Dems ex­press con­cern about Medi­care plan

Antelope Valley Press (Sunday) - - Front Page -

DES MOINES, Iowa (AP) — Kim Motl doesn’t work in the health in­sur­ance in­dus­try. But her friends and neigh­bors do. So when she saw Sen. El­iz­a­beth War­ren re­cently in Fort Dodge, Iowa, Motl pressed the Demo­cratic pres­i­den­tial can­di­date about her “Medi­care for All” plan, which would re­place pri­vate in­sur­ance with a gov­ern­ment-run sys­tem.

“What about the lit­tle guys that work in the in­sur­ance busi­ness, that sup­port our com­mu­ni­ties? The sec­re­tary that works for them, but maybe sup­ports their fam­ily, what hap­pens to them?” the 64-year-old hous­ing ad­vo­cate asked the se­na­tor.

“What hap­pens to all of those peo­ple who lose their jobs?” Motl asked in a later in­ter­view.

War­ren re­as­sured her that jobs would not be lost be­cause of her plan. But the ex­change is a re­minder that while rail­ing against the in­sur­ance in­dus­try can score points with the pro­gres­sive Demo­cratic base, it can also alien­ate po­ten­tial sup­port­ers in Iowa, where vot­ers will usher in the pres­i­den­tial pri­mary in less than two months.

Nearly 17,000 Iowans are ei­ther di­rectly em­ployed by health in­sur­ance com­pa­nies or em­ployed in re­lated jobs, ac­cord­ing to data col­lected by Amer­ica’s Health In­sur­ance Plans, an in­dus­try ad­vo­cacy group. Des Moines, the seat of the state’s most Demo­cratic county, is known as one of Amer­ica’s in­sur­ance cap­i­tals partly be­cause of the high num­ber of health in­sur­ance com­pa­nies and jobs in the metro area. Well­mark Blue Cross Blue Shield’s health in­sur­ance head­quar­ters em­ploys roughly 1,700 in the metro area, and that’s just one of the 16 health in­sur­ance com­pa­nies domi­ciled in Iowa, ac­cord­ing to the Iowa In­sur­ance Divi­sion.

For many Iowans, the Medi­care for All de­bate is per­sonal, and the prospect of los­ing a job could in­flu­ence whom they sup­port in the Feb. 3 cau­cuses.

Tamyra Har­ri­son, vicechair of the East Polk Democrats, says she has heard wor­ries at her lo­cal Demo­cratic meet­ings about “the ef­fect it would have on peo­ple that work in the in­sur­ance in­dus­try, and those that have small busi­nesses in the area.”

“They’re con­cerned about the reper­cus­sions on peo­ple liv­ing here that maybe the Democrats aren’t think­ing of” when they’re talk­ing about elim­i­nat­ing pri­vate in­sur­ance, she said.

The Democrats’ health care plans vary widely in terms of the speed and scope with which they would af­fect health care in­dus­try jobs, but ex­perts say ev­ery plan marks a sub­stan­tial re­con­fig­ur­ing

of one of the coun­try’s big­gest in­dus­try and thus all would af­fect thou­sands of jobs na­tion­wide.

Some, in­clud­ing War­ren and Sen. Bernie San­ders of Ver­mont, have called for re­plac­ing pri­vate in­sur­ance with a gov­ern­ment plan. Asked about this last month in Iowa, War­ren said, “Some of the peo­ple cur­rently work­ing in health in­sur­ance will work in other parts of in­sur­ance — in life in­sur­ance, in auto in­sur­ance, in car in­sur­ance,” or for the new gov­ern­ment-run sys­tem. She also cited five years of “tran­si­tion sup­port” for dis­placed work­ers built into the plan.

San­ders has pre­vi­ously ar­gued that his plan would see “all kinds of jobs opened up in health care,” and his bill in­cludes a fund to help re­train and tran­si­tion pri­vate in­sur­ance work­ers out of their cur­rent jobs.

For­mer Vice Pres­i­dent Joe Bi­den and Mayor Pete But­tigieg of South Bend, In­di­ana, would leave room for pri­vate in­sur­ers, but also in­clude a public op­tion, which they have ac­knowl­edged could ul­ti­mately put in­sur­ance com­pa­nies out of busi­ness. Sen. Cory Booker of New Jersey is try­ing to walk a line on the is­sue, hav­ing signed onto San­ders’ Medi­care for All bill in the Se­nate but on the cam­paign trail shied away from elim­i­nat­ing pri­vate in­sur­ance en­tirely.

Even those who say they would keep pri­vate in­sur­ance com­pa­nies face risks. But­tigieg re­vealed this week that he worked for Blue Cross Blue Shield in Michi­gan dur­ing his time as a con­sul­tant at McKin­sey & Co.

He said he “doubts” his work con­trib­uted to lay­offs the com­pany later an­nounced and has in­stead sought to high­light the im­pact of his op­po­nents’ plans. “There are some voices in the Demo­cratic pri­mary right now who are call­ing for a pol­icy that would elim­i­nate the job of ev­ery sin­gle Amer­i­can work­ing at ev­ery sin­gle in­sur­ance com­pany in the coun­try,” he said.

Economists say the jobs im­pact of any shift away from pri­vate health care would be felt na­tion­wide by hun­dreds of thou­sands of Amer­i­cans. It’s not just jobs at pri­vate in­sur­ance com­pa­nies that could be af­fected; those work­ing on pro­cess­ing in­sur­ance claims at hos­pi­tals and other ad­min­is­tra­tive health care jobs could be re­duced as well.

Ac­cord­ing to the Bureau of La­bor Sta­tis­tics, in 2018, nearly 386,000 Amer­i­cans were em­ployed by health and med­i­cal in­sur­ance car­ri­ers — but some an­a­lysts found the num­ber of jobs lost from elim­i­nat­ing pri­vate in­sur­ance could be much higher.

Economists at the Univer­sity of Michi­gan found in an anal­y­sis of San­ders’ Medi­care for All bill that the jobs of nearly 747,000 health in­sur­ance in­dus­try work­ers, and an ad­di­tional 1.06 mil­lion health in­sur­ance ad­min­is­tra­tive staffers, would no longer be needed if Medi­care for All be­came law.

In Iowa, how­ever, the is­sue could be par­tic­u­larly prob­lem­atic.

Around Des Moines, “you can’t swing a dead cat with­out find­ing some­one who works at an in­sur­ance provider or a com­pany,” said Mary McA­dams, chair of the Ankeny Area Democrats.

She said she be­lieves Democrats in her area aren’t as con­cerned about what would hap­pen to their jobs if pri­vate in­sur­ance were elim­i­nated be­cause they don’t have much al­le­giance to their com­pa­nies to be­gin with.

“They know full well th­ese com­pa­nies would drop them like a habit,” she said.

The eco­nomic reper­cus­sions of elim­i­nat­ing pri­vate in­sur­ance jobs could go be­yond sim­ply the loss of lo­cal jobs, as Paula Dieren­field, a Repub­li­can lawyer and the ex­ec­u­tive direc­tor of the Fed­er­a­tion of Iowa In­sur­ers, points out.

“This is an in­dus­try that em­ploys thou­sands of em­ploy­ees in high-qual­ity jobs,” she said. “All of those em­ploy­ees pay in­come taxes, sales taxes, prop­erty taxes, and the com­pa­nies that they work for also pay mil­lions in pre­mium taxes, as well as prop­erty taxes. So it would have a sig­nif­i­cant im­pact on the Iowa econ­omy gen­er­ally as well as here in the Des Moines metro area.”

The pe­riph­eral ef­fects of elim­i­nat­ing in­sur­ance jobs worry Mar­cia Wan­na­maker, a real es­tate agent from West Des Moines who raised her con­cerns about the fate of pri­vate in­sur­ance dur­ing a re­cent question-and-answer ses­sion with Bi­den.

“It’s re­ally go­ing to cut our jobs,” Wan­na­maker said.

She later noted in an in­ter­view that if the pri­vate in­sur­ance in­dus­try shrinks, peo­ple work­ing for such com­pa­nies would lose their jobs.

“Then that trick­les down to the hous­ing. They’re go­ing to have to move. I just think it’s go­ing to be a dis­as­ter,” she said.

“When you sell real es­tate, th­ese peo­ple buy homes. It’s just part of how the Iowa — and es­pe­cially in Des Moines, the econ­omy works.”

CHAR­LIE NEIBER­GALL/AP

Demo­cratic pres­i­den­tial can­di­date South Bend, Ind., Mayor Pete But­tigieg (right) waits back­stage as he is in­tro­duced to speak Fri­day at the Iowa Farm­ers Union Pres­i­den­tial Fo­rum in Grin­nell, Iowa.

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