We helped substantially to send a very strong message. Not only was reform possible and reform warranted, it would have been a different bill without our help.

Speaker Pelosi accuses the industry of leading the oppositon to consideration of a public plan option in the health exchange.

... If you call any of the major hospitals ... you'll see that they say that they can't [survive] on Medicare rates and Medicare plus five [referring to the reimbursement rates under the Energy and Commerce Committee compromise]. Talk to physician groups except for the AMA and you'll hear the same message. Health plans have been very straightforward from the beginning, weighing in on this. Employers have been worried about the public program actually taking down the system that has been built...

Have you been in touch with the White House since they turned you into the enemy?

We understand that this has been a political strategy, and we think that it's been an unfortunate decision because the American people need to understand that if we are going to pass legislation in the fall, there is strong consensus around insurance industry reform ... As a result of the decision to find the target and go to war, this whole consensus is being obscured.

So you're not going to run ads against health reform ... not going to take the bait?

No, we're going to follow [this] strategy all the way through. It's a breath of fresh air for American people to see industry leading the way.