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The right approach to promoting competition in the health care marketplace

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Healthy competition in the health insurance marketplace is one of the most critical elements in ensuring that Americans can access quality, affordable health care. When insurance companies are forced to compete, the American people win.

Unfortunately, too many families are still paying higher premiums and out-of-pocket costs today because of anti-competitive practices that health insurance giants are allowed to engage in under the law.

{mosads}One of the reasons? It’s a law few Americans have ever heard of—the McCarran-Ferguson Act of 1945.

Under this law, insurers can engage in egregious actions like price fixing, bid rigging, and market allocation with total impunity. These practices allow insurers to inflate their costs and impose burdens on middle class families all across our nation.

That’s why House Democrats have supported the full repeal of the McCarran-Ferguson Act since 1988, and passed legislation to end this antitrust exemption for health insurers in 2010 by a vote of 406-19.

This week, we worked with the same Republicans that opposed this measure in 2010 to pass H.R. 372, the Competitive Health Insurance Reform Act, legislation that repeals the antitrust exemption that has shielded health insurers for more than 70 years.

As the Council of Economic Advisors put it last year, robust enforcement of antitrust laws is “an important way in which the government makes sure the market provides the best outcomes for society with respect to choice, innovation, and price as well as fair labor and business markets.”

But make no mistake: while promoting competition in state markets will benefit consumers, the benefits will be lost if Republicans are able to repeal the strong consumer protections that exist as part of the Affordable Care Act.

These protections, which the American people overwhelmingly support, ensure that health insurance markets operate efficiently, lift limits on lifetime coverage amounts, and protect millions of Americans with pre-existing conditions from discrimination.

Furthermore, the Affordable Care Act dramatically increased the number of health insurers operating in local marketplaces, which has helped slow the growth rate in premium costs to their lowest level in 50 years.

In order to protect the progress we have made over the last seven years, it is critical that we work to strengthen the Affordable Care Act.

Yet, since Election Day, Republicans and President Trump have been squarely focused on repealing the law in its entirety and replacing it with a proposal they claim will establish a national marketplace for health insurance.

In fact, the same architects of the Majority’s “repeal and replace” effort—including Speaker Paul Ryan, Health and Human Services Secretary Tom Price, and Ways and Means Committee Chairman Kevin Brady—voted against repealing health insurer’s antitrust immunity in 2010.

They now claim that simply allowing the sale of insurance across state lines will serve as a magical elixir that brings down health care costs for good.

There’s only one problem with this claim: it’s already permitted under ObamaCare.

Section 1333 of the Affordable Care Act already allows states to establish “health care choice compacts” to allow out-of-state health insurers to sell health insurance products in-state.

Several states have already enacted statutes to provide for healthcare choice compacts. The National Conference of State Legislature reports that five states have passed out-of-state purchasing laws since 2008.

The fact is that promoting health insurance competition across state lines, as opposed to cracking down on anti-competitive practices, does little to lower costs for consumers. In fact, despite the existing law, few health insurers choose to engage in cross-state sales because there is little economic incentive for them to do so.

President Trump’s repeal and replace proposal will not change this underlying reality.

The president would be wise to withdraw his proposal and instead focus on joining our bipartisan effort to work across the aisle to improve and strengthen the Affordable Care Act.

Today, thanks to ObamaCare, the uninsured rate is at an all-time low, seniors are paying less for their prescription drugs, millions have received coverage under Medicaid expansion, and the number of competitors in local markets is growing.

The Affordable Care Act is improving Americans’ health care coverage and choice. President Trump owes it to the American people to build on this success rather than tear it down.

Rep. John Conyers is House Judiciary Committee ranking member and David N. Cicilline is ranking member of the Judiciary Subcommittee on Regulatory Reform, Commercial and Antitrust Law.


The views expressed by this author are their own and are not the views of The Hill.

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