No matter how it tries, Congress can’t seem to let go of healthcare reform.
After year of often acrimonious debate, the House last month approved — and, to great fanfare, President Obama signed into law — the Patient Protection And Affordable Care Act, designed to expand health coverage to 31 million Americans, and provide enhanced protection to those already covered.
The work didn’t end there, as the House and Senate subsequently each had to approve — and in the case of the House, re-approve — a package of reform “fixes” considered under special rules known as reconciliation.
Although Obama signed that reconciliation measure into law days later, the totality of healthcare reform still remains unfinished, at least in the Senate, according to the chamber’s second-highest Democrat.
Still outstanding, says Sen. Dick Durbin of Illinois, is the need for the Senate to pass stand-alone legislation to strip away the exemption to the nation’s antitrust laws that the health insurance industry has enjoyed since World War II.
The House overwhelmingly approved a standalone bill in February to repeal insurers’ antitrust exemption, but the Senate couldn’t include such a provision in the reconciliation bill due to “procedural reasons,” Durbin says, speaking last week at a news conference on healthcare reform held in Normal, Ill.
“For too long, insurance companies have had the freedom to do what they want– often at the expense of their customers,” Durbin says. “That is why it is time to repeal the McCarran-Ferguson antitrust exemption for health insurers. There are only two industries in America that are exempt from federal antitrust laws: major league baseball and the insurance industry. Baseball players aren’t afraid of competition, but the insurance companies sure seem to be.”
That exemption, known as McCarran-Ferguson and which dates to 1945, was intended only to be temporary, according to some lawmakers who support the repeal. That exemption, however, has remained permanent in the decades that followed, and the result has been falling competition among insurers and rising coverage premiums for consumers, Durbin says.
Repeal supporters in the House argued it was appropriate for Congress to repeal the insurers’ antitrust exemption because it created the special treatment in the first place. Not surprisingly, insurance industry lobbyists have argued hard to keep the exemption in place.
But even with the application of such political pressure, scores of Republican lawmakers joined Democrats by approving the repeal in the House on a lopsided 406-19 vote. In the Senate, Sen. Patrick Leahy (D-Vt.), chairman of the Judiciary Committee, has been fighting to repeal the insurers’ exemption since he first introduced a standalone bill to do so last year.
Under the exiting exemption, federal authorities can’t investigate or take action against insurers, even for blatant anti-competitive conduct like price-fixing or market allocation, notes Durbin, a member of Leahy’s judiciary panel.
“We need to let the Justice Department and the Federal Trade Commission use their resources to help keep insurers honest. We need to repeal McCarran-Ferguson in order to ensure a competitive market for health insurance,” he says.
The publisher of the news site On The Hill, Scott Nance has covered Congress and the federal government for more than a decade.