News and talk radio was abuzz about recent statements from three of the largest health insurance carriers.  In public announcements designed for maximum exposure, UnitedHealthcare, Aetna, and Humana let it be known that regardless of the future of the Affordable Care Act, they would continue to allow young adults to remain on their parent’s policies until the age of 26.  UnitedHealthcare and Humana also said they would no longer impose lifetime benefit limits on their policies.  So what happened? And why the announcement now, right before an anticipated Supreme Court decision?

There are two general explanations for this change of heart, and neither of them credits the large companies with generosity or altruistic motives.

Hardcore supporters of Obama’s health care reform policies see nothing but a PR conspiracy.  Activist group Health Care for America Now (HCAN) released a near hysterical statement on their web site under the headline of “Don’t be fooled by the big insurance companies”.  It says in part:

“This didn’t happen out of the goodness of the insurers’ hearts. This isn’t about corporations doing the right thing. And it didn’t happen now, just a few weeks before the Supreme Court announces its ruling, by coincidence. This is a PR offensive. The coordinated announcements by three of the five biggest health insurance companies is a cynical tactic…”

The problem with this explanation is that is grounded in ideology rather than reality.  Groups like HCAN don’t believe companies should make any profit at all offering health insurance.  Their agenda will not be fulfilled until health care is free for everyone and administered by the federal government.  So of course they see the motives as sinister and driven by greed.

Others see more reasonable business calculations at play in the announcements.  It is considered more likely than not that the Supreme Court will throw out at least part – if not all – of the Affordable Care Act.  But that doesn’t mean that the need for healthcare reform goes away.  It just means Congress will need to look at different solutions.  If Romney wins the Presidency and Republicans take full control of Congress it is almost certain that a more free market approach to reform will be explored.  The voluntary concessions put forth by the insurance companies happen to touch on many of the most popular aspects of the Affordable Care Act.   So instead of changing their minds the big insurers may be sending a message – this time we want to be seen as part of the solution instead of the problem.