Democrats Seek To Revoke Health Care Anti-Trust Exemption Laws

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Nancy Pelosi Heads For A Two-Track Plan For Health Care Reform



With the broader health care bill still perilously close to collapse, House Speaker Nancy Pelosi plans to take a shot at the health insurance industry next week by scheduling a vote on a smaller bill to revoke its half-century-old exemption from anti-trust laws.

The vote is part of her new two-track strategy to tackle things that won’t be included in a more sweeping bill — if Congress ever passes one — while giving her members something politically popular to vote on. The move also puts pressure on Republicans, the industry and wavering Democrats, who wish their leaders would abandon the push altogether.

The bill comes as party brass struggles to find a path forward in the broader health care reform effort and amounts to a concession to her caucus as more sweeping legislation twists in the wind.

The House bill would resemble a section of the House health care bill that ends an exemption for health and medical malpractice insurers and grants the federal government more authority to regulate antitrust laws.

The Senate didn’t include an Anti-Trust provision in its health care legislation because Majority Leader Harry Reid (D-Nev.) couldn’t muster the 60 votes needed to include it.

Also, Nebraska Democratic Sen. Ben Nelson — himself a former state insurance commissioner — opposed the House measure, so the bill would face long odds in the Senate.

But leaving a meeting with Pelosi, Reid said, “We will be happy to look at it.”

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Pelosi’s decision came as both chambers tried to chart a way ahead on health reform using reconciliation, a procedural maneuver that would allow the Senate to pass a “cleanup” bill to the House’s liking with just 51 votes.

Reid said he hopes Democrats can decide by next week on a way to move the health care bill forward.

“We had a discussion and we have a number of options,” Reid said. “We don’t have anything finalized yet.”

In terms of procedure, Reid said the Senate cannot pass a reconciliation bill before the House does because revenue measures must start in the House.

“We can’t go first,” Reid said. “I don’t know how procedurally we can start reconciliation.”

But Reid acknowledged that there is consideration of the House’s passing the reconciliation bill first, followed by the Senate. The House could then pass the comprehensive Senate bill.

“That seems like a strong possibility,” Reid said.

Agreement between the House and Senate on the order of the bills would help ease passage. House Democrats have insisted that they will not pass the Senate bill before changes are made.

But Reid is far from persuading his own caucus to pass the cleanup bill on reconciliation. Reid and Senate Finance Committee Chairman Max Baucus dropped by the regular meeting Tuesday of the Senate centrists — and asked them to withhold judgment on using reconciliation to pass health care reform until they see a package.

“All they said is, ‘Look, reserve expressing an opinion,’” Sen. Evan Bayh (D-Ind.) told reporters. “It seemed pretty reasonable.”

Senate moderates have been among the most vocal skeptics of the procedural maneuver, warning that it would further taint attempts to work across the aisle. POLITICO has identified at least 10 senators who have said they are opposed to reconciliation or have expressed strong reservations. Reid can lose only nine members of the Democratic Caucus and still pass a bill.

“If there is any way to avoid using it, it should be avoided,” Bayh said.

But as Reid tries to figure out whether he has the votes for reconciliation, Pelosi said she is intent on eliminating the antitrust exemption, which critics say has fostered anti-consumer and anti-competitive behavior by health insurance and medical malpractice insurance companies since it was first enacted in 1945.

Under the current antitrust exemption, the onus for regulating insurance industry practices has fallen to the states — which often lack the resources to go after offenders — and creates a patchwork of 50 different state regulatory regimes with inconsistent enforcement, supporters of the bill say.

It’s an appealing target for House Democrats, and it would be hard for Republicans to obstruct without facing charges that they were trying to protect insurance companies.

Apart from the politics of forcing an anti-industry vote, the strategy also serves Pelosi’s purposes, since the antitrust language is not something that would survive in any case if Democrats were to ultimately use Senate “fast-track” reconciliation rules to break the impasse on comprehensive reform.

The speaker has offered this idea in closed-door caucus meetings, after Democrats lost their 60th Senate vote when Republican Scott Brown won in Massachusetts, aides said.

Rules Committee Chairwoman Louise Slaughter (D-N.Y.), a major backer of repealing the antitrust exemption, said Tuesday night, “I’m delighted. ... I don’t know why anybody would think they should be exempt from antitrust.”


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Sources: Politico, MSNBC, CNBC, Meet The Press, Google Maps