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House passes antitrust and association plan bills

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Members of the U.S. House today passed two major health insurance bills that are not directly related to the Affordable Care Act.

House members voted 416 to 7 for H.R. 372, the Competitive Health Insurance Reform Act of 2017 bill. H.R. 372 purports to repeal the McCarran-Ferguson Act antitrust exemption for health insurers.

All Republicans voted for the bill, and all but seven of the Democrats who voted supported it.

Related: House to vote on antitrust and association plan bills

House members voted 236 to 175 to pass H.R. 1101, the Small Business Health Fairness Act bill. H.R. 1101 would let a multi-state association health plan sell coverage outside its state of domicile, even if the other states objected. The regulators in the state of domicile would regulate the plan.

All Republicans who voted on H.R. 1101 backed that bill.  All but four of the 179 Democrats who voted opposed that bill.

Related: Johnson brings back association health plan bill

H.R. 1101, the association health plan bill, was introduced by Rep. Sam Johnson, R-Texas, who has been working on the issue for years. The House passed similar bills in 2003, 2004 and 2005, but the bills always died in the Senate.

Rep. Robert Scott, D-Va., spoke today against H.R. 1101 on the House floor.

He said he had received letters opposing the bill from groups such as the American Cancer Society, the American Diabetes Association and the National Association of Insurance Commissioners.

The NAIC wrote in its letter that H.R. 1101 would eliminate states’ ability to enforcement their consumer protection and solvency rules, Scott said.

The NAIC wrote that “‘these protections are the very core of the state regulatory system that has served Americans for 150 years,’” Scott said, quoting the NAIC letter.

Rep. Virginia Foxx, R-N.C., chairman of the House Education and the Workforce Committee, rose to speak in favor of the bill. She said the current rules, which make it easy for large employers to get around state insurance regulations, by sponsoring self-insured health plans under Employee Retirement Income Security Act rules, are unfair to employers that are too small to self-insure.

“There’s no reason why they should be at a disadvantage when it comes to finding an affordable health care plan,” Foxx said.

H.R. 372, the health insurance antitrust bill, was introduced by Rep. Paul Gosar, R-Ariz.

The House has passed other health insurance antitrust bills, in 2008, 2010 and 2012. None became law. Drafters of the Patient Protection and Affordable Care Act of 2010, one of the two laws in the Affordable Care Act package, appeared to be on track to include an antitrust provision but cut it out during final negotiations.

Both Democrats and Republicans spoke in favor of H.R. 372.

It’s not clear how much effect the bill could have.

America’s Health Insurance Plans has argued that the current McCarran-Ferguson antitrust exemption covers only activities related to the “business of insurance,” such as sharing experience data for actuarial studies, not to matters such as mergers and acquisitions.

H.R. 372 itself includes exemptions for efforts to collect and analyze loss data, to provide actuarial services, and to develop standard forms and terminology.

The exemption for efforts to develop standard forms would apply only if insurers are not required to use the standard forms.

The exclusions for data collection and actuarial services appear to be similar to exclusions in the antitrust provision that was stripped out of H.R. 3596, the PPACA bill.


McCarran amendment passes House

Health antitrust proposal to reach Senate floor

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