Antitrust Regs, Public Option Get Renewed Interest in Reform Bills

Janice Simmons, for HealthLeaders Media , October 26, 2009

While a public insurance option appeared to be a sure thing in the nearly reconciled House bill, it seemed "iffy" at times for the emerging Senate bill—until last week. Now, a public option seems to be on track—although what form it will take remains under discussion. In the meantime, legislation that would overturn the federal health insurance antitrust law is quickly advancing in both chambers.

"I think we're very close to getting the 60 votes we need to move forward," said Sen. Charles Schumer (D-NY) on Sunday on NBC's "Meet the Press." "My guess is that the public option level playing field with the state opt out will be in the bill. But [Majority] Leader [Harry] Reid will make that decision after he talks to everybody several times."

"I think what we're going to end up with is having votes on a number of choices, said Sen. Claire McCaskill (D-MO), who reflected on the various alternatives that could pass on ABC's "This Week with George Stephanopoulos.

These choices could include "the ability for states to opt in to some kind of not for profit plan, the ability for states to opt out of some kind of not for profit plan to compete with the private insurance companies on this exchange, and then the option to trigger a not for profit plan if the insurance companies don't manage to bring down costs within a certain period of time," McCaskill said.

She added that she had "not drawn a line in the sand" on how she'll vote. "I support the public option. I'll vote for the public option. But I'm focused on these deficit costs, on how can we reconfigure the way we pay for healthcare."

Meanwhile, the White House sought to dispel "a rumor making the rounds that the White House and Sen. Reid are pursuing different strategies on the public option," said Dan Pfeiffer, the White House deputy communications director, in a White House blog.

Those rumors "are absolutely false," he said. He added that the president "completely supports [the Senate's] efforts."

On the antitrust front, the House Judiciary Committee voted 20-9 to overturn the McCarran Ferguson Act that would ban health insurers from sharing data and engaging in price fixing. In her weekly address last week, House Speaker Nancy Pelosi (D-CA) indicated that measure will be incorporated into the House's healthcare care reform bill.

Also, last week, Senate Judiciary Committee Chairman Patrick Leahy (D-VT), who introduced his own bill to overturn McCarran-Ferguson, and Sen. Reid announced that Leahy's bill will be offered as an amendment to health insurance reform legislation on the Senate floor.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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