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Congress bashes private insurers’ antitrust exemption

December 23, 2020

Topics: Quote of the Day

By Allison Bell
ThinkAdvisor, December 22, 2020

Members of the U.S. Senate approved H.R. 1418, a bill that would repeal a partial antitrust exemption for health insurers, and for dental insurers, by a voice vote Tuesday.

The House approved an identical version of the “Competitive Health Insurance Reform Act of 2020″ bill by a voice vote Sept. 21.

Congress is now sending the bill to the desk of President Donald Trump.

H.R. 1418 would change part of the McCarran-Ferguson Act of 1945, a law that establishes the framework for how the federal government shares oversight of insurance with state insurance regulators. One section exempts insurers from federal antitrust oversight under the Sherman Act.

H.R. 1418 would add a section that states that, “Nothing contained in this act shall modify, impair, or supersede the operation of any of the antitrust laws with respect to the business of health insurance (including the business of dental insurance and limited-scope dental benefits).”

Sen. Patrick Leahy, D-Vt., introduced the bill in the Senate together with Sen. Matt Daines, R-Mont. Reps. Peter DeFazio, D-Ore., and Paul Gosar, R-Ariz., introduced the bill in the House.

Health insurers, the National Association of Insurance Commissioners and the National Council of Insurance Legislators have been defending health insurers’ exemption from federal antitrust regulation for decades.

Matt Eyles, president of America’s Health Insurance Plans (AHIP), said in a statement about passage of H.R. 1418 that implementation of the bill would add layers of bureaucracy to health insurers and destabilize markets.

“Removal of this exemption adds tremendous administrative costs while delivering absolutely no value for patients and consumers,” Eyles said.

Consumer Reports put out a commentary welcoming passage of H.R. 1418.

“The antitrust exemption has essentially allowed health insurers to act as a monopoly, making demands in lockstep on the terms they will offer consumers and health care providers,” the advocacy organization said in a comment on bill passage. “The resulting squeeze puts pressure on providers to cut corners on service in order to increase the profits the health insurers can extract.”


H.R. 1418 – Competitive Health Insurance Reform Act of 2020:


By Don McCanne, M.D.

This little discussed measure passed the Senate by unanimous consent in the wee hours of the morning of December 22 and has been forwarded to President Trump for his signature. It may have historical significance.

In the 1940s, when health insurance was rapidly expanding as an employee benefit, Congress temporarily exempted health insurers from the federal McCarran-Ferguson antitrust laws, except that temporary exemption was never reversed. Efforts to do so have not met with success likely due to Congress’ very cozy relationship with the private insurance industry (check campaign donations for confirmation).

AHIP’s Matt Eyles, who represents the industry that has been responsible for hundreds of billions of dollars in their own administrative waste plus the administrative burden they have placed on the health care delivery system, seems to have suddenly become enlightened to the fact that administrative costs deliver “absolutely no value for patients and consumers.” He said that implementation of this bill would add layers of bureaucracy to health insurers and destabilize markets.

But there is a reason for antitrust laws and that is to prevent abusive monopolistic practices – practices that help explain why health insurance premiums are so high when their innovative products are designed to impair access to health care (high deductibles, narrow networks, benefit exclusions, etc.). The COVID pandemic is demonstrating how well the monopolies are working for the insurance industry considering their record profits while patients are being deprived of health care that they need.

Let’s hope that this bipartisan unanimous consent action in the wee hours of the morning represents the future relationship between the private insurers and Congress. Now that Congress acknowledges the industry for what it is, maybe they will be ready to take the next step. Throw out the private insurers and enact and implement our own single payer improved Medicare for All.

If nothing else, those supporting state efforts for single payer should jump at this opportunity to work with Congress to free up federal barriers to state single payer legislation. It seems like members of Congress may be ready to show the private insurers the door.

Hopefully this is a new day for health care justice in America.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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