WASHINGTON — Democrats and Republicans in the House of Representatives came together Wednesday and overwhelmingly approved a measure removing a 60-plus-year-old federal antitrust exemption for health insurers.
If not exactly a new era, passage of a health reform bill with bipartisan support marked a small victory for Democrats in their effort to find common ground with Republicans heading into today’s health care summit hosted by President Barack Obama.
“I’m proud of my colleagues on both sides of the aisle for standing up for a common sense bill,” said Rep. Betsy Markey, D-Colo., who sponsored the bill. “Long ago, the insurance industry got a special deal from Washington….It’s wrong, and this bill fixes it-once and for all.”
While they continue to press for the comprehensive reform that today’s summit will highlight, Democratic leaders in the House are peeling off smaller measures and moving them to the floor individually.
The hope, say party strategists, is to force Republicans to give up their uniform rejection of Democrats’ health care proposals or face voting against elements that have proven popular with voters. The antitrust bill passed 406-19, garnering 153 GOP votes, including assent from Colorado Republican Mike Coffman of Aurora. Rep. Doug Lam born, a Republican from Colorado Springs, voted against the bill.
But the bill — which makes insurance companies subject to federal laws pertaining to monopolistic behavior — also shows the limits of that strategy.
Even as lawmakers spent most of the afternoon hailing the bill as a major effort in attacking the high cost of health care in America, an array of economists and experts — including the nonpartisan Congressional Budget Office — said the move would have almost no impact on the price of health insurance premiums.
In its analysis of an earlier, similar bill, the CBO noted that states already bar activities that would be prohibited under the new legislation.
“It’s a fairly inadequate remedy in search of the wrong problem, which is called a good day on Capitol Hill,” according to Thomas Miller, a health care expert at the conservative-leaning American Enterprise Institute in Washington.
Obama and Democratic congressional leaders will use today’s health care summit at Blair House to continue to press for more sweeping reform, and they are expected to cite as evidence the recent announcement by Anthem Blue Cross in California that it will raise rates for individual policy holders this year by as much as 39 percent.
And while Republicans have promised to show up to the bipartisan forum, GOP leaders have already skewered the White House’s retooled reform proposal announced Monday.
That means that the path to passing comprehensive reform this year remains complicated, and House Democrats concede it’s possible that only very stripped-down legislation such as Wednesday’s bill will make it to the president’s desk this year.
In making their case for the bill, lawmakers have pointed out the near monopolies enjoyed by health insurance companies in many states. In 39 states, two health insurers control at least half the market, according to evidence presented in recent congressional hearings. In nine states, one insurer controls 75 percent of the market.
“It’s all a basic, simple story that doesn’t comport with the way the exemption works,” said Scott Harrington, a professor of health care management at the Wharton School in Pennsylvania.
Harrington said there is little evidence those monopolies have developed because of illegal practices such as price fixing, bid rigging or collusion in allocating markets that would be forbidden by federal antitrust laws.
Blue Cross Blue Shield of Alabama, which has a market share near 90 percent, was recently singled out in a speech by Obama to illustrate a distorted market. But Harrington, who has studied the company, said it is so successful because it has a low expense ratio and “minuscule” profit margin.
“There is nothing to prevent a health insurer from going into that market now except the solid performance of their competitor,” Harrington said.
David Balto, a fellow at the liberal Center for American Progress, said the lack of clear evidence of illegal practices in many cases results from weak state enforcement.
A recent survey by the center found that a third of states have never brought meaningful antitrust actions under existing authority. The bill has been endorsed by the National Association of Attorneys General, which cited lack of state resources for anti-trust enforcement.
“We don’t know because we haven’t really applied the antitrust laws yet,” Balto said. “The first prerequisite to making markets work is to make sure the competition laws apply and that’s what this legislation does.”
The bill has proven popular in surveys with voters, and many Republicans were already on record approving the idea.
Coffman said he supported the bill, calling it “good in principle,” even though he said it was unlikely to be very effective.
“It is clear this bill will not produce significant change and is hardly the stand against corporations and profiteering Democrats claim it is,” he said.
