ALEC’s Attempts to Thwart Obamacare

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As part of our ongoing focus on the American Legislative Exchange Council, or ALEC, we checked in with health insurance executive turned industry whistleblower Wendell Potter to learn about ALEC’s efforts to influence the health care debate and undermine The Affordable Care Act (a.k.a. Obamacare).

Lauren Feeney: ALEC turned 40 last week. How long has the organization been involved in trying to influence the health care debate?

Wendell Potter. Credit: Robin Holland

 Wendell Potter: I don’t know whether insurance companies were part of the initial founding of the organization, but I’m sure they were involved early on. Health insurance is regulated largely at the state level, and ALEC’s strategy is to work at the state level, bringing together state legislators and industry representatives to create “model bills” for state-level legislation. Insurance companies want to try to have consistency from state to state, so they have a vested interest in trying to make sure that laws that are to their benefit in one state are passed in others as well.

Feeney: How did you first encounter ALEC?

Potter: I’ve known of the organization for as long as I was in the insurance industry, and that goes back more than 20 years. The organization works very secretively, but a few years ago I became aware that people I used to work with were playing a role in drafting some of these model bills. Someone was able to disclose what ALEC has been doing, and I was able to review a lot of the model bills. It was pretty amazing, the scope and breadth of the legislation that the organization has been working on over the years to try to preserve the status quo for health care special interests.

Feeney: ALEC has been actively involved in behind-the-scenes efforts to undermine the Affordable Care Act (also known as the ACA or “Obamacare”). The organization produced a document called The State Legislators Guide to Repealing Obamacare. Can you tell us about it?

Potter: It’s a step-by-step guide that ALEC put together to tell friendly lawmakers what they can do to try to derail the ACA. Efforts to repeal it have failed, so this is an effort to try to thwart the implementation, and it’s certainly something that lawmakers in various states have used or been inspired by.

Feeney: Have they been successful? Can you give us some examples?

Potter: One of the most far-reaching successes has been lawmakers in many states blocking the expansion of the Medicaid program, which was one of the most important aspects of the ACA, one of the chief ways covering more people. The Supreme Court ruling on the ACA allowed states to opt out of Medicaid expansion. ALEC led lawmakers to believe Medicaid expansion under the ACA would create a financial burden on the states, which is of course not true. In the initial years, the federal government will pay 100 percent of the cost of the expansion, so refusing the expansion means leaving federal dollars on the table. By insuring more people, the expansion also removes the cost of treating uninsured patients, which taxpayers currently end up paying for. Nonetheless, ALEC is largely an ideological organization and they were able to persuade a lot of lawmakers. Many states that are controlled by either a Republican governor or Republican lawmakers (or both) have said that they do not plan to expand the Medicaid program, costing untold millions of Americans benefits that they otherwise would have.

Feeney: Some of the most extreme attempts to thwart the ACA have been in Missouri.

Potter: Yes, one of the most egregious is that the state passed legislation that prohibits any state worker from doing anything to help implement the Affordable Care Act in any way. The state also passed a bill that restricts consumer groups from helping people to understand the law and to make decisions on the best insurance options for them. This pertains to the Navigator Program, part of the ACA that provides funding for identifying and training people to help advise others on their options. Missouri established very stringent licensing requirements which make it almost impossible for anyone other than an insurance agent or broker to serve as a navigator, which is of course contrary to the intent of the law. But it protects the profits and the incomes of agents and brokers, which is what is really behind it.

Feeney: A number of states have enacted (and the vast majority of states have at least introduced) ALEC-model legislation called the Freedom of Choice in Health Care Act. What’s that, and what does it mean for states where the law has been enacted?

Potter: Boy, that’s a very Orwellian title; it’s about anything but health care freedom. But they’re very savvy; they spend considerable time coming up with titles for these model laws that are anything but what the title says. Essentially what it aims to do is thwart the implementation of Obamacare and preserve the so-called free market system of health care — in other words, let the insurance companies do exactly what they have been doing, underwriting health risks in ways that make health insurance far too expensive for people who’ve been sick in the past and for people as they get older, and in many cases enabling insurance companies to refuse to sell coverage to people at any price because of preexisting conditions.

But of course, even in states that pass this law, it’s superseded by federal law.

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  • JonThomas

    I’m curious, there was a comment here, I attempted to reply to it, but it was removed.

    If I may ask, why exactly was it removed? I don’t mind if it was for good reason, but I didn’t see anything expressly against the comment policy. Although, it’s very true that I’m not aware of everything involved. I do hope though, that it wasn’t taken down just because it was ‘controversial.’

    Here is the response to it that I wrote…

    “I hope it’s about control! Corporate irresponsibility is completely out of control, and no where is it more evident than in the healthcare industry. Control is exactly what is needed!

    I personally dislike many provisions of the ACA, and wish we went straight to some form of single payer-Government run healthcare.

    I won’t even go into the incredulous statements linking Obama to Socialists or Communists. Sorry, but that’s laughable!”

  • JonThomas

    Ok, I just re-read the comment policy…there were some statements, that at the very least, could indeed be considered ‘intentionally false or misleading.’

    Sorry, I guess I was just disappointed that I couldn’t reply. lol.

  • moderator

    Sorry about that! But I think your response is still valid on its own.

    Sean @ Moyers

  • Ron

    Except for corporate greed and having to face stockholders, it seems like the Insurance Industry will still rule the roost. Mandated healthcare for every man woman and child? How are the millions living on small or fixed incomes afford to add such an expense and still keep a roof over their head and food on the table? Furthermore, if you do not purchase some type of insurance through the ACA, you will be subject to fines. Surly this can’t be the “American Way.” I honestly can’t understand mandating anything upon the backs of American Citizens.

  • Susan

    Ron, people who are 133% of the poverty level will be subsidized.

  • Julius Norris

    We already have mandated auto insurance, and probably a few other mandatory things I can’t think of right now. And from what I’ve seen, the very poor will be subsidized, those who have more will be subsidized a little and those who have a lot will pay for their own, but it will be much more affordable than in the past, dealing just with a health Ins Co. I’m rooting for it, and can really use it right now, after 48 yrs of hard work. I think we should all stop listening to the naysayers, and give it our support and a chance. If it fails, then we can blame Obama for a bad idea. But then it’ll be based on fact not fears!

  • Elena Ferrante

    It seems to be that the focus is on the wrong area. The reason people can’t afford health care, is that so many of our jobs have been outsourced overseas. Why doesn’t our leadership focus on canceling the trade agreements that have left many of our towns and cities, burned out shells??? The answer isn’t to have the federal government subsidize health care, because, sooner than later, there will be no one to fund the “federal government”. Printing more dollars is another “solution” they have implemented, which has only served to devalue our currency. It seems preposterous that people who are paid to figure these things out, haven’t.

  • DesertSun59

    It seems preposterous that you’ve bought ALEC’s lies, hook, line and sinker. But it’s apparently true.

  • DesertSun59

    You’re not keeping up. Please keep up. When EVERYONE is covered, the COSTS go down. It’s simple economics. It’s called economies of scale. This concept was in my Business 101 class. Please take a class. ANY class.

  • warren

    The ACA aka Obamacare is a starting point for healthcare for a larger number of people who didn’t have access before . We the U.S. taxpayers are already paying (through our higher premiums) for uninsured people whose visits to emergency rooms and doctors cannot and will not pay for those services. This is a starting point and can be tweaked in the future to get rid of the bad points and improve the good points. What are the Republican answers to healthcare? Exactly nothing but “Too bad ,too sad ,get glad ” or “Shame on you for being old,disabled or impoverished because we could care less”.

  • justinterested

    So true.

  • Mick Jstal

    wow good info here

  • geraldinef

    ℶwww.JobK3.comℶ

  • Marcia Meister

    Could Moyer & Co. do a feature on Sequester? It is killing the Middle Class in my City.

  • James Morison

    The best solution is to do both, create more jobs that pay a living wage so people can afford better health care and bolster and revise the health care system so those that are relegated to Medicare and Medicaid can receive better treatment as well. ALEC and the Republican Legislators seemed set on doing neither for fear it will impact their profit margins adversely when the opposite may well be true. They are only blind siding themselves in the end.

    (edited to correct spelling errors – JM)

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  • trthbtld

    Make that 100% – 400%.

  • guy

    Many years ago I was transferred to London and used their NHS. First experience was prior to enrolling; a trip to the emergency room for stitches. They asked my name and that WAS ALL. After a 15 min wait I got stitched up and kicked out. Second experience was almost exactly the same; an overnight observation following food poisoning, with no paperwork, and no wait and no bill. Once I signed up at the local family practice (Battersea Bridge) I started doing regular preventive care etc. Typical wait was 30 min. Bottom line- Great service, NO PAPERWORK , didn’t even notice the minor paycheck deduction, and private insurance was DIRT CHEAP. Give me national health ANY DAY.

  • Rita Coyne

    ALEC still is not being explained by local media here. The wider public is unaware of its insidiousness. Our Senator Durbin was recently criticized for complaining about ALEC’s influence. An editorial in our local newspaper commented that Dubin didn’t respect the 1st Amendment that everyone has the right to their views including ALEC.

    The problem is that work of ALEC to undo legislation like the ACA, legislation which is in the public’s best interest, is not understood by the majority.

  • Anonymous

    Too bad you didn’t have something serious… you’d still be waiting.

  • Anonymous

    So why is everything skyrocketing? Obamacare is a big stinking load of sheet. People will demand it’s removal in a few years.

  • Anonymous

    Obamacare is the worst piece of legislation ever! It’s turning us into a nation of part timers.

  • trthbtld

    Your choice of words makes me think you are writing this with a purpose. “Mandated health care for every man woman and child?” You could also have said “for everyone”, but that would sound as a logical thing (which it actually is). Now it sounds dramatic. Again, “mandating anything upon the backs of American Citizens” sounds dramatic, while in reality, it is total nonsense. You know well that there are lots of mandated burdens “upon the backs of American Citizens” (such as, for instance, paying taxes). Receiving access to *affordable* health care insurance, otherwise out of reach, would not fit that category as far as I can tell. To the contrary. Having no access to health care, imagine that. Having to worry about your health and having to decide to go into debt to see a doctor, how is that for a burden?

  • NanC

    While I would have preferred single payer, I was behind AFA to begin with. Now I’m seeing all the ways opponents are trying to sabotage it along with the difficulties the administration is having in implementing it — subsidies are now put off an additional year. I’ve come to the conclusion that Dems created this needlessly complicated system only to appease Conservatives who would call single payer Communism and in so doing played right into their hands. Conservatives can point to the problems with the program and, in fact, there are many. Medicare for all would have worked much better and with systems already in place. Medicare would also be a much less expensive program if it covered everyone from cradle to grave instead of only those over 65 who tend to have more health problems. When will the Democrats understand that they can’t beat Conservatives at their own game?

  • Sally

    I would like to see a cost benefit analysis of ACA. We still have no information on healthcare.gov about the plans and requirements with sign up just a few weeks away. This does not speak well to the organization of this effort. Nor is there a massive effort to educate people about this. Based on what the pool price for health care for a government employee costs the employee and government I estimate that under the current system an individual premium will cost about $5000 a year. If we are enrolling 51 million uninsured persons, many who are living in poverty, this calculates to over $200 billion per year cost to the federal government with a possible 10% contribution by the states. Where is this money coming from? With the disparity in costs for different procedures even within a single state, the cost of health care is largely based on profitability and paperwork, which are eliminated in a single payer system.

    It was nice to hear how the British medical system works.

  • cgmcle

    One of the main points of the ACA is that federal and state governments do currently subsidize health care — for people who can’t afford health coverage, when those people visit emergency rooms. Emergency room care is more expensive than more routine health care. The ACA proactively subsidizes health care for people who can’t afford it and enables them to access it at a cost less than that of emergency room care.

  • Jim Young

    Go to http://www.trreid.net/works.htm to see the books and other works he has done comparing how other countries handle health care. I’m convinced the for profit models everywhere else are better than the US on a cost/benefit ratio but the ideal would be the most efficiently run universal health care systems.

    Our neighbor’s father was UAW President Walter Reuther’s personal pilot (lost in the crash that took all aboard). The connection helped my rather conservative, moderate, Republican family (that believes firmly in examining Devil’s Advocate information, find that Walter Reuther opposed continued special health care benefits for just union members (though he couldn’t sell his members on it), and seemed to support universal health care along the lines of what Bismark implemented in Germany (developing a healthy and well educated workforce more than paying back the investment in tax dollars).

    Wendell Potter is so on mark about so much of this that I forget to come back to his support often enough. It has been settled, in my mind, as what we should have been doing, albeit with constant monitoring to make sure it meets intent, or is improved as we find out what might even work better. It is a big step we must take since the alternatives/status quo are unsustainable.

  • Jim Young

    I wish there was a way to directly identify all ALEC clone bills but, until there is (or I find it), I’ll have to expand my use of http://sunlightfoundation.com/blog/2009/02/26/fifty-state-project/ resources. So far I’ve just been using it to track California bills on Disclosure, Campaign Finance, and telecommunications universal services bills (to me, to fight the privatization demands that keep communities from using bond money to build our own much faster, affordable, and open broadband services).

    The scope of ALEC attempts to outlaw public funding of utilities that could in any way prevent their corporate sponsors from making outrageous profits on sub-standard services, restricted to only that which they want you to see, is one of the most frightening things they do.

    The sunlight foundation enables you to track the very beginnings of the legislative processes you should be interested in, down to some pretty local levels. Be warned that everybody can use this and if you don’t, their operatives will. We must at least dilute their self-serving impact on our politics, and start having our wishes included.

  • cgmcle

    Apparently, guy, you don’t understand. You’re not listening to lots of Americans who know that socialized health care is expensive, inefficient, and ineffective. Anywhere there is socialized medicine you have to wait months for inferior service and outdated technology. Many Americans will tell you this is all true. It is so easy to know all these things — without leaving the comfort of one’s arm chair (and with full faith in the conservative media). After all, we’re number one.

  • Anonymous

    It is killing at least 90% everywhere. We’ll soon be back to the feudal system if people don’t rise up en masse and say, “NO MORE!”

  • Anonymous

    We all pay one way or another for the inexcusable lack of a national health care system. Add the monies charged above reasonable compensation for care, add monies lost for care of the indigent, add higher costs for care of indigent who put off getting care till it was critical, add costs of maintainimg and advertisement of insurance companies, add the unbelievable bonuses ( eg $22 million) given their executives add the overall inefficiency of the insurance system whose goal is to keep as much of your money as they can even if denying you needed services cause you disability or death. My brother was poor, had no insurance, could not afford a doctor. He died of congestuve heart failure at 35. With universal health care he would have lived to see his son grow up. Care for all is simply the humane thing to do.

  • Anonymous

    Or how about just knowing you do not have the money to see the doctor or buy medicine – sleeping sitting in a chair because you can’t breathe lying down – and your wife and son finding you dead in the morning. Shame on the politicians and insurance executives.

  • Oville

    A poster made this astute observation: “If we are enrolling 51 million uninsured persons, many who are living in poverty, this calculates to over $200 billion per year cost to the federal government with a possible 10% contribution by the states. Where is this money coming from?”

    People always misplace the conservative view on this — we are not opposed to fixing our broken health care system. FIRST, though, we have to cut the waste from government, get our SPENDING under control — then we’ll have the money to consider such a glorious revision to healthcare. ACA was rushed and ill-conceived, which does not make it better than nothing — it makes something bad worse. And with our national debt, we simply can’t afford that.

  • M. Deane

    Cutting waste and controlling spending is not the first priority. What’s needed most is a general public thoroughly informed about the essential benefits of the ACA, as well as educating the public about the Koch brothers, the American totalitarians who significantly funded ALEC, other extremist conservative entitities, and remain perhaps the primary threat to the democratic process. With tens of billions of dollars at their disposal, the Kochs are merchants of evil intent on destroying the nation’s social well-being and economic stability.

  • M. Deane

    Apparently, you are the one who is misinformed. No doubt having been indoctrinated by too many years of watching Fox News. The misinformation and lies circulated by conservative pundits about nations with socialized medicine are soaked up by undereducated conservative followers who do not question the distortions. Long waits for service and outdated technology are fallacies created in the U.S. by forces that want to maintain a health care system that “is expensive, inefficient and ineffective.”. Waits for medical appointments in the U.S. are generally long and the costs for treatments excessive. In fact, unless you are a patient of so-called boutique physicians (who request premium annual fees in advance of treatment), patients wait time for appointments are escalating nationwide. Health care in Britain, France and Scandinavian countries, for example, are far superior to services in the U.S., unless you are part of the upper two percent, a member of Congress or a federal employee.

  • David L. Allison

    I think we have to go into the belly of the beast and start writing letters and comments to the so-called mainstream media, including the media in the middle and on the right. The control of ALEC is something that most libertarians should be as concerned with as the progressives. I share the concerns of Moyers & Company and I know that there are many others who would agree with me. I am going on my social media pages to encourage my friends to sign up for the M & C newsletter and then a letter to a few newspapers asking them to cover the machinations of ALEC the TPP, the sit ins at the North Carolina legislature and other issues that do not seem to be penetrating the corporate bubble that a majority of Americans seem trapped in.
    Join me if you have the time.

  • ray4ausa

    Orville, I suggest you forgo the help of your local sheriff’s office when you have an intruder in your home. then I would suggest you stand in front of the bull dozer attempting to run over your farmland because there was no one available to enforce common sense laws and regulations. then I would suggest not using any of the following, electricity, public water supplies, public hospitals, any medical services, any educational services and ANYTHING supported with public dollars. Then you will understand what government does. If you can find the “waste” in government spending you will find that that “waste” is put directly into someone’s pocket, not yours or mine, but usually some faceless business owner with enough graft money to seduce a politician. Why don’t we prosecute these traitors and assure they spend 50 years in prison instead of keeping food and education from our needy. If you are serious about helping this society then demand HONESTY FROM YOUR ELECTED OFFICIALS.

  • cgmcle

    Actually, I agree with everything you said – except the first two sentences. It was an attempt at subtly satirical sarcasm.

    Add to your list South Korea. I recently had a long talk with a nurse from South Korea who I was helping with her master’s thesis. We met for several hours overall and, naturally, strayed off topic occasionally. She started trying to gauge my feelings about US health care. When she apparently became confident that I believe our health care system is broken in many ways, she opened the floodgates. She is appalled by our health care system and can’t believe how many people believe it’s the best in the world. (Well, maybe it is for the wealthy.) She told me about the inexpensive universal health care system in S. Korea. Comparing our system to theirs is like comparing a match to the sun — I can’t imagine ours ever being as good as theirs.

    If you find yourself in need of any kind of medical care in S. Korea, you go to the nearest medical center, typically a single building. You don’t make an appointment, you just walk in. After a brief “triage,” you’re sent to the appropriate place in the same building. You meet with a doctor or another health care professional that day and receive any ongoing care you need. Payment is handled through their health care system, no showing your insurance card, no co-pays, no paperwork, just high quality health care when you need it.

  • george the sceptical

    Gee, that’s funny…. Isn’t socialized medicine what we give to our service members and veterans? My experiences at VA hospitals were nothing like you describe. Privatization, as ALEC preaches, is when things seem to get expensive and inefficient.

  • george the sceptical

    Why should these well paid politicians try to figure anything out when ALEC will just write the legislation for them!

  • george the sceptical

    If politicians had any sense of responsibility, we could be studying the industrialized nations that have universal heath care to find out what works and what does not. We could then adopt what works, and avoid what doesn’t! Why are we not doing this? Does it just make too much sense?

  • Elena Ferrante

    No, actually, 20+ years in the health care industry gives me a much keener insight as to the possible remedies for the aspects of our system that need to be addressed, without adding the undue burden of an unworkable “overhaul”. Do a little investigating of your own instead of buying into the b.s. handed to you by our political leadership. And, you neglect to address the actual core problem which is putting so many Americans at risk, and that is the trade agreements. So, please refrain from the asinine barbs and dig a little deeper into the topic…

  • Elena Ferrante

    Correction…not only does the government “subsidize” e.r. visits, but guess what…so does every paying patient. Why do you think the cost of an aspirin is so high in the hospital? No one is saying that they system couldn’t stand some viable changes…but this ridiculous notion that “government run, universal care” is the answer, is just plain foolishness…

  • Anonymous

    ACA was never rushed and has been brought forth by at least two administrations. Sure, “first, though,” will always trump health care for the country, especially the sick, poor, hungry and homeless sick, poor, hungry …. However, that is not a priority of those on the Right, not even for the majority who are as poor as some others in America.

  • Patsy Ann Handy

    Thank you guys for providing this link. I had never heard of this org. I will keep up with is going on from now on.

  • Anonymous

    The AHCA…according to the CBO, does not add to the deficit. It raises revenue to the tune of $109 billion over a ten year period

  • Anonymous

    The
    Affordable Care Act is ALEC….all of it is written by corporations.
    States are mostly private health systems all with policy written by
    businesses.

  • http://www.billmoyers.com Theresa Riley
  • mgoodri

    That’s exactly the one I was talking about. Thanks Theresa.

  • mgoodri

    Wow! You’re all over the place with your beliefs. You just went from one side of an issue to the other side. ???????????

  • mgoodri

    It’s not hurting anyone in Congress. If it was, they’d do something about it. Look what they did when they had to wait longer for flights. They could care less about the suffering they’re inflicting on citizens all over the country. This Congress is brutally hateful. Why anyone votes for them is beyond me!

  • mgoodri

    We’re doing this because our present system had one purpose–to make money for insurance companies and CEO’s. That’s not healthcare! Do you know how many people could not get or AFFORD healthcare? The insurance companies wouldn’t insure them, because they didn’t want to pay to make them better. Insurance companies were allowed to cap how much they could spend on you to get you well, and if you weren’t better by the time you reached the cap, it was, “dude, you’re on your own–we’re not paying for anything else.” The insurance companies had the right to override your doctor, and deny coverage your doctor prescribed! Now what sense does that make? They can’t do it anymore. All the government is doing is trying to give citizens a fair playing field which we never had with our present system. That’s the purpose of the government–to put rules in place to protect its citizens. Too bad they took the regulations off Wall Street; we wouldn’t be where we are today. As far as the IRS having anything to do with your healthcare, that’s a bold face lie. All the IRS is going to do is give you a monthly tax credit to bring down your monthly premium. You won’t hear any of these protections from FOX. The lies they spread are despicable!

  • mgoodri

    Your idea is great, but our Congress is bought and paid for by corporate America (Koch Bros., Heritage Foundation, Americans for Prosperity, etc.); and when someone owns you, you have to do what you’re told to do. Therefore, ALEC is writing laws that corporate America wants, and the corporate owned puppets in Congress are passing them word for word. The laws they’re passing do nothing for every day Americans! And until we remove these corporate puppets, things are only going to get worse for our country.

  • Arthur Bundy

    The 14th Amendment provides the best answer for all our concerns about Corporate America, not just this one.
    Amend the 14th Amendment to include this phrase: “To define a person under the law as a biological thinking and breathing entity only.” A phrase that would unhinge about 150 years of the Corporate law and once and for all time end the concept of the corporation as person and therefore not equal in the eyes of the law to an individual.