Bipartisanship is so rare on Capitol Hill these days, especially in regard to health care, that when such comity breaks out, it’s worth reporting.

Around the time the House of Representatives was voting for the 30-somethingth time to repeal Obamacare, two lawmakers from Texas — Democrat Gene Green and Republican Joe Barton — introduced legislation to fix a problem that most folks with private insurance know nothing about. That’s because it only affects the poorest among us who are eligible for Medicaid.

The problem is referred to by policy wonks as “churn.” Because of the way Medicaid is administered by the states, millions of Americans enrolled in the program lose coverage temporarily every year because of often minor fluctuations in their income or even a change of address. Many are removed from the rolls simply because they can’t take time off from work to go to a Medicaid office to re-verify their incomes every three months, which some states require.

It’s called churn because most people who are “disenrolled” — to use insurance industry jargon — are eventually reinstated. Their eligibility for Medicaid never changed. They lost coverage solely because of paperwork requirements or a slight and fleeting bump in pay because of having to work overtime during a given week.

This is unknown in the private insurance world because once you enroll in a health plan, you can stay enrolled in that plan for a year, so long as you keep paying the premiums on time. It doesn’t matter if you move from one street to another or work an extra shift to make a few extra bucks.

Presidents often live to regret some of the words speechwriters put in their mouths. The first President Bush paid a steep price for his ill-advised “Read my lips. No new taxes!” promise in 1988. He lost his bid for a second term.

No doubt President Obama regrets saying, with equal bravado: “If you like your health care plan, you will be able to keep your health care plan.”

That was just plain stupid. For starters, he and his speechwriter either didn’t understand or chose to ignore this reality: for most Americans, whether or not they keep an existing health plan is not up to them or the government. Insurance companies and our employers are the ones making those decisions.

Like most Americans, Obama probably had never heard of terms like “benefit buy-down” and “full replacement.” Insurance company executives use them frequently, but almost never to anyone other than their corporate customers and Wall Street financial analysts.

If the employer-sponsored health plan you have today has fewer benefits or requires you to spend more of your own money for medical care than the plan you had last year — the one you liked but can’t keep — you have been the victim of benefit buy-down, a practice employers have been using for years to limit their share of the cost of providing coverage to workers.

And if you were in an HMO or PPO but found out during open enrollment that your employer has eliminated those options in favor of a high-deductible plan, you have become a victim of full replacement. The health plans you liked were fully replaced by a plan enabling your employer to shift more of the cost of care to you.

There is an age-old tradition in this country: if you don't like a law and can't get rid of it, look for a loophole.

That's what some companies that don't want to comply with an important Obamacare requirement have done, and it appears they've hit pay dirt.

The provision of the law mandating that all new insurance policies must cover certain "essential" benefits will take effect January 1, 2014. From that date forward, all polices offered on the online insurance marketplaces in every state must cover ten categories of benefits that range from prescription drugs and lab services to hospitalization and maternity and newborn care.

 The sponsors of the law hoped the provision was among those that would all but eliminate the need for Americans to file for bankruptcy because of medical debt.

The United States is alone among developed countries in having medical debt as the leading cause of bankruptcies, even among people who have health insurance. That's because a lot of the policies being sold today have such limited benefits, high deductibles and annual and lifetime coverage limits that many people realize after a serious illness or injury that their policies provide little help in paying medical bills.

"No longer will American families be a car accident or heart attack away from bankruptcy," said Senate Majority Leader Harry Reid in response to the Supreme Court's decision last June upholding the constitutionality of the law.

But as reported by the Wall Street Journal last week, corporate loophole hunters have invalidated Reid's statement, which honestly was an overstatement even then. While Obamacare will make affordable coverage available to millions of Americans for the first time, several million others — primarily low and middle-income workers — will still be left out.

I was not among those who believed the Supreme Court’s Citizens United decision would open the floodgates of corporate money to influence elections and public policy. While the decision enables corporations to call for the election or defeat of federal candidates, those expenditures have to be reported and few corporations will take the risk of losing customers by getting involved in politics so publicly.

The reality is, the floodgates have been open for years, and the attention focused on Citizens United has actually been helpful to corporations, because it has diverted the public’s attention away from the deceptive yet perfectly legal ways corporations are able to deploy enormous sums of money to advance their political agendas.

The mainstream media, meanwhile, seems to willfully ignore what corporations and other moneyed interests do to get what they want in Washington. That was certainly the case last week after National Journal reporter Chris Frates disclosed how America’s Health Insurance Plans, the insurance industry biggest PR and lobbying group, funneled hundreds of thousands of dollars to a longtime ally with a better reputation to pay for an industry-serving communications campaign. The only media outlets I could find that picked up the story were The Huffington Post, Bloomberg Businessweek and ABC News online.

As Frates’ investigation uncovered, AHIP in 2011 gave the National Federation of Independent Business $850,000 to finance an effort to persuade Congress to repeal a provision of Obamacare that will actually help many uninsured people afford coverage. NFIB is a nonprofit that calls itself the voice of small business but which I know from my days in the insurance industry has often been a voice for my former bosses.

The House of Representatives is expected to vote for the 40^th time this week to repeal ObamaCare, not because anyone believes the 40^th time will be the charm, but because the exercise will enable Republican freshmen to vote for repeal and brag about it during their campaigns next year.

Those lawmakers probably won’t tell their constituents that two of the most important provisions of the law they profess to hate were actually Republican ideas the Democrats embraced in hopes of getting bipartisan support for reform. The first such provision is the requirement that all Americans not covered by a public plan like Medicare or Medicaid must buy coverage from a private insurance company. The second provision: establishment of state health insurance marketplaces (called exchanges in the law) where private insurers compete online for customers.

One of the first states to set up such a marketplace was Utah, among the reddest of states, which had its exchange up and running months before ObamaCare was enacted. Starting this fall, Americans everywhere will be able to shop in Utah-like marketplaces for coverage effective January 1, the date the GOP-inspired requirement to have health insurance kicks in.

The reason Republicans once liked health insurance exchanges is that in theory they will facilitate choice and competition, which should bring down the cost of coverage. If the exchanges work as planned — and as ObamaCare stipulates — consumers will be able to make apples to apples comparisons among health plans and pick the one that seems to offer the best value.

Based on news out of Oregon last week, there is reason to believe that the theory is holding up and that consumers will indeed benefit from price transparency that until now had never been available to the layman.  

Will the implementation of some of the most important provisions of ObamaCare this fall and next year result in the “train wreck” Senate Finance Chairman Max Baucus (D-Mont.) predicted a few days ago?

No. But you can be certain that there will be no shortage of political candidates and high-powered political spin doctors who will be working relentlessly between now and the 2014 midterms to convince us that it will be.

ObamaCare — even though it already has reduced the number of uninsured Americans by several million and has limited price gouging by insurance companies — represents the best hope that many Republicans will have of maintaining or boosting their majority in the House and possibly retaking the Senate.

Think about it. The economy seems to be on the right track. Just last week the stock market reached record highs and the jobless rate fell to its lowest point in four years. The war in Iraq is over and most American troops are scheduled to be out of Afghanistan by the end of next year. The GOP appears to have lost the advantage to Democrats on gun control and immigration, and abortion and gay rights are no longer the reliable campaign wedge issues they once were.

That leaves ObamaCare and “big government spending” as just about the only issues that remain for right-leaning candidates, barring any unforeseen domestic or global calamity. But if their campaigns against ObamaCare next year are as successful as their campaigns against it were in the 2010 midterms — and the White House and supporters of the law are once again asleep at the switch — GOP candidates might not need anything else to talk about to take both houses of Congress.

If you have private health insurance, it’s almost certain that a portion of the premiums you pay every month is used to support political agendas that are not in your best interests. But good luck finding out how much of that premium money your insurance company spends to influence public opinion and public policy.

While all companies are required to report their federal lobbying and Political Action Committee expenditures, that money is just a fraction of what they often spend in the political arena to protect their profits. Millions more — probably billions more — are spent secretly every year by corporations and their trade associations to shape policy discussions and actions. Corporate America is determined to preserve that secrecy.

Among my responsibilities when I worked at Cigna was the administration of the company’s PAC. The money we doled out to state and federal candidates every year was not huge, but a lot of thought went into determining who got checks. The lion’s share each year would usually go to Republican candidates, but influential Democrats also benefited. In 2012, Cigna’s PAC reported contributing a total of $213,000 to 73 Republicans and 41 Democrats.

That’s pocket change compared to the $3.09 million Cigna says it spent lobbying lawmakers last year in both Washington and state capitals. And it’s also a fraction of what CIGNA probably spent through its trade associations and other groups to influence how you think about health care policy issues and how lawmakers vote on them. 

We don’t know how big the total is because there are no laws or regulations requiring corporations to report those expenditures. But there is a growing movement among shareholder groups to force companies to disclose this kind of spending because it may dwarf what they invest in lobbying and direct contributions to candidates.

When you’re shopping for health insurance, wouldn’t it be great if you could find out every insurer’s claim denial rate? And how much each one spent on lobbying and advertising — and how much they paid their CEO?

You can now find all of that information and more if you live in Vermont, thanks to a law that was enacted last year at the urging of the Vermont Public Interest Research Group.

In compliance with that law, the insurers that do business in Vermont have just disclosed data they’ve been able to keep secret for years. And that information should come in handy when Vermonters begin shopping for coverage at the state’s online health insurance exchange in October.

With just 626,000 residents, Vermont is the second smallest state in terms of population (only Wyoming has fewer people), and it has only three major health insurers — Blue Cross Blue Shield of Vermont, MVP Health Care and Cigna, the company I used to work for.

Blue Cross Blue Shield of Vermont is by far the biggest and the only one based in the Green Mountain State. MVP is headquartered in New York, and Cigna, the for-profit company among the three, is based in Connecticut. 

Which of the trio do you think denied the most claims on a percentage basis in 2012?

If you guessed the for-profit company, as I did, you would be right. But even I was shocked to see how Cigna compared with its competitors, especially Blue Cross.

Of all the claims submitted to it last year by health care providers and policyholders, Blue Cross denied 7.6 percent. Cigna denied 21 percent. MVP was in the middle at 15.5 percent.

Among insurance executives, Aetna CEO Mark Bertolini has been among the most vocal in warning of “premium rate shock” when major provisions of Obamacare kick in on January 1.  

"We've done all the math, we've shared it with all the regulators, we've shared it with all the people in Washington that need to see it, and I think it's a big concern," Bertolini told his company’s big shareholders and Wall Street financial analysts in New York last December.

If Aetna does, in fact, hike premiums by more than 100 percent for some of its customers, as Bertolini suggested at the meeting, no doubt part of that money will go to covering his shockingly lucrative paycheck.

While many Aetna employees were lucky to get two percent raises last year, Bertolini’s compensation nearly quadrupled. That’s right, quadrupled.

Aetna disclosed in a filings last week with the U.S. Securities and Exchange Commission that Bertolini’s total compensation in 2012 was $36.36 million, up from $9.7 million in 2011. If you include the $11.1 million in stock awards he was given that will vest later, his 2012 total jumps $47 million.

Bertolini’s “pay shock” so angered many current and former Aetna workers that several of them posted scathing comments on the Hartford Courant’s website.

“All Aetna employees should be picketing outside the office building in protest of this disgrace,” a former Aetna employee wrote. “What kind of leader gives his employees 2% while his earnings nearly quadruple???? Totally selfish.”

One of the reasons Bertolini mentioned “premium rate shock” to his company’s investors undoubtedly is that Aetna won’t be able to continue selling some of its most profitable health plans next year—the ones that have relatively low premiums but such limited benefits that they’ll actually be banned next year.