Plan B

Robert Laszewski

With word that the House is likely to take up the repeal of the health insurance industry anti-trust exemption it  is now clear the Democratic leadership has begun Plan B.

It is also clear that this is much more a part of a political Kabuki dance then any substantive effort at even piecemeal health care reform.

The House probably has the votes to pass the repeal. The Senate does not. I doubt that even all of the 59 Senate Democrats will vote for it if and when it does come up on the floor of the Senate.

The base of the Democratic Party, as well as many “progressive” Dems in the House and Senate, are rabidly mad about not being able to ram their health care bill through. That is why you continue to hear all of the talk about reconciliation options even though there is no chance such a scheme would pass either the House or Senate.

But what to do? The apparent answer is to bring up a few smaller health care bills the Democratic leadership views as popular back home and expect the Republicans will vote against them. Right now health care is a big negative issue for the Dems given the unpopularity of their effort to date. But if they can be seen trying to pass a few smaller measures “we can all agree on” only to be thwarted by Republican opposition their hope is they can turn the table on this issue to their advantage—well before they get to November.>

Interesting politics but no hope for any real progress while these games play out.


When the Democrats say they believe they can still pass a health care bill are they bluffing? That’s my opinion.

Here is a first rate story from Politico on their options and the dismal political reality each faces.

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17 replies »

  1. If “Anti-Trust reform” disables smaller insurance plans, then that’s the wrong direction. Perhaps this is not representative, but one CEO of a payor in northern New England said about pricing: “we just pass the costs on the the employers anyway.” The same probably goes for an over-concentration of providers too. And if its the norm in many markets, then meaningful anti-trust reform could be helpful.
    But maybe I misunderstand. I’d like to learn more. Can someone point out good research on the subject of anti-trust in healthcare markets (not just hospitals, but that of insurance plans)?

  2. archon, just throwing back some of your sarcasm. It appears Fox News and many Republicans want to at least fuel the Sarah Palin/Tea Party express to paint those demon Democrats as big government “socialists”. Ah, what a short memory voters have and how they wish for the good ole times of Bush/Republican policies.

  3. If empathy for the indigent were truly the moving force behind HCR, the House Democrats would simply adopt the Senate bill and send it to Obama. That, however, isn’t what this is all about. The liberals are boiling over with animus towards the insurers, and the Senate bill does little to gratify it. The “individual mandate” (which makes perfect sense to me), is an indignity beyond endurance. All this, on top of the loss of the “public option,” has thrown them into full tantrum modality. They need a good electoral whack on the head, and that will come in November.

  4. This post is about Democrat politics, not healthcare. The Dems need to replace their leadership in Congress. They have no credibility on anything.

  5. “The ironic thing about the anti-trust drive is that the legislation it repeals, as I understand it, primarily helped life and p&c companies (including ones that sell medical malpractice) to pool info to more accurately develop rates, not to help health insurers develop monopolies.”
    Kim is correct. The anti-trust exemption most benefits SMALL insurers who lack the breadth of claims data to accurately set rates. It has nothing to do with inhibiting price competition among insurers. Acquisitions are subject to rigorous scrutiny to ensure that they do not result in undue market concentration. If the anti-trust exemption were eliminated, the competitive position of the large health insurers would, if anything, be strengthened. Moreover, their own very large claims databases are more than sufficient to allow them to accurately set rates. Democrats huffing and puffing on this is much ado about nothing and little more than political hackery.

  6. The CBO, in a report dated 10-23-2009, addressed the effect of the proposed Health Insurance Industry Antitrust Enforcement Act of 2009, H.R. 3596. Here’s the money quote: “H.R. 3596 could affect the costs and premiums charged by private health insurance companies… but…the magnitude of the effects is ikely to be quite small.”
    Just sound and fury, signifying nothing. Bloody meat for the hard core.
    Nate, I’m reading that the anti-trust exemption doesn’t apply to mergers and aquisitions.

  7. No to higher taxes that will destroy jobs. No to government mandates to buy inferior insurance people don’t want or need. No to catastrophic cuts to Medicare. No to tax breaks for Unions that no one else gets. No to dirty back room deals to buy votes. No to all the lies used to sell Health Care Reform like the lie Obama told about keeping your insurance and doctor.(LOL) NO TO OBAMACARE!!!

  8. for having an anti-trust exemption both the feds and states sure extracted a lot of concessions from United with they bought pacificare and SHL/HPN. Not to mention Anthem as they grew. Never once have I seen anyone lay out exacty whay this supposed exemption does or more importantly what repealling it would accomplish

  9. Sounds like the Dems wants payback against the health insurance companies, many of whom didn’t support the reform bill.

  10. Perhaps the “progressives” can score a few points by trotting out some of the lesser known provisions of HCR–like the parts of HR 3200 assuring your course of treatment will be an adventure in multiculturalism.

  11. The ironic thing about the anti-trust drive is that the legislation it repeals, as I understand it, primarily helped life and p&c companies (including ones that sell medical malpractice)to pool info to more accurately develop rates, not to help health insurers develop monopolies. Current health insurers certainly seem to be subject to both state and federal anti-trust oversight. The Congressional move does smack of, as tcoyote said above, “rock throwing.”

  12. Reality is that alot of the festering and rotting problems that are still there on the international finance-scene are looking more and more likely to emerge in the very near future. Healthcare is going to take a huge back seat for the rest of the year even if there is still some real pressure from AARP, AMA, and House Democrats to get something done this year.

  13. …. and the angry Democratic base is getting even angrier for having our intelligence insulted, on top of having our principles tossed out the window….

  14. Voting to take down the anti-trust exemption isn’t health policy, it’s rock throwing, Pelosi attempting to palliate an angry Democratic base by striking a meaningless blow against an unpopular industry. It won’t do a damned thing, but it’ll sure “send ’em a message”. The message is: we’re angry too, and don’t have the faintest idea what to do.
    The House’s problem through this whole process: it was a lot more focused on punishing old enemies than fixing our nation’s health problems.
    Time’s up, Nancy. You’re the main reason this cratered.