House May Take Up Slice of Health Reform; Larger Bill’s Fate Still Unclear

The House of Representatives may vote next week on a bill to remove the health insurance industry’s antitrust exemption.

The move is the first attempt to jump-start the “two-track” health care reform effort that House Speaker Nancy Pelosi outlined last week, in which Congress would consider small pieces of health care legislation in separate bills while still working to negotiate a broader, sweeping reform bill.

Repealing the antitrust exemption, Democrats say, would promote competition and drive down prices, particularly in states with one dominant health insurer.

Insurers disagree. When the House Judiciary Committee approved the move in October, Karen Ignani, president of America’s Health Insurance Plans, wrote to members of Congress: “We believe that health insurers have not been engaging in anticompetitive conduct […] Thus, the bills attempt to remedy a problem that does not exist.”

Repealing the antitrust exemption was part of the comprehensive health care reform bill that passed the House, but it was not part of the bill that passed the Senate. It’s not clear that the measure on its own could garner enough Senate votes to pass.

Meanwhile, the fate of comprehensive health care reform remains uncertain.

President Obama rallied Democratic lawmakers at a meeting of the caucus Wednesday, reminding them that they had promised to pass health care reform.

“So many of us campaigned on the idea that we were going to change this health care system,” he said. “Well, here we are with a chance to change it. . . . We’ve got to finish the job on health care. We’ve got to finish the job on regulatory reform. We’ve got to finish the job, even though it’s hard.”

But the Democrats’ reform bill remains unpopular, and the president didn’t offer any specific legislative pathway to pass it.

In the wake of Democrats losing a Massachusetts Senate seat and their filibuster-proof majority to Republicans, the most likely path still seems to be reconciliation — passing the Senate bill through the House unchanged, then passing a series of budget-related “fixes,” or compromises that incorporate some of the House bill, through a process called reconciliation that requires only 51 votes.

But the process is legislatively complex and Democrats haven’t yet mustered the necessary votes in either the House or the Senate.

Senate Majority Leader Harry Reid seemed in no hurry Tuesday, telling the Wall Street Journal: “Don’t pin me down as to days or number of weeks. We plan to do health care this year, and do it as quickly as we can.”