Early in July, the shouts of Republicans determined to repeal the Affordable Care Act, popularly known as Obamacare, were deafening—even after the Supreme Court stopped short of ruling the law unconstitutional.
But will they repeal it?
It's one thing to pledge allegiance to the idea of repeal when talking that way can bring political gains. In reality, features of the law that have already come into effect have brought benefits to millions—the rule that insurance companies cannot exclude children with preexisting conditions is one example; the rights of parents to keep their children on their policies until age 26 rather than 24 is another.
And under a program set up by the law, adults with preexisting conditions and no coverage can now buy insurance on a sliding scale.
Opponents of the law attack those benefits at their political peril.
But there's another reason the law is unlikely to be repealed, according to former Cigna executive Wendell Potter.
The reason is simply that, whatever rightwingers and some moneyed interests say publicly, a law requiring everyone to buy coverage is good for the insurance business.
Potter, who blew the whistle on his former industry in his book Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans, wrote on Huffington Post July 16:
"GOP leaders have no intention of repealing the Affordable Care Act because their friends in the health insurance industry are counting on major provisions of the law going forward, especially the expansion of Medicaid. Don't be fooled by Republican governors like Florida's Rick Scott and Texas' Rick Perry, who are saying they'll opt out of the Medicaid expansion now that the Supreme Court says that's allowable. When the Feds start doling out billions in 2014 to bring an additional 16 million Americans into the Medicaid program, they'll be on board. Trust me.
"Want proof that Big Insurance has figured out how to make a lot of money off reform? Last Monday WellPoint announced it will pay nearly $5 billion to buy the country's largest private Medicaid managed care company, AmeriGroup. Rest assured that lobbyists for WellPoint and other firms wanting to get their hands on that new Medicaid money will have a 'Here's how it has to be' talk with their buddies on Capitol Hill."
Potter continues to cite evidence from within the industry:
"If you look at recent quarterly earnings reports from the big five for-profit insurance companies (UnitedHealth, WellPoint, Aetna, Cigna and Humana), you'll see that the biggest growth in their membership has come not from the private sector but from public programs like Medicare and Medicaid."
Potter isn't alone in his opinion. On June 29, just a day after the Supreme Court upheld the law, a headline in Forbes magazine proclaimed, "Obamacare Is Constitutional. Get Over It."
"The Affordable Care Act is officially constitutional," the article declared. "It is time for the naysayers to move on. ...
"The health insurance companies absolutely love this law. They just got a guaranteed customer base of at least 50 million."
And even before the Supreme Court issued its ruling, there were reports that some in the insurance industry, rather than hoping for a negative decision, actually feared it.
In March, for example, the New York Times quoted Michael A. Turpin, an executive with USI Insurance Services, a national insurance brokerage, as saying that insurers were far less apprehensive about complying with the law than about the "risk of repeal and starting from zero."