So when upwards of 80 percent of health care insurance markets are held by a single company (WellPoint, we’re looking at you, in Maine), it would seem like a matter for the Justice Department, right?
Not so fast. Health care insurance companies have been exempted from anti-trust laws because of the McCarran-Ferguson Act of 1945, which allows for state but not federal anti-trust regulation.
It’s been a nice loophole for the insurance companies — 94 percent of US health insurance markets meet the Justice Department standards for “highly concentrated” (or, little competition). And even if Congress had the will to overturn McCarran-Ferguson, critics say this will do next to nothing, as since 1996, according to the American Medical Association, the federal government has cleared 400 mergers in health insurance. This would coincide with the time period when most Americans saw their premiums soar and services plummet.
But Congress looks ready to give it a whirl, anyway. Both the House and the Senate have approved language that will drop the anti-trust exemption, and while the insurance industry dismisses this as a temper tantrum several congressional sources tell us that “the Senate is awfully motivated.”
Right now, the move has bipartisan support. One reason might be the study recently released by the Business Roundtable, a nonpartisan group representing CEOs of major companies. It found that without “significant” marketplace reforms to reduce costs, health care costs per employee will triple to nearly $29,000 over the next decade.
Will Congress win our hearts?
Terrific post! I always wondered why the federal government was so hesitant to invoke the Sherman Anti-trust Act against the medical insurance cartels. Now I get it. I wonder if there’s a loop hole against enforcing Sarbanes Oxley against insurers as well. They are corporations, after all. I know Cigna settled one suit in brought by shareholders for $93 million for failing to disclose material facts about problems with its computer system. If the SEC ever wakes up, they could just look up the facts of the case and get their share.