Health insurance lobbyists are gearing up for post-election trips to Capitol Hill and they are armed with....charts.
Lots and lots of charts.
No matter who wins the election, rising heath care costs will near certainly continue to be a financial burden. That's true for individual consumers, who keep spending more on premiums, and the federal government.
In those discussions, health insurers rarely come across in a positive light. One survey back in the late 1990s had people say whether various industries do "good jobs." Health insurers came in third-last, with 48 percent of Americans thinking they did a good job. Even oil companies came across as better, although insurers did beat out tobacco manufacturers.
During the health reform debate, insurers often found their premium increases playing foil to the president's call to pass the Affordable Care Act.
Moving into a potential debate over deficit reduction, health insurers want to carve out a different role in Washington. Namely, they don't want to be the bad guys anymore. To that end, they'll soon start arming their lobbyists with data that argues that other health care sectors are actually the ones to blame.
"For a number of years, when people talk about health care costs the debate has focused exclusively on premiums," said Association of Health Insurance Plans president Karen Ignagni. "If you're going to have a debate and discussion about what's driving health care costs, you have to get under the hood."
Ignagni expects that in any discussion of deficit reduction, "one of the first things we'll do is turn our heads towards rising health care costs." It's possible that Medicare Advantage plans, for example, might end up on the table for reduced reimbursement rates. States could take a second look at how much they pay the health insurers who administer their Medicaid programs.
Ignagni is readying for these types of fights. Her organization plans to use federal data to argue, in state houses and in Washington, that they're not the ones to blame for the growth in health care costs.
AHIP has put together an iPad app called "US Health Care Spending 101," which its state and federal lobbyists will soon bring into legislators' offices. It has charts, all drawn from federal data, that show that health care costs are indeed growing very quickly. It includes this one that shows health care spending as a percent of the economy:
Then there are the charts that look at the role insurers play in rising health care costs. From AHIP's vantage point, its a pretty small one. You can see this in this chart they've pulled together. It compares the percent increase in the cost of benefits (what it costs to pay the various doctors and hospitals who see patients) to the percent increase in cost of premiums.
"When our lobbyists go up to the Hill, this is going to be at their finger tips in an easy to use format," said Robert Zirkelbach, AHIP vice president for strategic communications.
They also will have charts that show how much other sectors account for health care costs. That's what this chart is all about: It charts the cost of insurance administration (the orange section) against all the other actors in the system. This includes hospitals, physicians and spending on prescription drugs.
Much of the health care law focused on stronger regulation of the insurance industry. Insurers must now have any double-digit rate increase reviewed by regulators. They must also spend at least 80 percent of consumer premiums on medical expenses, limiting salaries and administration to 20 percent.
Ignagni makes the case that going forward, it's other sectors that ought to be the target of similar efforts. She points to hospitals, which often charge hugely different rates for the same procedure, as one area she'd like to see legislators explore.
"As we look at the challenge of rising hospital costs, for example, I think there are questions of how do we have more transparency about what they're charging," she said.
The goal, she said, is to dig further into what actually drives up costs. That's a debate, Ignagni thinks, that the insurers are well-positioned to have, and win - with their many charts in hand, of course.