Of course, urging isn't forcing. But as Avik Roy of Forbes notes, the difference is subtle. Also last week, HHS also announced last week that it will consider compliance with its suggestions when determining which plans to allow on the exchanges next year. A request from HHS is like being asked a "favor" by the Godfather; compliance is less than voluntary.
The irony, as Christopher DeMuth recently noted in the Weekly Standard, is that if the architects of Obamacare had their way, the insurers would have been in even worse shape today. The original plan was for a "public option" that would have, over time, undercut the private insurance market to the point where single-payer seemed like the only rational way to go. If it weren't for then-Sen. Joe Lieberman's insistence that the provision be scrapped, DeMuth writes, "Obamacare's troubles would today be leading smoothly to the expansion of direct federal health insurance to pick up millions of canceled policies and undercut rate increases on terms no private firm could match."
In other words, the insurers knew the administration never had their best interests at heart but got in bed with it anyway.
Articulating my sympathy for the insurance companies is difficult without the accompaniment of the world's smallest violin. But, still, I have to wonder, do those running these firms have no backbone whatsoever? I understand that the insurance companies have been consolidating into de facto utilities for decades. But they at least once mustered some passion for defending their status as private enterprises. Sure, they have obligations to shareholders, but their obligations do not end there. Can't one of them resign on principle and speak up? Or are their mouths so stuffed with gold that they couldn't get the words out even if they tried?