The political battle over health-care reform has many experts citing research by the Lewin Group, a consulting firm whose research is cited by opponents of a public insurance option.
To Rep. Eric Cantor (Va.), the House Republican whip, it is “the nonpartisan Lewin Group.” To Republicans on the House Ways and Means Committee, it is an “independent research firm.” To Sen. Orrin G. Hatch (Utah), the second-ranking Republican on the pivotal Finance Committee, it is “well known as one of the most nonpartisan groups in the country.”
Generally left unacknowledged, or perhaps unknown, is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation’s largest insurers. More specifically, the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied UnitedHealth and other insurers with data that allegedly understated the “reasonable and customary” doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.
In January, UnitedHealth agreed to a $50 million settlement with the New York attorney general and a $350 million settlement with the AMA, covering conduct going back as far as 1994. Lewin Group Vice President John Sheils said his firm had nothing to do with the Ingenix reimbursement data. Lewin has gone through “a terribly difficult adjustment” since it was bought by UnitedHealth in 2007, he said, because the corporate ownership “does create the appearance of a conflict of interest.”
Lewin’s clients include the government and groups with a variety of perspectives, including the Commonwealth Fund and the Heritage Foundation. A February report by the firm contained information that could be used to argue for a national system known as single-payer, the approach most threatening to insurers, Sheils noted.
But not all of Lewin’s reports see the light of day. “Let’s just say, sometimes studies come out that don’t show exactly what the client wants to see. And in those instances, they have [the] option to bury the study,” Sheils said.
Lewin produced one of the most widely cited statistics of the health-care debate: Under a particular version of a public option, the number of people with private, employer-sponsored coverage would decline by more than 100 million.
Opponents of the public option have invoked the finding as proof that offering a government-run health plan would deprive people of their employer-sponsored coverage and lead to a government takeover of the health-care system. “The nonpartisan Lewin Group predicts that two out of three Americans who get their health care through their employer would lose it under the House Democrat plan,” Cantor, the second-ranking member of the House Republican leadership, said in a July 12 commentary in the Richmond Times-Dispatch.
Since then, adjusting its analysis to reflect the latest version of legislation drafted by House Democrats, Lewin has estimated that 88.1 million workers would shift from private, employer-sponsored insurance to the proposed public plan. The Congressional Budget Office came to a different conclusion, saying that enrollment in the House Democrats’ proposed public plan would total 11 million to 12 million people.
Insurance companies have been trying to block the public option, saying it would undercut their prices and put them out of business by slashing payments to doctors and hospitals. Though the millions of people Lewin was describing would lose their employer-sponsored coverage, they wouldn’t be forced into a government-run health plan, Sheils said in an interview. Rather, they would be able to choose between the government plan and other private options, and “they might very well be better off,” he said.