Wendell Potter discusses his views on the current federal government shutdown triggered due to Congress’ failure to renew ACA subsidies that will cause millions of policyholders’ premiums to skyrocket. He also talks about the many failures of the U.S. healthcare system and the reforms he advocates to reduce costs and achieve universal coverage. Potter is speaking in Hartford, Connecticut on Oct. 15.
Potter is a former vice president for corporate communications at Cigna and author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans.
SCOTT HARRIS: Yeah. Well, Wendell, I know you’re coming to Connecticut. There’s an event this Wednesday, Oct. 15, Connecticut Citizen Action Group is sponsoring a screening of the movie “Midas”, followed by a panel discussion with you and the Midas filmmaker. But this evening I wanted to make sure that we talk about the federal government shutdown and the nation’s long-running healthcare crisis. But I thought it would be important for some of our listeners who may not be familiar with your incredible story. Briefly tell us about your journey from being a health insurance executive to a healthcare justice warrior and reformer.
It’s all people not getting the care that they need because of burdensome prior authorization requirements, which has only gotten worse since I left the industry. I’ve been moved into plans with high out-of-pocket obligations, high deductibles and I knew I came to realize that most Americans just don’t have enough money in the bank to cover the out-of-pocket requirements that their insurance companies require. And all the time, these companies continue to raise premiums every single year. It’s a big burden not only to families but to our employers. And so I left, that’s after what I’ve often described as a crisis of conscience. I just couldn’t continue to be a spokesperson for the industry and to be in the business of misleading so many people.
SCOTT HARRIS: Well, I’m thankful that you’ve crossed over to the other side and can speak firsthand about what you witnessed inside the insurance industry that we all have to suffer through. I wanted to ask you about the federal government shutdown that’s now in its 13th day, triggered certainly in a major way by the Democrats’ fight to restore federal subsidies to the Affordable Care Act to prevent the doubling—in some cases more than doubling of monthly premiums—for millions of Americans that will likely throw millions off health insurance, insurance policy holders to lose their health insurance coverage. I wondered if you would talk about your view of the current government shutdown, its causes and possible future solutions.
WENDELL POTTER: You know, as awful as a shutdown is, there’s so many people—certainly that includes federal workers—but a lot of people who depend on federal government to be operating as it should. That aside, this focuses a lot of attention on healthcare and health insurance once again in ways that we haven’t seen in a long time. And as you noted, the thing that is keeping the two parties apart is over subsidies to make health insurance affordable for millions of Americans.
It is important to note that increasingly, as I noted earlier, premiums have been going up every single year. Right now, a family policy costs on average—if you get it through an employer—more than $25,000 a year, and it’s the policies in the ACA marketplaces, which is what we’re talking about here. The Obamacare plans have similar price tags and people just simply cannot afford health insurance in that marketplace unless there is federal support.
And during the pandemic, there were some additional subsidies that were put in place that make it possible for more people to get some help, financial help covering their premiums. They’re set to expire at the end of this year and the Democrats are saying that they will not support this bill to reopen the government, the spending bill, unless there is a deal to extend those subsidies. Republicans have kind of dug in saying, “No, we’re not gonna, that’s not on the table. We’re not going to talk about that now.” So it leaves millions of people in a quandary. It even leaves insurance companies wondering what to do because they have to determine how much they’re going to charge next year and people will start having to enroll or make decisions on Nov. 1st. So time is running out here and pretty soon, people are going to be getting notices from their insurance companies if they get coverage in the ACA marketplaces, as you noted—big, big, big increases in their premiums.
SCOTT HARRIS: Wendell, I did want to ask you about Trump and the Republican party’s big, cruel and obscene federal budget bill, not the “Big Beautiful Bill” as they call it. That bill was passed by Congress on July 4th and it cut over $1 trillion in federal healthcare spending which the Congressional Budget Office, the nonpartisan congressional budget office says will cause 10 to 17 million Americans to lose their healthcare insurance. In your view, what’s the long-term impact of these very deep cuts, I think by historical standards are the largest cuts to healthcare in U.S. history? And the impact of course on our already failing U.S. healthcare system that leaves out so many millions of Americans.
WENDELL POTTER: Yeah. And we’ve seen the headlines or most of us have seen the news reports that many millions of Americans who currently get Medicaid benefits will lose those benefits because of these cuts in future years. What goes largely unreported is the fact that this will affect all of us and in ways that we probably don’t realize. People who don’t have insurance still need to get healthcare and in many cases they wait until it’s too late or they have an accident and wind up in the emergency room. That’s very costly. Hospitals have to admit people. They have to at least stabilize them and so these people will still get care. It may not be optimal care, but hospitals in particular will wind up with a lot of so-called uncompensated care with people who are not able to pay their bills. They already are seeing big spikes in uncompensated care because of what I mentioned before. People are in health plans with high deductibles and they just simply don’t have the money to pay out of pocket before their coverage will kick in.
So they delay care and often delay and delay and delay until they have a very serious illness or need to go to the hospital. And they still aren’t able to pay their medical bills. So this will get even worse as more and more people are back into the ranks of the underinsured, obviously uninsured, and I suspect we’ll see ER emergency rooms even more crowded than they are now and we will see that a lot of small hospitals, particularly in rural areas, will be closing. They’ve already closed in many states. Many rural hospitals have closed because—it’s a patient mix—they see and treat a lot of people on Medicaid and Medicare and they’re not getting the compensation they need already. So this will be an additional hit for them, so we can expect to see a lot of hospital closures in the coming years.
SCOTT HARRIS: Thank you for that, Wendell. We’re going to introduce you again here. This is Wendell Potter speaking here on Counterpoint, a former vice president for corporate communications at the Cigna Health Insurance company. He’s currently president of the Center for Health and Democracy and he writes the newsletter Healthcare Uncovered. He’s the author of the book, Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate Public Relations is Killing Healthcare and Deceiving Americans.
Wendell, I did want to ask you about long-term solutions. Everywhere around the world in industrialized, developed nations, they have a single-payer healthcare system or something along those lines that covers most of their citizens, not forcing them into bankruptcy if they get sick. Bernie Sanders and other legislators have proposed a Medicare for All system in this country for many years now. But the health insurance industry has used its influence and campaign contributions to stop most major reforms, including Medicare for All. What’s in your view as being a former health insurance company insider, what’s your view what it’s going to take to move the needle and get the United States in a place where most of the rest of the world is in terms of universal healthcare for its citizens?
WENDELL POTTER: I think we are about to witness a collapse, if you will, of our healthcare system in ways we haven’t seen before because of some of the things we’ve talked about. As people who get their insurance through the ACA marketplace, as they see their premium spike more than double, they’re going to join the ranks of the uninsured. As people lose their Medicaid coverage, we’re going to see another big spike in the uninsured. What I am seeing right now is something that I haven’t seen in the past and I’ve been a part of or involved in healthcare and healthcare advocacy for a long time on one side of the fence or the other. And I’m seeing that the insurance industry, yes, it’s enormously powerful, spends huge sums of money in Washington and state capitals to protect the status quo. But they’re losing some of their important allies.
Increasingly, hospitals and physician groups are saying that these guys are not living up to what they say they can deliver. We’ve got decades of empirical evidence now that these companies do not control healthcare cost. Otherwise, we wouldn’t see premiums increase at such a rapid pace along with continued increases in out-of-pocket requirements.
And all the burdens they’re placing on people and on doctors and hospital administrators. The prior authorization requirements are a huge, huge expense and time suck for hospitals and physicians, as well as patients. So I think we’re going to see that the health insurance industry is going to be standing pretty much alone as we go forward because it has alienated so many people in this country, is probably the most vilified and despised industry that we’ve ever had in this country. They will spend, like I said, enormous sums of money to continue the status quo for as long as they can, but I think that we will start seeing unusual strange bedfellows come together, if you will, and say, this is just not working.
These guys that we have allowed to largely run the healthcare system are running it into the ground. They’re sucking so much money out of the pharmacy supply chain as well as from the taxpayers through all the money they get to operate the Medicare Advantage plans and from us, from our employers, from us as individual citizens. I think we’re pretty soon going to see more and more people say, enough is enough. Now it will be incumbent upon advocates and all of these strange bedfellows to come to some agreement on what to do next. Whether we will get to a Medicare for All system in the next few years remains to be seen, but I think that we will see that more and more people will decide that this is so broken. We’ve got to do something significantly different and let’s look to see what other countries have done that spend half as much as we do, make sure everybody is covered, and the quality of care is in many cases better and people are living longer. So I think the time is getting closer in which we’re going to have another big debate and I think the insurance industry is going to be standing largely alone.
SCOTT HARRIS: That’s the optimism I want to hear. Thank you. I mean, it’s not optimistic that things are collapsing, but I guess you need that kind of dramatic shift to move people to a new place and that’s hopefully what will happen. Wendell, thank you so much for spending time with us and yeah, we just want to mention the event you’ll be speaking at this Wednesday (Oct. 15), I believe that’s the legislative office building at the Capitol in Connecticut there in Hartford, Connecticut Citizen Action Group is sponsoring a screening of the movie Midas, and there is a panel discussion that you’ll be talking about. What are the things that you’ll be bringing to that panel?
SCOTT HARRIS: Great. Wendell, it’s been a pleasure speaking with you with that last bit of optimism, buoyed me for the next week, despite all the hell that’s breaking out everywhere else. But thank you so much for spending time with us.
SCOTT HARRIS: Me too. Thanks, Wendell. Bye-bye. Thank you. That’s Wendell Potter and he’s president of the Center for Health and Democracy.
