Why Aetna Should Pay Reparations
“This is a civil rights bill—this is reparations,” Rush Limbaugh said of the Affordable Care Act back in 2010. As you might expect, he didn’t mean it in a good way. Limbaugh’s ability to condemn the Civil Rights Act and reparations in a single breath is an achievement of insolence. But though Limbaugh can get down with the dirtiest of this country’s democracy-loving dirtbags, that doesn’t mean his views should be dismissed as “fringe.” A large portion of America has more obliquely expressed this same fiercely ideological, race-based fear of the ACA’s promise to serve up genuine health care justice. Study after study of Americans’ attitudes toward health care reform show this much.
Fast-forward to May 2014, when the dialogue about reparations began to sound quite different. Ta-Nehisi Coates, in his blockbuster essay for The Atlantic, “The Case for Reparations,” re-opened and re-shaped the discussion around the possibilities for political and economic reparations for black Americans. “As surely as the creation of the wealth gap required the cooperation of every aspect of the society bridging it will require the same,” Coates wrote.
Still, while progressives may be making ideological strides when it comes to framing the conversation about racial justice (whether or not it ever results in material restitution), conservatives own the health-care-as-reparations narrative, hands down. But they shouldn’t, seeing as how twenty-four states are refusing to expand their Medicaid programs under the ACA, which also happens to provide the loophole. This gap affects an estimated 4.3 million people—mostly in states with Republican-controlled legislatures—and has a disproportionate effect on poor people of color.
Which brings me to my main point: While we should continue pushing to close the holes left open by the massive Medicaid gap, there is another health care-related issue of racial restitution we could address right now. Aetna, the third-largest health insurance supplier in the country, should pay reparations.
Here’s what we know. Aetna was founded in 1853, and according to its own records wrote fewer than a dozen policies to slave owners in the decade or so it was operating before abolition, insuring them against the loss of their slaves. The company claims they first acknowledged this history in a report published in 1956.
Going purely off the information contained in the “history” portion of their website, Aetna would seem like the quintessential American company. Aetna began as a small business but molded itself over the course of a century and a half into America’s largest health insurer (in the mid-1980s). Aetna bonded the construction of the Hoover Dam, the National Archives Building in Washington D.C., several aircraft carriers deployed during World War II, and the restoration of the Statue of Liberty. They provided insurance coverage for the Manhattan Project. America’s original seven astronauts took out life insurance policies with Aetna.
The only bit of quintessentially American history Aetna omits from its informative timeline is the time it spent conspiring with American slave holders. Back in 2000, the issue of Aetna paying reparations was finally raised in earnest, thanks to then-law student and activist Deadria Farmer-Paellmann, who, through her research, discovered that Aetna used to issue insurance policies for the lives of slaves, which would reimburse slave owners when their property died.
Farmer-Paellmann contacted Aetna, requesting more information on the subject from their archives. In an interview with Democracy Now!, Farmer-Paellmann told host Amy Goodman that Aetna had initially appeared cooperative. Aetna sent her copies of two policies, which confirmed that the company was selling the nefarious insurance deals for at least four years (one policy was dated February 1854, the other November 1858). The policies were also taken out in two different cities, New Orleans and St. Louis, suggesting that the business was much more expansive than Aetna had let on.
Initially, Farmer-Paellmann explained, the company had assured her that they would make a formal apology and pay restitutions. Then, a few weeks later, Gwen Houston, the head of diversity at Aetna at the time (now Global Diversity and Inclusion Manager at Microsoft), said to her that “they would make an acknowledgement apology, not an apology per se. And they would enhance scholarships to university and college students, and that would be the form of restitution that they were going to pay.”
Two days after that, they apparently changed their mind again, saying they would publicly apologize, but that there would be no restitution. That was the version of the story that Aetna ultimately stuck to. The same Democracy Now! segment included an interview with Aetna spokesperson Fred Laberge, who claimed, “there’s no evidence that [Aetna] even ever collected the premiums on this or that any of these policies were paid on.” It was a callous response, even for a corporate shill.
Goodman pressed him, asking if Aetna would be willing to open its archives to the scrutiny of scholars and the African American community. Again, Laberge replied with bluster, “You’re—again, you said you wanted to ask me one more question, and you just try to engage me, when I thought what we agreed to was that I would give you our statement.” Laberge also explained the company’s reasoning for backing off the promise of paying reparations, citing the company’s “numerous philanthropic and workplace diversity initiatives,” its “commitment to a diverse workplace in society today,” and “record of diversity and our support of fairness and equality for all people.”
It’s true; the company does make a point to advertise its commitment to diversity. According to the company’s 2010 “Annual Diversity Report,” 31 percent of Aetna employees are people of color, and 15 percent of those in senior leadership positions are people of color. Aetna’s “Corporate Responsibility” report from 2012 declares, “we are diversifying our supplier base, purchasing nearly $184 million in goods and services from small business and certified minority, women and LGBT-owned business enterprises.”
But this isn’t enough. These corporate adjustments are cosmetic, and serve only to protect Aetna’s interests, which include smoothing over a corrupt history. When the smallest increment of change is called “justice,” the systems of power in place will always seem to add up.
At a talk at the Carnegie Council in New York City back in April, Ezekiel Emanuel, a major architect of the ACA, responded to concerns about the persistent Medicaid gaps left open by the act, saying, with respect to the American health care system, “We’re going to be in a stage of reform and modification forever. At least for the rest of our lives.” This is, by all counts, a deeply cynical view of what’s possible.
We as nation apparently can’t redistribute wealth to African Americans, but we can redouble our philanthropic efforts; we can’t have a single-payer healthcare system, but we can rest easy knowing that a growing number of racial minorities work for the health insurance companies that deny them social and economic justice in myriad other ways.
“When we think of white supremacy,” wrote Coates, “we picture COLORED ONLY signs, but we should picture pirate flags.” It’s time we apply this same reimagining of American race relations to our broken and historically corrupt health care system.