Support Growing For Repeal Of Health Care Antitrust Exemption

NU Online News Service, Jan. 22, 2:00 p.m. EST

WASHINGTON–A health care analyst and lawyer said today there is growing bipartisan support for repealing the McCarran-Ferguson Act's antitrust exemption for health insurers as a means of helping control health care costs.

In a conference call with interested parties, William Oldaker, a founding partner of The Oldaker Group LLC, Washington, D.C. also said House support for the Senate legislation is the key to the near-term fate of health care reform legislation.

Currently, Speaker of the House Rep. Nancy Pelosi, D-Calif., said she doesn't have the votes to pass the Senate, and that members of her caucus are demanding major changes in the Senate bill before they would vote for it.

Mr. Oldaker made his comments in a conference call sponsored by the Argyle Executive Forum.

He also said stakeholders are looking for President Obama's State of the Union address Wednesday for further signs on what the president will do on health care reform in the wake of the loss of the Democrat's filibuster-proof majority in Congress through the election of a Republican to the Senate from Massachusetts.

At the same time, he said, if bill doesn't go through in some form, "it will be viewed as a major, major defeat for Democrats and a tremendous blow to Congress."

Mr. Oldaker made his comments about McCarran-Ferguson in the context of next-steps if the bill collapses.

If that is the case, he noted, then Sen. Tom Harkin, D-Iowa, chairman of the Health, Education, Labor and Pension Committee, has already said he will seek to take up the bill in pieces.

There seems to be some bipartisan support for ending the McCarran-Ferguson exemption for health insurers, even in a narrowed-down bill," that will be handled by Sen. Harkin, Mr. Oldaker said.

Regarding Medicare Advantage (MA), Mr. Oldaker said he was surprised that the last proposal was to accept the Senate version of the legislation, which calls for cuts in the program to finance the broad bill through competitive bidding of MA.

The House bill proposes that over a three-year period MA expenditures would be the same as for the Medicare fee-for-service program.

He said that one proposal that had been under consideration is for competitive bidding in states with large populations, and another system for funding MA in rural states. "It is unclear how that will work out," he said.

Mr. Oldaker added that strong support for the bill remains amongst members of the Pharmaceutical Research and Manufacturers of America, the American Medical Association, the AARP and hospitals, especially because the bill will add tens of millions of subscribers to the private insurance rolls through subsidies and mandates.

At the same time, Lynn Shapiro
Snyder, a senior member of Epstein Becker & Green, P.C., Washington, D.C. who was also on the Argyle conference call, said one positive about the bill is that there is limited instructions about congressional intent in the current version of the legislation, which will give a lot of leeway for federal regulators to write rules implementing it.

That means, Ms. Snyder said, "there is no congressional history. The less words the better, because it gives stakeholders a stronger opportunity to shape the way the legislation is implemented."

In other developments, a new Kaiser Family Foundation poll released today finds that Americans are divided over congressional health reform proposals, but also that large shares of people, including skeptics, become more supportive after being told about many of the major provisions in the bills.

The group said that the January Kaiser Health Tracking Poll, conducted before the Massachusetts Senate vote, finds opinion divided when it comes to the hotly debated legislation, with 42 percent supporting the proposals in the Congress, 41 percent opposing them and 16 percent withholding judgment.

"However, a different and more positive picture emerged when we examined the public's awareness of, and reactions to, major provisions included in the bills," the Foundation said.

"Majorities reported feeling more favorable toward the proposed legislation after learning about many of the key elements, with the notable exceptions of the individual mandate and the overall price tag," Kaiser Foundation officials said.