House GOP lawmaker targets key healthcare reform provision

A powerful House Republican is setting in motion a congressional challenge to a key provision of the healthcare reform law.

Republican Conference Secretary John Carter (R-Texas) is trying to build momentum for a Congressional Review Act (CRA) challenge to a recent regulation that requires insurers to spend at least 80 percent of their premium dollars (85 percent in the large-group market) on healthcare services.

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The House GOP majority is expected to approve legislation Wednesday that would repeal the reform law, but the Democratic-controlled Senate will likely block it. With no way forward on the bill, the GOP will turn its attention to attacking Obama administration regulations in an attempt to weaken the healthcare law.

Carter used the annual Republican retreat this past weekend to try to generate support for a CRA challenge to the so-called medical loss ratio (MLR) requirements for insurers, spokesman John Stone told The Hill.

On Wednesday, Carter reintroduced a resolution disapproving of the MLR requirements, which were published in November. The requirements aligned closely with recommendations made by the National Association of Insurance Commissioners.

When Carter first introduced the resolution in December, he said the rule would “wreck” the individual insurance market.

“Our national goal should be to increase health coverage for all Americans,” Carter said in a statement. “This regulation is heading in the exact opposite direction, and must be stopped before it becomes effective.”

Since the CRA was enacted in 1996, the law has been wielded successfully just once, when Congress overturned a Clinton-era ergonomics rule in 2001.

The CRA operates under special rules. After receiving a regulation, Congress has 60 legislative days to orchestrate a disapproval of the rule. Once in the Senate, any senator could bring up the resolution for an expedited vote without opportunity to add amendments.

President Obama can veto any CRA challenge, but Carter’s spokesman said he is hopeful that Republicans can gain Obama’s support to overturn “bad regulations.”

“The whole healthcare bill was put together so piecemeal that there’s going to be some very bad regulations issued that even supporters of the initial bill will say, ‘That’s not what we wanted to do,’ ” Stone said.

Health and Human Services Department regulations postponed MLR requirements by one year so that so-called “mini-med” plans offering limited coverage could meet the new requirements. Insurers that fall short of the MLR requirements must provide rebates to enrollees.

Democrats, ramping up their defense of the reform law, have emphasized its consumer protections — such as the MLR requirements — to generate support.

“By pledging to repeal health reform, House Republicans would eliminate this important protection and allow insurance companies to continue unlimited spending on CEO bonuses, profits and lobbying — and less on patients’ health care,” said Rep. Pete Stark (D-Calif.) in November after the MLR regulations were issued.