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IA Dems:Medicare for All Hurts Industry12/14 09:52

   DES MOINES, Iowa (AP) -- Kim Motl doesn't work in the health insurance 
industry. But her friends and neighbors do. So when she saw Sen. Elizabeth 
Warren recently in Fort Dodge, Iowa, Motl pressed the Democratic presidential 
candidate about her "Medicare for All" plan, which would replace private 
insurance with a government-run system.

   "What about the little guys that work in the insurance business, that 
support our communities? The secretary that works for them, but maybe supports 
their family, what happens to them?" the 64-year-old housing advocate asked the 

   "What happens to all of those people who lose their jobs?" Motl asked in a 
later interview.

   Warren reassured her that jobs would not be lost because of her plan. But 
the exchange is a reminder that while railing against the insurance industry 
can score points with the progressive Democratic base, it can also alienate 
potential supporters in Iowa, where voters will usher in the presidential 
primary in less than two months.

   Nearly 17,000 Iowans are either directly employed by health insurance 
companies or employed in related jobs, according to data collected by America's 
Health Insurance Plans, an industry advocacy group. Des Moines, the seat of the 
state's most Democratic county, is known as one of America's insurance capitals 
partly because of the high number of health insurance companies and jobs in the 
metro area. Wellmark Blue Cross Blue Shield's health insurance headquarters 
employs roughly 1,700 in the metro area, and that's just one of the 16 health 
insurance companies domiciled in Iowa, according to the Iowa Insurance Division.

   For many Iowans, the Medicare for All debate is personal, and the prospect 
of losing a job could influence whom they support in the Feb. 3 caucuses.

   Tamyra Harrison, vice-chair of the East Polk Democrats, says she has heard 
worries at her local Democratic meetings about "the effect it would have on 
people that work in the insurance industry, and those that have small 
businesses in the area."

   "They're concerned about the repercussions on people living here that maybe 
the Democrats aren't thinking of" when they're talking about eliminating 
private insurance, she said.

   The Democrats' health care plans vary widely in terms of the speed and scope 
with which they would affect health care industry jobs, but experts say every 
plan marks a substantial reconfiguring of one of the country's biggest industry 
and thus all would affect thousands of jobs nationwide.

   Some, including Warren and Sen. Bernie Sanders of Vermont, have called for 
replacing private insurance with a government plan. Asked about this last month 
in Iowa, Warren said, "Some of the people currently working in health insurance 
will work in other parts of insurance --- in life insurance, in auto insurance, 
in car insurance," or for the new government-run system. She also cited five 
years of "transition support" for displaced workers built into the plan. 

   Sanders has previously argued that his plan would see "all kinds of jobs 
opened up in health care," and his bill includes a fund to help retrain and 
transition private insurance workers out of their current jobs.

   Former Vice President Joe Biden and Mayor Pete Buttigieg of South Bend, 
Indiana, would leave room for private insurers, but also include a public 
option, which they have acknowledged could ultimately put insurance companies 
out of business. Sen. Cory Booker of New Jersey is trying to walk a line on the 
issue, having signed onto Sanders' Medicare for All bill in the Senate but on 
the campaign trail shied away from eliminating private insurance entirely.

   Even those who say they would keep private insurance companies face risks. 
Buttigieg revealed this week that he worked for Blue Cross Blue Shield in 
Michigan during his time as a consultant at McKinsey & Co. He said he "doubts" 
his work contributed to layoffs the company later announced and has instead 
sought to highlight the impact of his opponents' plans. 

   "There are some voices in the Democratic primary right now who are calling 
for a policy that would eliminate the job of every single American working at 
every single insurance company in the country," he said.

   Economists say the jobs impact of any shift away from private health care 
would be felt nationwide by hundreds of thousands of Americans. It's not just 
jobs at private insurance companies that could be affected; those working on 
processing insurance claims at hospitals and other administrative health care 
jobs could be reduced as well.

   According to the Bureau of Labor Statistics, in 2018, nearly 386,000 
Americans were employed by health and medical insurance carriers --- but some 
analysts found the number of jobs lost from eliminating private insurance could 
be much higher. Economists at the University of Michigan found in an analysis 
of Sanders' Medicare for All bill that the jobs of nearly 747,000 health 
insurance industry workers, and an additional 1.06 million health insurance 
administrative staffers, would no longer be needed if Medicare for All became 

   In Iowa, however, the issue could be particularly problematic. 

   Around Des Moines, "you can't swing a dead cat without finding someone who 
works at an insurance provider or a company," said Mary McAdams, chair of the 
Ankeny Area Democrats. She said she believes Democrats in her area aren't as 
concerned about what would happen to their jobs if private insurance were 
eliminated because they don't have much allegiance to their companies to begin 

   "They know full well these companies would drop them like a habit," she said.

   The economic repercussions of eliminating private insurance jobs could go 
beyond simply the loss of local jobs, as Paula Dierenfield, a Republican lawyer 
and the executive director of the Federation of Iowa Insurers, points out.

   "This is an industry that employs thousands of employees in high-quality 
jobs," she said. "All of those employees pay income taxes, sales taxes, 
property taxes, and the companies that they work for also pay millions in 
premium taxes, as well as property taxes. So it would have a significant impact 
on the Iowa economy generally as well as here in the Des Moines metro area."

   The peripheral effects of eliminating insurance jobs worry Marcia 
Wannamaker, a real estate agent from West Des Moines who raised her concerns 
about the fate of private insurance during a recent question-and-answer session 
with Biden.

   "It's really going to cut our jobs," Wannamaker said.

   She later noted in an interview that if the private insurance industry 
shrinks, people working for such companies would lose their jobs.

    "Then that trickles down to the housing. They're going to have to move. I 
just think it's going to be a disaster," she said. "When you sell real estate, 
these people buy homes. It's just part of how the Iowa --- and especially in 
Des Moines, the economy works."


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