Introduction

Republicans weren’t the only big winners in last Tuesday’s election. So were health insurance companies, many of which spent heavily to influence the outcome.

There are several provisions of the Affordable Care Act that the insurance industry would like the next Congress to change. If insurers get what they want — and with the GOP in control of both houses of Congress, it’s a decent bet they will — Wall Street will be exuberant indeed.

Just the anticipation of what a Republican controlled Congress might be able to pull off has put insurance company shareholders in good humor. Within 24 hours of knowing that Mitch McConnell would replace Harry Reid as Senate Majority Leader, investors were active buyers of health insurance stock. In fact, the share prices of five of the six largest for-profit health insurers — Cigna, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem — reached their highest points in a year last Wednesday. Some even reached historic highs. Aetna was the only one that fell short of reaching a 52-week high, but only by pocket change.

Even though there is still chatter about repealing Obamacare, GOP leaders and insurance company executives understand that isn’t likely to happen. And they really don’t want it to. Insurance firms and their shareholders actually love the billions of dollars in new revenue they’re getting as a result of the law’s requirement that most of us buy coverage from private insurers. They’re pretty confident that the cash will continue to flow, because, even with Republican control of Capitol Hill, the law will not be repealed.

No doubt a full repeal bill will pass in the House, just as previous bills have every year since the GOP took control of that chamber four years ago. But there’s almost no chance the Senate version will match the House’s action. Republicans still won’t have the 60 votes necessary to overcome an almost-certain Democratic filibuster of any bill that would repeal or gut the reform law. Even if they did, President Obama would surely veto it.

But we can expect Republican lawmakers to quickly introduce bills in the new Congress that would strip the law’s “root and branch,” to use a favorite McConnell phrase. This is part of a skillful game of political chess insurance company executives and lobbyists have played since the beginning of the health reform debate. Despite the fact that they have given more money through their PACs to Republicans than Democrats and have sided with groups that have sought to abolish the law, the insurers have also played Democrats at both ends of Pennsylvania Avenue to their advantage.

While they didn’t get all they wanted during the reform debate, they won the major battles. The insurance companies got the White House and Democratic leaders to stifle any real discussion of single payer health care. And they were able to kill the idea of a government-run public option to compete with them.

As a consequence, even with the provisions of the law that protect consumers from insurance company abuses, such as refusing to sell coverage to applicants with pre-existing conditions, insurers have thrived.

While the Dow Jones Industrial Average has increased an impressive 160 percent since President Obama signed the reform bill into law on March 23, 2010, the price of the insurers’ shares have doubled — and in some cases even tripled. If you had invested $25,000 in UnitedHealthcare stock in 2010, you would have $78,750 today, a 315 percent return.

But that’s not enough for the companies or their shareholders. They figure they can do even better with a few industry-friendly “fixes” to the law. For one thing, they want to get rid of a tax on some health plans that covers some of the cost of the government subsidies to help low-income folks buy insurance. Even though the subsidies go to the insurers, they want to get rid of the tax, and they have the GOP on their side.

They also want to be able to once again sell policies that only cover 50 percent of a person’s medical expenses. Not only are Republicans on board to allow that, so are many Democrats.

With Obama in the White House and the GOP in control of Congress, insurers are in the catbird seat. They know the president won’t allow the law to be repealed or even altered substantially, which will be good for future profits, and they also know they can count on the Republicans to push through legislation to get rid of the health plan tax and let them sell low-value policies again.

No wonder shareholders are smiling — all the way to the bank.

Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Obamacare: What’s in It for Me? What Everyone Needs to Know About the Affordable Care Act.