For an example of just how heartless and profit-obsessed health insurers are, take a look at what is playing out in Connecticut, where my former employer, Cigna, is based. 

Low income people with diabetes in Connecticut and other states are having a hard time paying for the insulin that they must have to stay alive–even though they have insurance. That’s because in many cases, their copays and deductibles are so high they can’t afford to pick up their prescriptions.

As the Register Citizen in Torrington, CT and other news outlets reported this week, one in four Americans, many of whom are insured, are putting their lives at risk by rationing insulin. To provide some relief, Connecticut lawmakers have introduced legislation that would cap the cost of insulin supplies at $25 a month for people enrolled in health plans regulated by the state, including Medicaid. 

Unfortunately, the proposed law would NOT apply to people who get their insurance through an employer (as most Americans do) because employer-sponsored plans are exempt from state oversight. So even though the bill would only apply to a relatively small segment of the population in Connecticut–the poorest who have to buy coverage on their own without the help of an employer and those who are enrolled in Medicaid–lobbyists for the insurance industry are trying to kill the bill. 

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The bill undoubtedly would save lives, but that is of little concern to the Connecticut Association of Health Plans, the lobbying group for the state’s insurers, which argues that “capping copays unfortunately doesn’t do anything to address the actual cost of the drugs and the supplies.” 
 

I honestly don’t know how those people sleep at night. 
 

There are two things to understand here. One, we are talking about a relatively small amount of money, pocket change, really, when you consider the enormous profits the big insurers are making, especially during the pandemic, but the insurance industry doesn’t want to give up a dime in profits. By trying to kill this bill, they are doing what I witnessed routinely when I was an industry spokesman: they’re putting the interests of their shareholders above the interests of patients. They don’t even want to throw their customers a bone. 

The other thing to understand is that the insurance companies, through their public comments, are acknowledging that they are largely incapable of holding down the cost of medications by any means other than making their customers pay more out of their own pockets for life-saving drugs. 

The insurance industry’s top lobbyist in the state was quoted as saying that insurers use copays as leverage in negotiating lower prices with pharmaceutical companies. That is tantamount to an admission that insurers view patients as hostages and are telling drug makers, “I’ll deny this patient affordable access to a drug she needs unless you lower the price.”

Folks, that should not be happening in America. If health insurers can’t come up with more acceptable ways to help their customers manage medical expenses than by using them as hostages, what is their “value proposition?” 

“The more prices go up, the more insurers can force their customers to pay in premiums, copays and deductibles.”

One of the things health insurance lobbyists will not admit is that health insurance executives and their shareholders actually benefit from rising health care costs. The more prices go up, the more insurers can force their customers to pay in premiums, copays and deductibles. Higher premiums translate into higher revenues, meaning there is more money available to convert to profits and reward shareholders. And by increasing copays and deductibles, insurers make their customers pay more out of their own pockets before their coverage kicks in. As long as we allow this rigged game to go on, shareholders will continue to win at our expense. 

It is outrageous that people with insurance are dying every day in this country because of ever-increasing copays and deductibles. It is equally outrageous that industry lobbyists would try to block efforts that could save some of those lives.  


Wendell Potter
Chairman of the Board at To Be Fair, Inc. | + posts

To Be Fair, Inc. and Tarbell.org founder Wendell Potter is an American consumer advocate, New York Times bestselling author, consultant, and former health insurance industry executive. A critic of HMOs and of the tactics used by insurers, Potter is also an advocate for major reforms of the industry, including universal health care.