There is growing bipartisan support for repealing the McCarran-Ferguson Act's antitrust exemption for health insurers as a way to help control health care costs, a healthcare analyst and lawyer said today.
House support for the Senate legislation is the key to the near-term fate of health care reform legislation, said William Oldaker, a founding partner of the Oldaker Group L.L.C., Washington.
Oldaker made his comments in a conference call discussing possible next steps if repeal of McCarran-Ferguson collapses.
Stakeholders are looking for President Obama's State of the Union address Wednesday for further signs on what the president will do on healthcare 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, Oldaker said.
At the same time, if bill doesn't go through in some form, "it will be viewed as a major, major defeat for the Democrats," he said.
Sen. Tom Harkin, D-Iowa, chairman of the Health, Education, Labor and Pension Committee, has already said if the measure fails, he will seek to take up the bill in pieces, Oldaker noted. There seems to be some bipartisan support for ending McCarran-Ferguson for health insurers, even in a narrowed-down bill that would be handled by Harkin, he said.
Oldaker said he was surprised by a proposal by some in Congress to accept the Senate version of the legislation, which calls for cuts in the Medicare Advantage program to finance the broad bill through competitive bidding for Medicare Advantage.
Speaker of the House Rep. Nancy Pelosi, D-Calif., said she doesn't have the votes to pass the Senate measure in the house and that members of her caucus are demanding major changes in the Senate bill before they would vote for it.
The House bill proposes that over a 3-year period, MA expenditures would be the same as for the Medicare fee-for-service program.
Oldaker said that one proposal that had been under consideration is for competitive bidding in states with large populations, while another system would fund MA in rural states.
"It is unclear how that will work out," he said.
He said strong support remains for the bill among members of the Pharmaceutical Research and Manufacturers of America, the American Medical Association, the AARP and hospitals, especially because the bill would add millions of subscribers to the private insurance rolls through subsidies and mandates.
Lynn Shapiro Snyder, a senior member of Epstein Becker & Green P.C. , Washington, who was also on Argyle conference call, said the current version of the legislation gave limited instructions about congressional intent. That would give a lot of leeway for federal regulators to write rules implementing it.
"The fewer words, the better because it gives stakeholders a stronger opportunity to shape the way the legislation is implemented," Snyder said.
In other developments, a new Kaiser Family Foundation poll released today found that Americans are divided over congressional health reform proposals but also that large percentages of people, including skeptics, become more supportive after being told about many of the major provisions in the bills.
The foundation's January Kaiser Health Tracking Poll, conducted before the Massachusetts Senate election, found opinion divided on the hotly debated legislation, with 42% supporting the proposals in the Congress, 41% opposing them and 16% withholding judgment.
"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 said.
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