Bill Would Apply Antitrust Laws To Insurance
With Congress still at an impasse over how to proceed with a major health overhaul, the House this week will vote on a small piece of the measure instead: a bill to repeal a decades-old insurance industry exemption from antitrust laws.
"For 65 years, the insurance industry has had a unique — well, they and Major League Baseball — but the insurance industry has had an exemption from antitrust legislation in terms of price fixing and collusion, and you name it," said House Speaker Nancy Pelosi.
The bill, to change the 1945 McCarran-Ferguson Act, is highly popular with House Democrats, although less so in the Senate. David Balto, a former policy director at the Federal Trade Commission, now a senior fellow at the liberal Center for American Progress, says repealing the antitrust exemption is a good place for Congress to begin a health overhaul.
"It's a critical first step to making these markets work effectively and the House is right on in focusing on this," says Balto.
Balto says the antitrust exemption has been a "substantial obstacle" to consumer protection and other enforcement efforts aimed at insurance companies at both the state and federal level. "In over a third of the states, including all the states with highly concentrated [insurance] markets, there were zero enforcement actions over the past five years," he says.
Backers of the legislation say they hope that more aggressive enforcement of antitrust laws against health insurance companies can reverse the trend toward consolidation — where just one or two or a handful of companies control the entire market. And that more competition can mean lower premiums.
But other analysts, including both the Congressional Budget Office and the Congressional Research Service, say they doubt that eliminating the antitrust exemption will have much of an impact on competition or premiums.
In fact, says Kevin Bingham of the American Academy of Actuaries, "quite honestly, it would lead to what I believe and what the academy believes would be reduced competition, and potentially higher rates."
Bingham says that's because what the exemption was meant for in the first place was to allow insurance companies to share data about insurance risk. That's important, because without that data, insurance companies could end up setting premiums too low. Then the insurance companies could become insolvent, and unable to pay claims.
Large insurers — the ones Democrats say are taking over the health insurance markets — probably wouldn't even be affected by the repeal, says Bingham, because they collect data themselves.
But the effect could actually be negative on smaller or start-up companies, he says, "and without that ability to look at that industry data and kind of looking at cost estimates, it might push them away from getting involved at all." And if small companies stay on the sidelines, competition could actually be reduced.
Meanwhile, House and Senate leaders and President Obama are still working to see if they can figure out how to clear a path for their bigger bill.
In New Hampshire last week, the president continued to make his case to finish the job this year, if only for the people with insurance problems whose letters he reads every night. "I will not walk away from those people, and Congress shouldn't either. We should keep working to get it done; Democrats and Republicans together. Let's get it done this year," he said.
But about the only concrete comment on the subject came from House Majority Leader Steny Hoyer, who, when reminded that he promised to announce a way forward on the health bill by the end of last week, replied, "Did I say that? Then I was in error."
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STEVE INSKEEP, host:
As recently as last month, health care was job number one for Congress. Now, we're told, jobs are job number one, but the health-care overhaul is not quite dead. On Sunday, President Obama announced that he is inviting lawmakers from both parties to a bipartisan health-care conference at the White House. It'll happen on February 25th. The president and his allies are still struggling to figure out how to resurrect their health plan. NPR's Julie Rovner reports.
JULIE ROVNER: To listen to President Obama, all Congress needs to get its health bill back on track is a little push. Here he was last Monday, in a town hall meeting broadcast on YouTube.
President BARACK OBAMA: It is my greatest hope that we can get this done - not just a year from now, but soon.
ROVNER: On Tuesday in New Hampshire, the president talked about the people who'd be hurt if Congress doesn't act soon.
Pres. OBAMA: I will not walk away from these people and Congress shouldn't, either. We should keep working to get it done. Democrats and Republicans together, let's get it done this year.
ROVNER: And on Wednesday, he took the message right to the source: a meeting of Senate Democrats themselves.
Pres. OBAMA: We've got to finish the job on health care.
ROVNER: But several private meetings last week with House and Senate leaders failed to break the impasse over how to proceed with the health effort now that the Senate has lost its 60-seat majority and with it, the ability to thwart Republican filibusters on the bill. About the most clarity reporters could get was this, from House Majority Leader Steny Hoyer.
Representative STENY HOYER (Democrat, Maryland): I anticipate making a decision just as soon as the way forward is clear.
(Soundbite of laughter)
Unidentified Man: Last week, you did say it would be this week. Last week, you said by the end of this week, you would make that decision.
Rep. HOYER: Did I say that?
Unidentified Man: Yes, sir.
Rep. HOYER: I was in error.
(Soundbite of laughter)
ROVNER: But while leaders try to figure out how to move forward on their large-scale bill, the House has made one decision. This week, it will vote on one small piece of the overhaul effort that's very popular with House Democrats. The bill would repeal a decades-old exemption from antitrust laws enjoyed by the insurance industry. Democrats say that would increase competition and lower premiums. House Speaker Nancy Pelosi announced the decision at her weekly meeting with reporters last Thursday.
Representative NANCY PELOSI (Democrat, California; Speaker of the House): For 65 years, the insurance industry has had a unique - well, they and Major League Baseball - but the insurance industry has had an exemption from antitrust legislation in terms of price fixing and collusion, and you name it.
ROVNER: David Balto, a former official at the Federal Trade Commission, says repealing the insurance industry's antitrust exemption is a good place to begin a health system overhaul.
Mr. DAVID BALTO (Former Official, Federal Trade Commission): The House is taking absolutely the right first step by eliminating the McCarran-Ferguson exemption, and allowing the lodestar of competition to provide guidance in health insurance markets.
ROVNER: McCarran-Ferguson is the name of the 1940s law that provided the exemption in the first place. But there's far from universal agreement that repealing the anti-trust exemption will have the effect its backers are hoping for. In fact, says Kevin Bingham of the American Academy of Actuaries:
Mr. KEVIN BINGHAM (American Academy of Actuaries): Quite honestly, it would lead to what I believe, and the academy believes, would be reduced competition and potentially higher rates.
ROVNER: That's because what the exemption was meant for in the first place was to allow insurance companies to share data about insurance risk. That's important, says Bingham, because without that data, insurance companies could end up setting premiums too low. Then, the insurance companies could become insolvent and unable to pay claims.
Large insurers - the ones Democrats say are taking over the health insurance markets - probably wouldn't even be affected by the repeal, says Bingham, because they have enough of their own data.
But the effect could actually be negative on smaller or start-up companies.
Mr. BINGHAM: Without that ability to look at that industry data and kind of come up with cost estimates, it may kind of push them away from getting involved at all.
ROVNER: And if small companies stay on the sidelines, competition could actually be reduced. And it's not just the actuaries who say that. The Congressional Research Service and the Congressional Budget Office both say repealing the anti-trust exemption would have little or no effect on health insurance premiums. The House vote is expected later this week. The Senate, however, has no plans to follow suit.
Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright National Public Radio.
