Dems Aim To Strip Insurance Industry Of Anti-Trust Exemption

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DAVID ESPO | 10/21/09 09:34 PM | AP

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WASHINGTON — Democrats launched a drive at both ends of the Capitol on Wednesday to strip the insurance industry of its decades-old exemption from federal antitrust laws, part of an increasingly bare-knuckled struggle over landmark health care legislation sought by President Barack Obama.

If enacted, the change would put an end to "price-fixing, bid-rigging and market allocation in the health and medical malpractice" insurance areas, said Sen. Patrick Leahy, D-Vt., chairman of the Senate Judiciary Committee. Leahy said he would seek a vote on the plan when the Senate debates health care legislation in the next few weeks.

Leahy made his comments at virtually the same time the House Judiciary Committee voted 20-9 to end an industry exemption that dates to 1945. Three Republicans supported the move.

Senior Democratic officials in the House said the leadership was inclined to incorporate the measure into the broader health care bill expected to be brought to the floor for a vote within a few weeks. No final decision has been made, they added.

In response, an industry official said Democrats were targeting a problem that does not exist.

The events coincided with a vote in the Senate to sidetrack legislation averting a 21 percent cut in Medicare payments for doctors in January and raising their fees by $247 billion over a decade. The 47-53 vote was 13 short of the 60 needed to advance the bill, reflecting concerns that the measure would have raised deficits. The result was a defeat for Democrats and an embarrassment for the American Medical Association, which had mounted a seven-figure advertising effort to assure passage of one of its top priorities.

Republicans grumbled that Senate Democrats timed the offensive on antitrust matters to obscure their defeat on the bill setting pay rates for doctors, a measure that GOP leader Mitch McConnell, R-Ky., called "the Senate's first vote on health care this year."

Even so, taken together, the threats to revoke long-standing antitrust protections reflect the fury Democrats have projected in response to recent insurance industry attempts to influence the shape of legislation. The events occurred less than a week after the insurers' trade association issued a report saying a measure in the Senate Finance Committee would produce sharp increases in premiums for millions of people who currently have insurance.

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Democrats and the White House reacted angrily, attacking the study as flawed and politically motivated.

Responding to the day's developments, the industry said the legislation was based on a misperception of existing law. "We believe that health insurers have not been engaging in anticompetitive conduct and that McCarran-Ferguson does not provide a shield for such conduct," Karen Ignagni, president and CEO of American's Health Insurance Plans, wrote to Rep. John Conyers, the Michigan Democrat who chairs the Houses Judiciary Committee.

"Thus, the bills attempt to remedy a problem that does not exist," she wrote.

The McCarran-Ferguson Act of 1945 gives states authority to regulate the insurance industry for antitrust matters, and the companies are exempt from federal jurisdiction.

To buttress its case, industry officials circulated a paper from JPMorgan, the investment bank. "Ultimately, just using the terms antitrust and health insurers in the same sentence makes a great headline, but in practice given the narrow scope of the act, we doubt a repeal has meaningful implications for the publicly traded companies," it said.

The industry holds a large conference beginning on Thursday several blocks from the Capitol.

The White House had no reaction. Instead, aides pointed to Obama's statement last weekend that insurers are earning "profits and bonuses while enjoying a privileged exception from our antitrust laws, a matter that Congress is rightfully reviewing."

The developments came as Democrats struggled in both houses of Congress to enact Obama's call for legislation to expand health care to millions who lack insurance, provide greater consumer protections to millions more, and rein in the cost of medical care in general.

In the Senate, Reid, key committee chairmen and White House aides are at work crafting legislation the Senate can vote on later this fall.

The House is also on track for a vote this fall, although weeks of private negotiations among Democrats have yet to produce agreement on a bill.

Among the most controversial unresolved issues concerns proposals for the government to sell insurance in competition with private companies. The House bill is certain to include such a provision. Although the rank and file have yet to come to an agreement on key details, officials said the leadership was counting carefully to see if it had the votes to establish a system that would pay doctors 5 percent more than they receive for treating Medicare patients. Hospitals and other providers would be paid at Medicare rates, without the additional 5 percent, they said.

It is unclear what type of so-called "public option" will be incorporated into the Senate measure, where Democratic moderates are wary of the idea, even though public polling consistently shows its popularity.

Until recently, the insurance industry has played a noncommittal role as legislative proposals developed in both houses of Congress. AHIP announced months ago it supported comprehensive health care reform and Obama called on Ignagni to speak at a televised White House event designed to showcase widespread agreement that the time had come to change the current system.

Essentially, industry offered a trade. It agreed to abandon practices such as denying coverage on the basis of pre-existing medical conditions if the legislation required nearly universal coverage, a step that would give it access to millions of new customers. At the same time, it vigorously opposes any legislation that would allow the government to sell insurance.

The tone began to change when the Finance Committee voted to excuse an estimated two million lower income Americans from a requirement to purchase insurance, at the same time it greatly reduced the penalties for those who were still covered, but refused to buy coverage.

___

Associated Press writer Erica Werner contributed to this report.

WASHINGTON — Democrats launched a drive at both ends of the Capitol on Wednesday to strip the insurance industry of its decades-old exemption from federal antitrust laws, part of an increasingly...
WASHINGTON — Democrats launched a drive at both ends of the Capitol on Wednesday to strip the insurance industry of its decades-old exemption from federal antitrust laws, part of an increasingly...
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- ReedYoung I'm a Fan of ReedYoung 139 fans permalink
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So, what we REALLY need is a general public option, plus a triggered "Deluxe" public option for states in which health "insurance" corporations have gotten away with the most, where enforcing antitrust law is likely to disrupt the market the most, probably to patients' detriment if past is prologue.

    Reply    Favorite    Flag as abusive Posted 11:15 AM on 10/23/2009

The only Americans who support Obamacare (in all its manipulating forms) are his accomplices and those who have been dumbed down by a substandard and politicized education as per the warnings of Soviet defector Yuri Bezmenov.

In 1985, Bezmenov told us that our enemies were working hard at brainwashing us (dumbing us down) and would succeed if we did not defend our principles: http://www.dailymotion.com/video/k6KUDv1wzraWhwlBt1

The dumbed down are obviously unable to understand that Obamacare will further contribute to “the American descent into Marxism,” which “is happening with breath taking speed, against the back drop of a passive, hapless sheeple…” http://english.pravda.ru/opinion/columnists/107459-american_capitalism-0

Fortunately, as we can see in the town halls and the marches, most Americans have NOT been dumbed down! Most Americans are NOT sheeple! Most Americans are ready to defend their FREEDOM and the freedom of their children and grandchildren from the abomination of Obamacare and socialism/Marxism.

    Reply    Favorite    Flag as abusive Posted 12:36 AM on 10/23/2009
- Opygollopy I'm a Fan of Opygollopy 81 fans permalink

First of all, your country has been dealing with a form of Fascism for years. The Industries - Health, Gas, Coal, Oil - have all called the shots over the government.

Your must have excellent health care or have never been denied it ever or you are a shill for the Health care industry or an uninformed person. Your remarks and opinion are offensive to people who have been denied health care for any reason after paying premiums for years or people who have lost loved ones due to the same reason. Bankruptcy is running rampant due to health care denials. Either you have listened to the Health Care Industry which have been abusing Americans for decades or you are a person without a conscience. Health care is necessary for a healthy and vibrant country which is something you do not have right now.

    Reply    Favorite    Flag as abusive Posted 02:19 AM on 10/23/2009
- ReedYoung I'm a Fan of ReedYoung 139 fans permalink
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Dirt poor Soviet defector named Bezmenov is met at the dock by ultra-conservative wrong-wing "think" tank which offers him comfortable income to endorse fascism.

Bez: "Steady Work?"

Wrong-wingers: "You betcha!"

Bez: "Da."

    Reply    Favorite    Flag as abusive Posted 11:18 AM on 10/23/2009
- Wombaticus I'm a Fan of Wombaticus 32 fans permalink
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The logic should be to HAVE exemption from the norm ONLY when there is a reason. The norm is anti-trust regulation. There is no reason presented (to my knowledge) as to why the health insurance companies should have such status.

A fair system would allow the insurance industry to plead their case in a public venue before the Legislature, with the news media covering it in an impartial fashion so the public could see all.

It is not so complicated...to design it. To have it HAPPEN...well...

    Reply    Favorite    Flag as abusive Posted 01:54 PM on 10/22/2009

So if its really "a problem that does not exist" there shouldnt be any resistance to congress revoking it right? I mean if they arent breaking any laws or getting away with stuff they shouldnt be then they shouldnt be worried about federal prosecution right??

Health Care Industry = Slime

    Reply    Favorite    Flag as abusive Posted 12:51 PM on 10/22/2009
- MBWinters I'm a Fan of MBWinters 2 fans permalink
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Greetings Citizens...

The Art of Intimidation...Step 23

When you cant get your way employ step 23 in the art of intimidation....

Since the Obama Administration made the federal goverment a majot stock holde in AIG does that mean that Congress is attacking itself as owner in a monopoloy?

    Reply    Favorite    Flag as abusive Posted 04:20 AM on 10/22/2009

No. AIG is required to pay that money back.

    Reply    Favorite    Flag as abusive Posted 11:13 AM on 10/22/2009
- johnsonc20 I'm a Fan of johnsonc20 32 fans permalink
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The fact that the taxpayers had to step in to keep our economic system from collapsing is not a good argument for allowing unfettered monopolies to grow and prosper at the expense of the little guy. What is your point? That we should leave the insurance companies alone, stop trying to get adequate health care to Americans, and let the "invisible hand" of the market continue to give the rich insurance companies an "invisible hand" job?

    Reply    Favorite    Flag as abusive Posted 12:10 PM on 10/22/2009
- TheSheeple I'm a Fan of TheSheeple 2 fans permalink

These "Insurance Companys" must be stopped now so they will not cut into the health rackett once it is taken over by this administration. This is a good start.

    Reply    Favorite    Flag as abusive Posted 11:53 PM on 10/21/2009
- jwredd I'm a Fan of jwredd 50 fans permalink

Does that mean we're getting single payer? I hadn't heard that yet.

    Reply    Favorite    Flag as abusive Posted 10:17 AM on 10/22/2009
- Greg Petty I'm a Fan of Greg Petty 10 fans permalink
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Einstein, this helps everyone including you,

    Reply    Favorite    Flag as abusive Posted 07:17 PM on 10/22/2009
- NWBrunette I'm a Fan of NWBrunette 59 fans permalink

Its always disconcerting when Mr. Reid AIMS to do something. Seems like it always goes off in his face. Hopefully this time he'll have a couple extra spines at the ready and he'll get some help with his aim.

    Reply    Favorite    Flag as abusive Posted 10:51 PM on 10/21/2009
- 1murillo I'm a Fan of 1murillo 24 fans permalink

All exemptions for large industries should be nullified. If something is so good, or so important, then that 'thing' should be able to succeed within a level 'playing field.' Especially with billions of dollars to begin, if an organization cannot succeed with that platform, it is not a very good organization.

    Reply    Favorite    Flag as abusive Posted 10:03 PM on 10/21/2009

WTF? Why did the insurance industry have an exemption int he first place????

    Reply    Favorite    Flag as abusive Posted 09:15 PM on 10/21/2009
- S1m0n I'm a Fan of S1m0n 93 fans permalink
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They bought it fair and square.

~~

But that's a good point. Who else is exempt from this law, and why?

    Reply    Favorite    Flag as abusive Posted 10:08 PM on 10/21/2009
- NWBrunette I'm a Fan of NWBrunette 59 fans permalink

Since the 80s the repubs have been bound and determined to create a mega-wealthy, aristocratic, corporatist elite in this country. And they've been quite successful. Nice that some Dems are finally starting to notice.

    Reply    Favorite    Flag as abusive Posted 10:53 PM on 10/21/2009
- Weirdwriter I'm a Fan of Weirdwriter 332 fans permalink
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Back in 1945, they were nonprofits considered to be delivering an essential public service.

Like Major League baseball.

    Reply    Favorite    Flag as abusive Posted 12:50 AM on 10/22/2009
- huff-fan I'm a Fan of huff-fan 32 fans permalink
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Here it is again. Patrick Leahy want you to send this to your representatives.
The McCarran-Ferguson Act of 1945 exempts health insurance companies from the antitrust regulations that apply to nearly every other industry, rules that protect consumers from anti-competitive business practices like price-fixing.

Passing health care reform with an effective public option is one key way to promote competition in the health insurance marketplace, but we must also eliminate this unjustified and unnecessary antitrust exemption currently enjoyed by insurance giants.

That's why I urge you to support the Health Insurance Industry Antitrust Enforcement Act, S. 1681, as an amendment to the Senate's health care reform bill.

This legislation will eliminate the outdated insurance industry antitrust exemption, and force health insurance companies to compete fairly -- like virtually every other business in America.

Thank you for supporting the Health Insurance Industry Antitrust Enforcement Act.

    Reply    Favorite    Flag as abusive Posted 08:00 PM on 10/21/2009
- NickConrad I'm a Fan of NickConrad 17 fans permalink
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Just an addition, these antitrust regulations don't just apply to nearly every other industry. They apply to the health insurance industry and one other. Major League Baseball.

    Reply    Favorite    Flag as abusive Posted 08:29 PM on 10/21/2009
- Weirdwriter I'm a Fan of Weirdwriter 332 fans permalink
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Never could figure out why baseball. Is football not exempt?

    Reply    Favorite    Flag as abusive Posted 12:51 AM on 10/22/2009
- Viper I'm a Fan of Viper 248 fans permalink

For those who dont understadn how the rates paid for the services provided by a hospital or Doctoprs are set.

Those providing the service dont set the rate. The insurance company does, not the DOCs/Providers whether that be Medicare/medicaid or Private insurance. The middleman sets the rpice.. so we are already not dealing with capitalism.

Almost all rates are now based on Medicare rates. Rates paid by insurance companies are from 120% of medicare rates down to 80-60% of medicare rates for Private Medicare Advantge HMOs ( the repugs attempt to privitize and bankrupt Medicare along with medicare Part D). medicaid rates are 50% of Medicare rates.

You have insurance companies and thus Repugs now constantly wanting to reduce Medicare rates... because then their cost go down and their profits go up and providers close down.

In the last decade reimbursment rates in real constants dollars are down by more than 50%... but insurance premiums have more than doubled! Thats does not compute.

Regards

    Reply    Favorite    Flag as abusive Posted 06:43 PM on 10/21/2009
- belyeu I'm a Fan of belyeu 12 fans permalink
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In addition, fees doctors and hospitals charge are based on the usual and customary fees doctors and hospitals charge for the same services in the area where the services are being rendered. That is why different markets charge different fees for the same services.

BTW, CPT codes are used to bill for medical procedures. The insurance industry did not create these codes, the AMA did.

Currently medicare and private insurance companies use CPT codes for billing purposes.

    Reply    Favorite    Flag as abusive Posted 08:32 PM on 10/21/2009

The government gave AMA control over CPT codes, which provides millions in revenues for AMA. Most doctors, however, no longer support AMA. Only 17% of doctors are currently members of AMA. Most doctors ardently oppose the Obamacare scam and are furious with Obama for lying when he said that doctors support Obamacare. AMA supports the scam because they'll make even more money from us. Most doctors are totally opposed to the scam, in all its manipulative versions.

    Reply    Favorite    Flag as abusive Posted 12:34 AM on 10/23/2009
    Reply    Favorite    Flag as abusive Posted 06:42 PM on 10/21/2009
- Viper I'm a Fan of Viper 248 fans permalink

It was not a limited Anti Trust exemption until Supreme court ruled it so. But the reason granted was so they could share information.

Insurance companies used trust/ anti-competative behavior to try to stop "Any Willing Provider" legislation in states... they Lost in the Surpreme court ten years later, only when the Supreme Court ruled the reason for the exemption was not what the insurance companies were pushing.. that they had a complete exemption.

Here is what insurance companies did during the HMO hey day. They promised providers who accepted lower rates that they would then restrict competition by not allowing any new providers on their provider list. Thats illegal. Its anti competative behavior.

We opened the newest MRI imaging center in Houston in 1994 and could not get on their provider lists. Were frozen out of business (and the research to 3D custom generated hip replacements made to exactly fit the patient, reducing operating time and recovery period).

Went to the best lawyers in the country.. and were told you cant sue them for anti competitive behavior because of their exemption.. Any one who works in the bowels of the insurance industry is a blood sucking crook and responsible for millions of jobs leaving this country and the deaths of a million people. People excepting a bonus based on how many treatments you deny are of the lowest morla fiber.



Regards

    Reply    Favorite    Flag as abusive Posted 06:25 PM on 10/21/2009
- Viper I'm a Fan of Viper 248 fans permalink

Now ask me how I really feel about health insurance companies. A POX on them ALL! They are anti American!

When you have over a 50% market share in an area... thats a geographical monopoly and can be broken up once this excemption is gone. HUMANA, WELL POINT and United healthcare can now be broken up!

Imangine a small clinic of a couple fo doctors having to take on these Gigantic companies in setting reimbursment rates when they have 70% of your patients! You get what they say you get or you go out of business. 40% of a DOCs time is now dealing with these clowns and their staffs in India.

regards


regards

    Reply    Favorite    Flag as abusive Posted 06:30 PM on 10/21/2009

Who created this monster??

    Reply    Favorite    Flag as abusive Posted 07:45 PM on 10/21/2009

And we have people afraid we are becoming a socialist country?

What are those penny pinching Republicans doing about this? Oh, they're on the insurance company's gift list!

    Reply    Favorite    Flag as abusive Posted 07:47 PM on 10/21/2009

As a provider in the mental health field, it is very annoying to hear that "the panels are closed" and yet hear from patients that there is an eight-week wait for an intake with other providers. Then, the insurance company comes down on the providers with the waiting lists (or long waits for appointments), saying that they are keeping patients in treatment for too many psychotherapy sessions, in spite of obvious medical necessity, which has allegedly created the backlog.

Our area really needs more providers who take insurance, not restrictions by insurance companies on numbers of providers on the panels so they can keep patients "moving". It's more complicated than that but it does not amount to good patient care and it puts providers in ethical dilemmas. The vast majority of providers (psychotherapists) do not keep people in therapy longer than necessary. For one thing, it is unethical. For another, we do like people to get on with their lives and be out of therapy. Other reasons too.

    Reply    Favorite    Flag as abusive Posted 03:15 PM on 10/22/2009
- Matt7 I'm a Fan of Matt7 241 fans permalink

Trust busting we will go
Trust busting we will go
I simple 60 votes and then
Trust busting we will go.

    Reply    Favorite    Flag as abusive Posted 05:36 PM on 10/21/2009
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People!!!! You have to understand this: The Exemption is a LIMITED exemption!!! Insurance companies are given an exemption to share uniform policy forms. They are also allowed to share loss cost information. This loss information is a common data base of actual claims to which the individual companies use their own actuaries to formulate RATES for their own companies. They are not allowed to share rate information. Thus all this talk is BS.

This exemption was put into law to PREVENT price fixing AND enhance competition.

Pure BS People!! (I am an insurance agent and a study of the insurance industry I work in)

    Reply    Favorite    Flag as abusive Posted 05:26 PM on 10/21/2009
- Lavafalls I'm a Fan of Lavafalls 243 fans permalink
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If you work for the industry, your pretty much the last person I'd believe. Conflict of interest comes to mind.

    Reply    Favorite    Flag as abusive Posted 05:33 PM on 10/21/2009
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Then why does BCBS of MI have 97% of ALL HC policies in the state?

And why did they announce a 28% increase in premiums and 31% increase for Seniors?

Because they have NO competition and THEY CAN.

    Reply    Favorite    Flag as abusive Posted 05:44 PM on 10/21/2009

The McCarran-Ferguson Act of 1945 (15 U.S.C.A. § 1011 et seq.) gives states the authority to regulate the "business of insurance" without interference from federal regulation, unless federal law specifically provides otherwise.

The act provides that the "business of insurance, and every person engaged therein, shall be subject to the laws of the several States which relate to the regulation or taxation of such business." Congress passed the McCarran-Ferguson Act primarily in response to the Supreme Court case of United States v. South-Eastern Underwriters Ass'n, 322 U.S. 533, 64 S. Ct. 1162, 88 L. Ed. 1440 (1944). Before the South-Eastern Under-writers case, the issuing of an insurance policy was not thought to be a transaction in commerce, which would subject the insurance industry to federal regulation under the Commerce Clause. In South-Eastern Underwriters, the Court held that an insurance company that conducted substantial business across state lines was engaged in interstate commerce and thus was subject to federal antitrust regulations. Within a year of South-Eastern Underwriters, Congress enacted the McCarran-Ferguson Act in response to states' concerns that they no longer had broad authority to regulate the insurance industry in their boundaries.


http://legal-dictionary.thefreedictionary.com/McCarran-Ferguson+Act+of+1945

    Reply    Favorite    Flag as abusive Posted 05:49 PM on 10/21/2009
- kasinca I'm a Fan of kasinca 162 fans permalink
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The healthcare industry is the biggest monopoly in the country. It is time to find a new profession. The people have to get some relief!

    Reply    Favorite    Flag as abusive Posted 06:15 PM on 10/21/2009
- Viper I'm a Fan of Viper 248 fans permalink

Simply not true, it was not a l;imited Anti Trust exemption. But the reason granted was so they could share information.

Insurance companies used anti trust ant anit-competative behavior to try to stop "Any Willing Provider" legislation in states... they Lost in the Surpreme court ten years later, only when the Supreme Court ruled the reason for the exemption was not what the insurance companies were pushing.. acomplete exemption.

Here is what insurance companies did during the HMO hey day. They promised providers who accepted lower rates that they would then restrict competition by not allowing any new providers on their provider list. Thats illegal.

We opened the newest MRI imaging center in Houston in 1994 and could not get on their provider lists. Were frozen out of business (and the research to 3D custom generated hip replacements, reducing operating time and recovery period).

Went to the best lawyers in the country.. and were told you cant sue them for anti competitive behavior because of their exemption..

Any one who works in the bowels of the insurance industry is a blood sucking crook and responsible for millions of jobs leaving this country and the deaths of a million people.

Now ask me how I really feel about helath insurance companies. A POX on them ALL! Thye are anti American!

Regards
.

    Reply    Favorite    Flag as abusive Posted 06:16 PM on 10/21/2009
- Matt7 I'm a Fan of Matt7 241 fans permalink

Good comment, Viper.

    Reply    Favorite    Flag as abusive Posted 06:26 PM on 10/21/2009
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