AHIP’s self interest is now emerging, and so are the beginnings of a fight to protect its turf. Despite polite comments from their PR types, insurers will fight to the death on this one. The last thing they want is competition from a more efficient public program that might offer more comprehensive coverage at less cost.

The press needs to look critically at another of the industry’s major proposals—its offer to insure every American, no matter how sick, in exchange for requiring every American to have health insurance. That means if people don’t get it at work or from public programs like Medicare or Medicaid, they will have to buy it in the so-called individual market, where companies are already at the drawing boards dreaming up new policies to sell. Robert Laszewski, who blogs at Health Care Policy and Marketplace Review and who has been around insurance reform efforts before, says “AHIP’s proposal is “not a proposal for reform. It’s a Trojan horse.” The industry knows that no reform will cover everyone.

This fall, a report by consulting firm The Lewin Group said that, under Obama’s plan, 45 percent of the currently uninsured would remain without coverage. With people still uninsured, companies could still pick and choose only the healthiest for coverage. It will be business as usual for the carriers.

An industry insider put it another way: “They are not doing anything that puts their skin in the game.” If by some chance everyone is covered, insurers will win big. Think of the business that will flow to AHIP members. No wonder Karen Ignani is excited by Democratic approaches that include the idea of every American having coverage. What a deal! That’s a new storyline for the media, one that the public just may want to hear.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.