Health care

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From the beginning of the debate around passage of the Affordable Care Act (also known as the ACA or “Obamacare”), the U.S. Chamber of Commerce has worked to undermine efforts to expand access to better quality healthcare for more Americans and to reduce industry profiteering. From spending more than $100 million on behalf of the big health insurers to oppose the ACA in 2009 and 2010 to undermining the funding sources of the law in 2014, to opposing allowing Medicare to bargain with pharmaceutical companies in order to lower drug prices, the Chamber has consistently sided with giant health insurance corporations and Big Pharma against expanded health care coverage and increased affordability for the American people. The Chamber now looks to capitalize on the election of President Trump and the GOP Congress as an opportunity to repeal the ACA, preferring huge tax cuts for corporations and the wealthy over health insurance for tens of millions of Americans.

Through the Chamber, Big Insurance and Big Pharma Game the System

While the Chamber does not disclose its members, we do know, based on several companies’ own disclosures, that many big health insurers and pharmaceutical companies fund the Chamber. This list includes health insurance giants such as Aetna, Cigna and UnitedHealth Group, and pharmaceutical powerhouses like Merck, Allergan, Pfizer and Mylan. The Chamber’s board of directors also includes health-related corporations such as Celgene, Pfizer, Anthem and Bayer.

The Chamber’s primary argument against the ACA is that it is a job killer and would harm small businesses. These claims are both false. Recent academic studies indicate that the ACA has not had a significant impact on businesses’ demand for labor. In fact, research suggests that repealing the ACA may actually lead to significant job losses. And what about the Chamber’s contention that the law would “crush small businesses with billions in penalties?” Also false – the bill exempts some small businesses from penalties and gives credits to most of the others.

The Chamber’s real opposition to the ACA lies with the fact that it imposes taxes on industry and the wealthy and it limits industry profiteering and executive pay. For example, the ACA levied taxes on drug companies, health insurance providers and medical device manufacturers in order to help offset the costs of expanding coverage. The Chamber framed its opposition to these taxes as defending the middle class, in one instance exaggerating the impact of the medical device tax on small businesses. In reality, repealing these taxes would primarily benefit industry groups. Similarly, eliminating ACA taxes such as the increased investment income tax would benefit wealthy Americans at the expense of average citizens.

The ACA attempts to rein in the excesses of the insurance industry through other avenues as well. The law includes the 80/20 rule, designed to ensure that health care providers are spending at least 80% of premiums on actual care, and limits tax deductions for executive pay, capping the amount health insurance companies can deduct at $500,000. These provisions all threaten the Chamber’s primary goal of maximizing corporate profits and executive compensation.

The Chamber has seized on the opportunity provided by the Trump administration to attempt to repeal and replace the ACA. The Chamber has been a prominent supporter of the American Healthcare Act (also known as the AHCA, “Trumpcare,” “Ryancare,” or “Wealthcare”), which would have led to an estimated 23 million Americans losing their health insurance. It is interesting to note that the Chamber spent more than $16 million between 2012 and 2016 backing 10 of the 13 authors of the Senate’s version of the AHCA.

Although a grass-roots mobilization of millions of Americans across the country was able to defeat the GOP efforts to repeal the ACA in 2017, repeal remains a priority for the Chamber which means that Trump and the GOP Congress may try again in 2018 to kill the ACA.

The Chamber’s support for corporate-friendly policies like forced arbitration, which blocks consumers’ access to courts when they have disputes with companies, also benefits healthcare companies. In 2016, the Obama administration implemented a rule to ban forced arbitration clauses in nursing home contracts. This rule is designed to ensure nursing home residents have access to the court system if they are injured or abused. The Chamber has declared its opposition to the rule, arguing that arbitration works “at least as well” as the court system for consumers, despite clear evidence to the contrary. The Trump administration unfortunately appears likely to repeal the rule in any case, notching another win for the Chamber and the predatory corporations these forced arbitration clauses would protect.

The Chamber’s ties to the pharmaceutical industry account for its persistent focus on expanding intellectual property rights. For example, the Chamber lauded the strong patent protections contained within the Trans-Pacific Partnership that would have vastly increased pharmaceutical companies’ profits in foreign countries and put potentially life-saving drugs beyond the reach of the citizens of many developing countries. More recently, the Chamber took a strong stance against legislation that would allow for the speciously arguing that these medications might be ineffective or harmful.

Although the Chamber claims that it advocates for health care policies that will “control costs, expand access, and improve the quality of care,” history suggests that the Chamber puts profits before people and is actually far more focused on the health of big corporations’ bottom lines.