McCarran-Ferguson Repeal Subjects Insurers to Antitrust Laws

In the waning days of the 116th Congress and the Trump Administration, organized medicine achieved a major legislative victory. The long-sought McCarran-Ferguson repeal subjecting healthcare insurers to antitrust laws cleared the Congress in late December and was signed into law by President Donald Trump on January 13, 2021. This vital law will begin to level the playing field between healthcare providers and insurers.

The new statute’s significance lies in finally stripping healthcare insurers of their coveted antitrust law exemption. For more than 70 years, healthcare insurers have been empowered by federal law to consolidate markets for their own benefit; to stifle competition within statewide or regional markets; and to impose unreasonable terms on subscribers and providers. The practical implications for Pennsylvania’s orthopaedic community are that insurers will no longer be enabled to maintain secret provider reimbursement schedules nor will they be authorized to impose “take it or leave it” provider contracts. In addition, more healthcare insurers may now enter Pennsylvania’s market to challenge the incumbent blue and hospital plans and to provide more benefits for patients and physicians. While the new statute’s value may not immediately be felt, please be assured that this is a significant victory for patients and physicians.

PAOrtho has advocated for the Competitive Health Insurance Reform Act for many years. Our Board of Councilors representatives made this issue a top priority in their every congressional encounter since 2016. Similarly, PAOrtho’s National Orthopaedic Leadership Conference delegates effectively advocated for this initiative during the 2020 virtual NOLC and the last three in-person events in Washington, DC.

This bipartisan legislation passed the US House on a voice vote on September 21, 2020. It likewise passed the US Senate by voice vote on December 22, 2020. Based on the congressional records reviewed, every member of the Pennsylvania Delegation voted in favor of the measure. US Representative Mary Gay Scanlon (D, Delaware, Chester, Montgomery, Philadelphia) played a major role in US House passage by making the critical motion to suspend the rules and pass the bill as amended. PAOrtho thanks Representative Scanlon and the entire Pennsylvania Delegation for acting on this vital legislation.

Legislation Repeals Federal Antitrust Immunity For The Health Insurance Business | Fox Rothschild LLP - JDSupra