WASHINGTON BUREAU — The House could hold a vote on H.R. 2, the Repeal the Job Killing Health Care Law Act bill, as early as next week, and the National Association of Health Underwriters is reminding lawmakers of producers' strong support for the repeal bill.
House leaders originally had planned to hold a vote on the repeal bill today. They postponed the vote in the wake of the Jan. 8 attack on Rep. Gabrielle Giffords, D-Ariz., and others attending a Giffords' constituent meeting in Tucson, Ariz.
Alex Vachon, a health care analyst and former Senate Republican staffer, says shootings may cause the rhetoric during debate on the bill to be "modestly muted" but will make no material difference in terms of the substance of the debate.
Vachon expects the H.R. 2 vote to take place soon.
In related news, NAHU, Arlington, Va., has sent a letter to House Speaker John Boehner, R-Ohio, and House Majority Leader Eric Cantor, R-Va., asking lawmakers to replace the Patient Protection and Affordable Care Act (PPACA) with "more meaningful and sustainable healthcare reform initiatives."
NAHU objects to what it believes to be a lack of meaningful cost controls in PPACA, the PPACA minimum medical loss ratio (MLR) requirements, and the PPACA health insurance exchange 
provisions, NAHU Chief Executive Janet Trautwein writes in the letter.
The PPACA MLR provision, which starts to take effect this year, will require plans to spend 85% of large group premiums and 80% of individual and small group premiums on health care and quality improvement efforts, or else send rebates to customers.
The MLR provision affects "more than 100,000 health insurance agents, brokers and employee benefit specialists nationally involved on a daily basis in the sale and service of health insurance," Trautwein says. "MLR provisions and ensuing regulations fail to accommodate the vital role of professional agents and brokers, by classifying their services and compensation as typical 'administrative'
expenses to be ratcheted down."
Congress should repeal the MLR provision, or at least remove agent and broker compensation from MLR calculations, Trautwein says.
"Doing so would help preserve existing cost-saving practices in current health insurance markets, advance the intent of the MLR provision to reduce overall spending on administrative costs, and maintain an important operation for small businesses and individuals," Trautwein says.
Trautwein also expresses concerns about the PPACA health insurance exchange system, which is supposed to start distributing subsidized individual and small group health coverage starting in 2014.
The exchange mechanism offers "perverse incentives for employers to drop coverage," by allowing them to "essentially dump their workers into subsidized health insurance exchanges," Trautwein says. "We already hear from our members anecdotal evidence from many employers that they are thinking in this direction, because the employer 'penalty' for not offering mandated coverage is significantly less than the cost of offering the mandated benefits package."
The MLR issue is starting to get more attention outside the insurance community. R. Bruce Josten, a lobbyist for the U.S. Chamber of Commerce, Washington, told reporters Tuesday that the chamber wants the MLR provision revised.
Some states are home to insurance companies with plans that will never meet the PPACA MLR minimums, Josten said.
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