Health insurers are “very mindful” of brewing single-payer battle

On June 1, Matt Eyles will take over as the chief executive of America’s Health Insurance Plans (AHIP), the lobbying group that represents insurers. Between a brewing single-payer debate and Obamacare’s unknown future, he has a lot on his plate stepping into this new role.

Eyles currently serves as AHIP’s vice president for public policy. Earlier this week, Dylan Scott and I had the chance to sit down with him to chat about what the health care landscape looks like from his vantage point. Today, I wanted to share some of the parts of our discussion that I found most interesting.

One question I had for Eyles was how a group like his will weather the single-payer debate that is brewing within the Democratic Party. There are lots of plans floating around Capitol Hill right now that would have the government play a more significant role in running the health care system — and less of a role for the plans Eyles represents.

”We’re very mindful of that trend within that wing of the party that is focused on moving toward what might be a more single-payer type approach,” Eyles says.

He gave me a bit of what felt like a preview of the arguments you’ll hear from the industry as this debate continues. “We see obviously a lot of risk with that,” he says. “If you think of 180 million people who are covered by the employer market today, that would be enormously disruptive. If you think of all the people that are in Medicare, are they just going to be cut out of that, or what will happen to those in Medicaid?

”There are so many different elements that need to be addressed across so many different problems. We want to focus on making what we have work a lot better rather than fundamentally disrupt what is going on.”

One comment Eyles made that I found especially interesting was how he thought about the origins of this single-payer push — why it’s being discussed at this particular moment.

”We’re very mindful that this has been brewing for quite a while, and a lot of it has to do with costs within the system, and what has happened within the individual market,” he says. “That’s still such a small part of the system, but it feels like, from a bigger-picture debate perspective, we’ve spent so much time on the individual market. ... I think it’s the instability that we’ve seen there that has fed into this.”

There have been rumors here and there about a renewed push toward Obamacare repeal from congressional Republicans.

Eyles, for his part, doesn’t expect to see that happen this year.

”I think it’s very, very small [the odds of a repeal push]. There’s not a lot of hunger, I think, to address that right now,” he says. “Certainly there are, in some corners, people who will say we need to come back and do it. ... But I think to come in at this point, as we head into the summer and as we start focusing on the midterms, I think it’s just ... really hard to say that we want to come back to that big discussion right now.”

There’s this one policy idea that has quietly been gaining bipartisan support among health care wonks: automatic enrollment. The idea is to sign up uninsured Americans for a bare-bones health insurance plan to get them into the market.

I thought insurers would be pretty into this idea, as it would mean more consumers enrolled in their products. But Eyles definitely had a measured reaction to the idea.

”It’s an attractive idea but very difficult to actually administer,” he says. “There’s a way it could be workable, but would people feel differently about auto-enrollment and would it create some sort of political challenge? People don’t like a mandate. Would they like auto-enrollment? I don’t know that we’ve actually gone out and asked people that question.”

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