Antitrust exemption bill: first step in new reform strategy?

If Speaker Pelosi has her way, this week the House will take up legislation that would strip health insurance issuers of their exemption from the federal antitrust laws.

Sound familiar? As we discussed last fall, a similar provision was included in the House version (scroll to page 155) of health care reform. The measure, co-sponsored by freshman legislators Tom Perriello (D-VA) and Betsy Markey (D-CO), would strip health insurance issuers, and the issuers of medical malpractice policies, of the protections of the McCarran-Ferguson Act.

Now, one fairly recent GAO study suggests that the exemption has already been narrowed by various court decisions over the years, and many experts doubt that repealing the exemption would either increase coverage or lower health costs in any significant way.

Regardless, observers see two reasons for House Democrats to pursue the measure now. For one thing, it gives the Speaker an opportunity to provide a nice PR boost for two freshman Congressmen reportedly in tough reelection fights.

More importantly, though, it’s a first test of an alternative strategy for getting health reform done: break the larger bills down into smaller pieces. The theory is that, as Rep. Perriello describes it, “a simple, clean bill—no carve-outs or special deals” will be easier to pass.

Maybe so. But the antitrust exemption wasn’t included in the Senate package passed in December—one report suggests that Ben Nelson (D-NE) (to name one) opposed it. So what’s changed to make Senate passage more likely? Will Scott Brown, the newly sworn-in Republican Senator from Massachusetts, be the 60th vote? Really?