Insurers Go From Friend To Foe For Democrats; Industry Still Needed In Reform

President Obama and Democrats have gone from praising health insurers to demonizing their erstwhile partners as they try to rally support for a health care overhaul.

From the high point in May when Mr. Obama praised the industry for helping to find $2 trillion in savings over 10 years, it's been a quick descent. House Speaker Nancy Pelosi, California Democrat, branded health insurance companies "villains," and a key Democratic senator has asked the Centers for Medicare and Medicaid Services to investigate insurer tactics.

Liberal groups are sponsoring television ads that accuse the firms of greed and have organized a protest in Washington against "big insurance."

Democrats say insurance companies make a good "bad guy" to help mobilize supporters, though they acknowledge they're walking a tight line and need the insurers to stay at the negotiating table. But the companies say the attacks are an unfair response to their years-long effort to reduce health care costs.

"It's not productive," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, a trade group of about 1,300 insurers. "That type of divisive political rhetoric isn't going to get anybody covered, and it's not going to get health care costs under control."

Mr. Zirkelbach said the industry has "stepped up" and offered several proposals for reform, including the elimination of recisions and denial of coverage based on pre-existing conditions. He blamed misinformation for negative publicity surrounding company profits, noting that margins for health insurers average about 3 percent.

Democrats are well aware of the power insurance companies can wield in the debate. In the 1990s, when President Clinton tried to overhaul health care, the industry's "Harry and Louise" ads, featuring a couple befuddled at the complexity of the proposal, partly doom Mr. Clinton's efforts.

Mr. Obama tried early on to work with the insurers and extracted a commitment in the spring that the companies would try to reduce costs by $2 trillion over the next decade. The president even touted the fact that the people behind the "Harry and Louise" ads were on his side this time.

But since then, Mr. Obama and Democrats have become critical of the companies, with the president this weekend saying insurers' profits are too high and that they're "gonna have to be ponying up." Even the language of the debate has changed, as Democrats no longer say they're attempting "health care reform," but rather "health insurance reform."

It's not clear whether Americans agree with the president.

A Rasmussen Reports poll from August found that 51 percent of voters feared the federal government more than private insurers, while 41 percent held the opposite view.

But Democrats still think they have a live target, with lawmakers on Capitol Hill last week hammering health care executives for earnings and compensation at a House hearing on health insurance bureaucracy.

"Private health insurance bureaucrats play with the lives of people - our constituents - when they are at their most vulnerable," Rep. Dennis J. Kucinich, Ohio Democrat and chairman of the Oversight and Government Reform subcommittee on domestic policy, told representatives from six major health insurers Thursday. "From the insurer's perspective, people who really need their health insurance to cover life-saving medical treatment threaten the company with medical losses, and investors want medical losses to be minimized in order to maximize profits."

Energy and Commerce Committee Chairman Henry A. Waxman, California Democrat, appears to be planning a similar hearing after he earlier this year requested financial data from 52 insurers. In the Senate, Finance Committee Chairman Max Baucus - Montana Democrat and author of a compromise proposal - recently urged the Centers for Medicare and Medicaid Services to investigate insurance company tactics after one insurer sent a letter to beneficiaries regarding the health care plans before Congress.

One Democratic strategist, speaking on background to discuss the matter candidly, described the attacks on insurance firms as a coordinated effort to create a political "villain."

"On the one hand, they can't risk having the insurers walk away; on the other hand, insurers are not particularly popular and you need that villain to get people emotional and invested," the strategist said. "It's a very interesting tight rope that they're trying to walk."

While Mr. Obama has been critical of health insurance companies, the rhetoric coming from the White House has been far cooler than that of activist groups, particularly those supporting the so-called public option, which is vehemently opposed by insurers. In one recent TV spot, Health Care for American Now warns: "If the insurance companies win, you lose."

The strategist said the rhetoric is only going to heat up as next year's midterm elections draw near.