[Congressional Record (Bound Edition), Volume 163 (2017), Part 4]
[House]
[Pages 4541-4549]
[From the U.S. Government Publishing Office, www.gpo.gov]




            COMPETITIVE HEALTH INSURANCE REFORM ACT OF 2017

  Mr. GOODLATTE. Mr. Speaker, pursuant to House Resolution 209, I call 
up the bill (H.R. 372) to restore the application of the Federal 
antitrust laws to the business of health insurance to protect 
competition and consumers, and ask for its immediate consideration.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. Pursuant to House Resolution 209, in lieu of 
the amendment in the nature of a substitute recommended by the 
Committee on the Judiciary printed in the bill, an amendment in the 
nature of a substitute consisting of the text of Rules Committee Print 
115-8 is adopted and the bill, as amended, is considered read.
  The text of the bill, as amended, is as follows:

                                H.R. 372

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Competitive Health Insurance 
     Reform Act of 2017''.

     SEC. 2. RESTORING THE APPLICATION OF ANTITRUST LAWS TO THE 
                   BUSINESS OF HEALTH INSURANCE.

       (a) Amendment to Mccarran-Ferguson Act.--Section 3 of the 
     Act of March 9, 1945 (15 U.S.C. 1013), commonly known as the 
     McCarran-Ferguson Act, is amended by adding at the end the 
     following:
       ``(c)(1) Nothing contained in this Act shall modify, 
     impair, or supersede the operation of any of the antitrust 
     laws with respect to the business of health insurance 
     (including the business of dental insurance and limited-scope 
     dental benefits).
       ``(2) Paragraph (1) shall not apply with respect to making 
     a contract, or engaging in a combination or conspiracy--
       ``(A) to collect, compile, or disseminate historical loss 
     data;
       ``(B) to determine a loss development factor applicable to 
     historical loss data;
       ``(C) to perform actuarial services if such contract, 
     combination, or conspiracy does not involve a restraint of 
     trade; or
       ``(D) to develop or disseminate a standard insurance policy 
     form (including a standard addendum to an insurance policy 
     form and standard terminology in an insurance policy form) if 
     such contract, combination, or conspiracy is not to adhere to 
     such standard form or require adherence to such standard 
     form.
       ``(3) For purposes of this subsection--
       ``(A) the term `antitrust laws' has the meaning given it in 
     subsection (a) of the first section of the Clayton Act (15 
     U.S.C. 12), except that such term includes section 5 of the 
     Federal Trade Commission Act (15 U.S.C. 45) to the extent 
     that such section 5 applies to unfair methods of competition;
       ``(B) the term `business of health insurance (including the 
     business of dental insurance and limited-scope dental 
     benefits)' does not include--
       ``(i) the business of life insurance (including annuities); 
     or
       ``(ii) the business of property or casualty insurance, 
     including but not limited to--
       ``(I) any insurance or benefits defined as `excepted 
     benefits' under paragraph (1), subparagraph (B) or (C) of 
     paragraph (2), or paragraph (3) of section 9832(c) of the 
     Internal Revenue Code of 1986 (26 U.S.C. 9832(c)) whether 
     offered separately or in combination with insurance or 
     benefits described in paragraph (2)(A) of such section; and
       ``(II) any other line of insurance that is classified as 
     property or casualty insurance under State law;
       ``(C) the term `historical loss data' means information 
     respecting claims paid, or reserves held for claims reported, 
     by any person engaged in the business of insurance; and
       ``(D) the term `loss development factor' means an 
     adjustment to be made to reserves held for losses incurred 
     for claims reported by any person engaged in the business of 
     insurance, for the purpose of bringing such reserves to an 
     ultimate paid basis.''.
       (b) Related Provision.--For purposes of section 5 of the 
     Federal Trade Commission Act (15 U.S.C. 45) to the extent 
     such section applies to unfair methods of competition, 
     section 3(c) of the McCarran-Ferguson Act shall apply with 
     respect to the business of health insurance without regard to 
     whether such business is carried on for profit, 
     notwithstanding the definition of ``Corporation'' contained 
     in section 4 of the Federal Trade Commission Act.

  The SPEAKER pro tempore. The bill shall be debatable for 1 hour 
equally divided and controlled by the chair and ranking minority member 
of the Committee on the Judiciary.
  The gentleman from Virginia (Mr. Goodlatte) and the gentleman from 
Michigan (Mr. Conyers) each will control 30 minutes.
  The Chair recognizes the gentleman from Virginia.


                             General Leave

  Mr. GOODLATTE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and include extraneous materials on H.R. 372.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Virginia?
  There was no objection.
  Mr. GOODLATTE. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise today in support of a bill that will move us a 
step closer towards restoring healthy competition in the health 
insurance industry. Today, the health insurance industry is besieged by 
dwindling competition and skyrocketing premiums. Insurance providers, 
States, and the public have been dealing with the disastrous 
repercussions of ObamaCare for the past 6 years and overregulation by 
States for much longer.
  Congress finally has the opportunity to pass legislation to reverse 
the downward spiral of our health insurance industry. Any such 
legislation must encourage a robust and competitive health insurance 
market in which insurance providers actively compete for customers. 
Healthy competition ensures premiums are accurately priced and that 
customers are able to find a variety of policies to meet their specific 
needs and demands.
  H.R. 372, the Competitive Health Insurance Reform Act of 2017, 
represents a step on that journey, repealing the McCarran-Ferguson Act 
as it applies to the business of health insurance. There is wide 
support for this bill, and the Judiciary Committee has favorably 
reported similar legislation in the past, including legislation that 
was passed by the House, 406-19 during the 111th Congress.
  The stated goal of the bill is to help restore competition in the 
healthcare market. I support this goal and firmly believe this bill 
must be coupled with larger changes to the existing Federal and State 
healthcare regulatory schemes.

[[Page 4542]]

  As Speaker Ryan has noted, States ``should be empowered to make the 
right tradeoffs between consumer protections and individual choice, not 
regulators in Washington.''
  This bill does not impact the State's ability to regulate the 
insurance market. Rather, this legislation levels the playing field for 
all healthcare industry participants. While insurers have been exempt 
from Federal antitrust laws for the past 70 years, healthcare providers 
and other participants have not.

                              {time}  1445

  This bill removes this exemption, ensuring that health insurers are 
better able to compete to provide quality coverage, thereby benefiting 
hospitals, doctors, and, most importantly, patients.
  In addition, if separate legislation is passed to allow for the more 
open sale of health insurance across State lines, the Competitive 
Health Insurance Reform Act will allow uniform Federal antitrust laws 
to be applied across the marketplace while allowing States to maintain 
authority as the primary regulators of the health insurance market 
outside of the antitrust sphere.
  The McCarran-Ferguson Act was originally passed to leave the 
regulation of the business of insurance with the States and to allow 
insurers to engage in certain procompetitive collaborative activities.
  This legislation limits significant uncertainty and unnecessary 
litigation that would likely result from a broader McCarran-Ferguson 
repeal, through the use of safe harbors for such historically 
procompetitive collaborative activities, specifically the collection 
and distribution of historical loss data, the determination of loss 
development factors, the performance of actuarial services that do not 
involve restraints of trade, and the use of common forms that are not 
coercive.
  Absent these safeguards, insurers will likely disengage from certain 
proconsumer collaborative activities, eliminating or impeding smaller 
insurers from competing and disincentivizing larger insurers from 
exploring new products and markets. This will lead to further market 
consolidation and fewer product choices, the impact of which will 
eventually be borne by the consumer.
  These narrow safe harbors create a presumption that certain 
procompetitive activities can continue while maintaining regulation and 
oversight to the extent any activity crosses over into a restraint of 
trade. As a result, insurers can continue to engage in proconsumer 
business practices and will be encouraged to provide a diverse range of 
offerings at fair and reasonable prices.
  I thank Mr. Gosar for introducing this legislation, and I urge all of 
my colleagues to vote for the Competitive Health Insurance Reform Act.
  Mr. Speaker, I reserve the balance of my time.
  Mr. CONYERS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in qualified support of H.R. 372, the Competitive 
Health Insurance Reform Act, but I do not endorse the majority's 
exaggerated claims regarding the bill's impact on the affordability and 
availability of health insurance.
  H.R. 372 would partially repeal the limited Federal antitrust 
exemption for the business of insurance established by the McCarran-
Ferguson Act in 1945. Specifically, the bill only permits Federal 
antitrust enforcement with regard to the business of health insurance.
  Now, House Democrats have long supported a full repeal of McCarran-
Ferguson's antitrust exemption for all insurers, not just for health 
insurers. In 2010, under a Democratic House majority, we passed 
legislation to repeal the McCarran-Ferguson exemption for health 
insurers by a vote of 406-19, even though House Republicans had not 
previously supported moving any version of a McCarran-Ferguson repeal 
bill.
  But let me be clear. Enacting H.R. 372 would in no way be a 
substitute for the many health insurance guarantees of the Affordable 
Care Act. The two things are completely separate. To begin with, 
enacting H.R. 372 would not significantly improve healthcare 
affordability or coverage. According to the Congressional Budget 
Office, H.R. 372's effect on health insurance premiums would probably 
be quite small, and enacting the bill would have no significant net 
effect on the premiums the private insurers would charge for health or 
dental insurance. That is according to the Congressional Budget Office.
  The Consumers Union observes that the application of the antitrust 
laws to some health insurance activity, by itself, is simply not enough 
to create a vibrant insurance market because our long experience shows 
you can't expect a healthcare system to run effectively on competition 
alone. That is the Consumers Union.
  Likewise, the majority's claim that enacting H.R. 372 would create 
major new competition by allowing cross-State insurance sales is 
unavailing. Current law, including the Affordable Care Act, already 
allows States to agree with each other to allow cross-State insurance 
sales.
  Enabling Federal antitrust agencies to police certain forms of 
anticompetitive conduct will not, in and of itself, incentivize health 
insurers to offer products across State lines beyond the incentives 
that already exist for offering such products. It just won't happen by 
itself. Whatever the incentives for health insurers to offer such 
products, they have little to do with Federal antitrust law or 
enforcement.
  Finally, enacting H.R. 372 would not ensure that the Affordable Care 
Act's prohibitions against discrimination and limits on premium growth 
would remain in place. H.R. 372 only applies to certain anticompetitive 
conduct and does not preserve or enhance existing protections for 
consumers of health insurance. For instance, it does not prohibit 
discrimination by health insurers on the basis of preexisting 
conditions, nor does it reduce premium growth or require health 
insurers to be accountable for price increases.
  Repeal of the antitrust exemption for health insurance is a 
complement to and not a replacement for the Affordable Care Act's many 
consumer protections. This is not an either-or situation. We need H.R. 
372 and the Affordable Care Act to be in place to maximize benefits, 
improve quality, and lower costs for consumers.
  So while I support the bill with some reluctance, I take issue with 
the majority's rhetoric. It is very important that we set the record 
straight here.
  Mr. Speaker, I reserve the balance of my time.
  Mr. GOODLATTE. Mr. Speaker, I yield 5 minutes to the gentleman from 
Arizona (Mr. Gosar), who is the chief sponsor of the legislation.
  Mr. GOSAR. Mr. Speaker, I thank Chairman Goodlatte and the Judiciary 
Committee for their thorough work on this bill. I would also like to 
express my appreciation to the broad group of stakeholders who have 
helped to shape, improve, and support this commonsense and consumer-
centric legislation.
  As Congress, once again, faces the preeminent task of repairing our 
Nation's healthcare system, first and foremost, we must establish the 
proper foundation for a competitive and consumer-driven health 
insurance marketplace that empowers patients.
  The Competitive Health Insurance Reform Act of 2017 will restore the 
application of Federal antitrust laws to health insurance and infuse 
much-needed competition and transparency to the industry. Ending the 
special-interest exemption is the essential first step to broader 
healthcare reform. Popular cost-reducing reform priorities, such as 
selling insurance across State lines and developing diverse, consumer-
driven plans, are predicated on the robust competitive markets this 
bill will enable.
  As a healthcare provider for more than 25 years, I understand 
firsthand the importance of a competitive and dynamic health insurance 
market. Patients, doctors, and hospitals alike benefit when health 
insurers compete to provide a variety of quality coverage options.
  It is apparent that after 70 years, McCarran-Ferguson, the broad-
stroked exemption created by Congress in the

[[Page 4543]]

1940s, was not wise. Over decades, and expeditiously since the passage 
of ObamaCare in 2009, the health insurance market has devolved into one 
of the least transparent and most anticompetitive industries in the 
United States. These antiquated exemptions are no longer necessary for 
health insurance. There is no reason in law, policy, or logic for the 
industry to have special exemptions that are different from all other 
businesses in the United States.
  The interpretation of antitrust law has narrowed dramatically over 
the decades. Many of the practices which insurers say they need this 
exemption to do, such as analyzing historical loss data, have proven to 
be permissible by the Federal Trade Commission and the courts over the 
decades since McCarran-Ferguson was passed.
  This narrowing of scope has resulted in a law whose efficacy and 
usefulness long since expired. Yet, the shell of this zombie law lurks 
to scare off potential, legitimate legal challenges from States, 
patients, and providers. These entities do not have the tools, money, 
or manpower to challenge these monopolies in court or head-on in the 
current market. Only the Federal Government, with its resources, can 
enforce the laws which rebalance the playing field of interstate 
commerce fairly.
  I would like to stress the point that this legislation does not 
affect any other type of insurance other than health insurance. The 
language of the bill was carefully and deliberately drafted to exclude 
other areas of insurance, such as life insurance, property and casualty 
insurance, and excepted benefits like disability income insurance. In 
short, the legislation before the House today does not repeal the 
McCarran-Ferguson Act for life insurance, annuities, property and 
casualty insurance, disability income insurance, and long-term care 
insurance.
  The broad stakeholders of healthcare professionals, insurance 
providers, and consumer protection groups support this narrow and 
important scope of the language. I am open to efforts to strengthen the 
narrow and deliberate scope of this legislation going forward should 
the need and opportunity arise.
  Repeal of this specific section of the McCarran-Ferguson Act, which 
applies only to health insurance, has strong bipartisan support. As 
labeled earlier, in the 111th Congress, it passed by a vote of 406-19 
and passed the Republican-led House in the 112th Congress by a voice 
vote. Similar legislation has been introduced by multiple Democratic 
Members of the House, and the text of my bill has been included in the 
Republican Study Committee's healthcare reform bill for the last four 
Congresses in a row.
  The passage of the Competitive Health Insurance Reform Act into law 
is an important first step towards increasing competition in health 
insurance markets and will assist with setting the foundation for real, 
competitive, and patient-centered healthcare reform.
  At the end of the day, you can tell a lot about a bill by who 
supports it. H.R. 372 has the support of the healthcare professionals 
that actually provide care to patients, including doctors, dentists, 
surgeons, pharmacists, chiropractors, optometrists, and others. This 
key law, by liberating, liberates the insurance industry and doctors 
and empowers the patients. Doctors will see and insurance will see that 
the patient is empowered for new opportunities. Things that we can't 
even imagine today will exist through competition. It is the American 
way.
  Mr. Speaker, I thank the chairman and the members of the committee 
for their work on this issue. I urge my colleagues to support this 
bill.
  Mr. CONYERS. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Rhode Island (Mr. Cicilline), who is a distinguished 
leader of the Judiciary Committee.
  Mr. CICILLINE. Mr. Speaker, I thank the gentleman for yielding and 
for his extraordinary leadership on this legislation.
  Mr. Speaker, H.R. 372, the Competitive Health Insurance Reform Act of 
2017, would partially repeal a longstanding antitrust exemption 
established by the McCarran-Ferguson Act with respect to the business 
of health and dental insurance.
  To qualify for this limited antitrust exemption, an insurer must be 
engaged in the business of insurance regulated by a State that is not 
designed to boycott, coerce, or intimidate.
  While these requirements somewhat constrain anticompetitive conduct, 
it is clear that they do not preclude the most egregious antitrust 
violations, such as price fixing, bid rigging, and market allocation, 
by health insurance providers.

                              {time}  1500

  Health insurers should not be immune from antitrust scrutiny, 
particularly when they collude to increase prices, reduce availability, 
or otherwise engage in anticompetitive behavior.
  That is why House Democrats passed a measure that is substantively 
similar to H.R. 372, in 2010, by a vote of 406-19, and in 2009, as 
well. In 1988, 1992, and 1994, Judiciary Democrats likewise favorably 
reported legislation to completely repeal the McCarran-Ferguson Act.
  While H.R. 372 is only a partial repeal of this exemption, I 
encourage my colleagues to support this measure. But let me be 
perfectly clear about three things:
  First, promoting competition in health insurance markets cannot occur 
at the expense of the strong protections established by the Affordable 
Care Act to make health markets more efficient and prohibiting 
discriminatory insurance policies. These protections are ``textbook 
measures that help promote competition in the insurance marketplace,'' 
as Professor Tim Greaney, a leading antitrust expert, testified in 
2015.
  Second, contrary to President Trump's suggestions on Twitter, 
repealing McCarran-Ferguson's antitrust exemption for health insurance 
will not remove State barriers or create new pathways for insurance 
companies to compete and offer products across State lines.
  This simplistic approach to healthcare policy overlooks the fact that 
the Affordable Care Act already allows States to establish healthcare 
choice compacts to provide for cross-State insurance sales, while five 
States have already enacted out-of-State purchasing laws. But these 
laws have done little to encourage cross-State insurance sales because 
health insurers are simply not interested in selling these products 
across State lines.
  The barriers to entry into health insurance markets ``are not truly 
regulatory, they are financial and they are network,'' as Professor 
Sabrina Corlette of Georgetown University's Health Policy Institute has 
observed.
  Notwithstanding President Trump's exaggerated claims to the contrary, 
it is also clear that enacting this legislation is not a precondition 
for Congress authorizing cross-State insurance sales.
  My Republican colleagues on the Judiciary Committee agree, noting in 
their report on the bill that ``the general consensus, including among 
witnesses at the most recent Judiciary hearing on the Competitive 
Health Insurance Reform Act, is that if Congress decides to allow 
insurers to sell across State lines, such action does not necessarily 
require a repeal of McCarran-Ferguson.''
  And third, there is no evidence that enacting this bill alone will 
improve the affordability or availability of health insurance.
  According to the Congressional Budget Office, the effect of H.R. 372 
on health insurance premiums ``would probably be quite small,'' and 
enacting the bill will have ``no significant net effect on the premiums 
that private insurers would charge for health or dental insurance.''
  Additionally, because the McCarran-Ferguson Act does not apply to 
mergers, H.R. 372 will not prevent further concentration in health 
insurance markets.
  The truth is, Mr. Speaker, if Republicans were serious about actually 
enforcing the antitrust laws, they would fully fund the antitrust 
agencies. But as we know from the Trump administration's budget 
blueprint, Republicans

[[Page 4544]]

plan to make deep cuts to the funding of enforcement agencies like the 
Justice Department, likely to the detriment of economic opportunity and 
fair competition.
  In addition, President Trump has not even nominated heads to the 
antitrust agencies. According to the Partnership for Public Service, 
even though he has been in office for 60 days, President Trump has not 
picked a nominee for 497 of the 553 positions requiring Senate 
confirmation.
  Worse still, President Trump is reportedly considering appointing a 
former lobbyist for a health insurance giant to run the Justice 
Department's antitrust division, which is tasked by Congress ``to 
protect economic freedom and opportunity by promoting free and fair 
competition in the marketplace.''
  Citing lobbying reports, the International Business Times notes that 
this particular lobbyist participated in the ``antitrust issues 
associated with Anthem's proposed acquisition of Cigna,'' and his firm 
received $375,000 in lobbying fees.
  Just last month, the Justice Department won an important lawsuit 
initiated under the Obama administration to block this merger, which, 
according to the Department of Justice, would have harmed consumers 
through increased health insurance prices, while stifling the exact 
innovation that is necessary to lower healthcare costs.
  It is unsurprising that President Trump's corporate cabinet will 
probably include yet another lobbyist that will pursue an extreme 
agenda on behalf of special interests. But the significance of this 
potential appointment cannot be overstated and absolutely will not 
result in lower prices or more choices for the American people.
  In closing, Mr. Speaker, while I support H.R. 372 as a complement to 
the Affordable Care Act, I agree with the ranking member that this bill 
is not a solution to improving the availability or affordability of 
health insurance.
  Mr. GOODLATTE. Mr. Speaker, I reserve the balance of my time.
  Mr. CONYERS. Mr. Speaker, how much time is remaining?
  The SPEAKER pro tempore. The gentleman from Michigan has 18 minutes 
remaining. The gentleman from Virginia has 21 minutes remaining.
  Mr. CONYERS. Mr. Speaker, I yield such time as she may consume to the 
gentlewoman from Texas (Ms. Jackson Lee).
  Ms. JACKSON LEE. Mr. Speaker, let me thank the gentleman very much 
for his leadership. I acknowledge the chairman of the committee for 
his, as well.
  I thank the gentleman for yielding to me, and although I will make 
the points that I think are important, I wanted to take the time to 
thank Mr. Conyers for the thoughtful legislation that he has introduced 
over the years.
  This leads me to call this the Conyers bill because of the important 
contributions it makes to ensuring that our health care is competitive, 
our health insurance is competitive, and his thoughtfulness in this 
legislation. As it comes to the floor, I am reminded of Mr. Conyers' 
influence on this legislation. It is an interesting time at which it 
comes, Mr. Speaker.
  Mr. Speaker, I rise to acknowledge the importance of H.R. 372, the 
Competitive Health Insurance Reform Act of 2017, a proposal to remove 
the antitrust exemption in the McCarran-Ferguson Act as it applies to 
health insurance.
  Overall, the proposed legislation, as well as previous attempts by 
the Judiciary Committee to repeal the McCarran-Ferguson Act's antitrust 
exemption for health insurance, does not raise new or pressing issues.
  Opponents of repeal assume problems that cannot be documented, unlike 
the very tangible and real economic and competitive costs that will be 
incurred if the exemption is allowed to continue.
  As the Justice Department has explained, where there is effective 
competition, coupled with transparency, in a consumer-friendly 
regulatory framework, insurers will compete against each other by 
offering plans with lower premiums, reducing copayments, lowering or 
eliminating deductibles, lowering annual out-of-pocket maximum costs, 
managing care, improving drug coverage, offering desirable benefits, 
and making their provider networks more attractive to potential 
members.
  That sounds, of course, like the Affordable Care Act, which we will 
celebrate tomorrow, for that was the day it was signed. That is what 
health insurance should be for the American people.
  This legislation is a very thoughtful legislative initiative, and I 
am hoping that its coming to the floor is not like trying to put 
lipstick on a pig. That, of course, is the latest configuration of the 
meaningless TrumpCare, and which the amendment that will be coming 
forward will, again, in essence, throw people off health insurance. It 
will take away all that we are intending it to do, but this legislation 
has reason.
  Other current enforcement tools and regulatory policies already in 
place address competition issues at the State and Federal level to 
police health insurance competition. In this and numerous other ways, 
effective regulation can promote improved healthcare delivery and 
improved cost control by ensuring that all insurance companies are 
required to follow certain basic consumer-friendly rules of the road.
  Again, wouldn't it be great to have this very thoughtful legislation 
with all of the points of the Affordable Care Act: it eliminates 
preexisting conditions, has lowered premiums and continues to lower 
premiums, and is lowering or eliminating deductibles. All of those were 
thoughtful of Mr. Conyers, and they would have been the right 
complement to the Affordable Care Act.
  However, the additional risks of adding new regulatory uncertainty, 
increasing boundary-testing litigation, and distracting policymakers 
from more important ways to reduce healthcare costs and improve 
healthcare competition suggest that further caution and delay on this 
front is inadvisable, given present circumstances and conditions.
  But let us not fool ourselves into thinking that the legislation 
before us is a panacea that will lead to affordable, accessible, high-
quality health care for all Americans. If that worthy goal is the 
objective sought, the best way to achieve it is to retain and 
strengthen the Affordable Care Act and abandon the misguided effort of 
House Republicans to repeal this landmark legislation and replace it 
with the pay more for less act masquerading as a healthcare bill.
  The Affordable Care Act works. I think we in the Judiciary Committee 
know it full well. We held hearings and briefings; we heard from the 
victims of those who did not have insurance, who had lost insurance, 
did not have enough insurance, or the insurance would not cover them.
  I am reminded of a very emotional story of an 8-year-old girl in the 
office of an insurance company where her family was begging for 
coverage because she had leukemia; obviously, a preexisting condition. 
It is sad to say, but I understand that she lost her life.
  The Affordable Care Act has significantly improved the availability, 
affordability, and quality of health care for tens of millions of 
Americans, including millions who previously had no health insurance at 
all.
  Americans are rightly frightened by Republican attempts to repeal the 
ACA without having in place a superior new plan that maintains 
comparable coverages and comparable consumer choices and protections, 
not throwing off 24 million Americans who will have no insurance.
  It is beyond dispute that the pay more for less plan proposed by 
Republicans fails this test miserably. The Republican pay more for less 
act is a massive tax cut for the rich, paid for on the backs of 
America's most vulnerable: those who work and who happen to be of low 
income. This Robin-Hood-in-reverse bill is unprecedented and 
breathtaking in its audacity. No bill has ever tried to give so much to 
the rich while taking so much from the poor.
  One number comes to mind: $880 billion taken away from Medicaid 
insurance covering nursing homes, patients, the blind, the disabled; 
again, then giving a great plus and a great refund in

[[Page 4545]]

tax credits to the richest in America. They will be happy. It won't be 
health care. They have got private health insurance. But it certainly 
will be a big check that they get in the mail.
  This pay more for less bill represents the largest transfer of wealth 
from the bottom 99 percent to the top 1 percent in American history. 
This Republic scheme gives gigantic tax cuts to the rich, and pays for 
it by taking insurance away from 24 million.
  In addition, Republicans are giving the pharmaceutical industry a big 
tax repeal, worth nearly $25 billion over a decade, without demanding 
in return any reduction in the cost of prescription and brand-name 
drugs. That is very important.
  To paraphrase Winston Churchill, of this bill, it can truly be said 
that never has so much been taken from so many to benefit so few.
  The pay more for less plan destroys the Medicaid program. CBO 
estimates 14 million will lose Medicaid. In 2026, 52 million Americans 
will be uninsured.
  We know that these combined policies will not help to cure some of 
the thoughtful deliberations that went into the underlying bill. We 
want more competition. We want the insurance products to be the kind of 
products that we can be sure provide health care.
  In short, the Republican pay more get less plan represents a clear 
and present danger to the financial and health security of American 
families and to the very stability of our Nation's healthcare system.
  Mr. Speaker, the healthcare marketplace is complex in how it operates 
and how it motivates providers, insurers, and consumers.
  If I can quote the 45th President, he said: ``I didn't know how 
difficult this would be.'' Well, we know how difficult it can be, and 
was.
  Mr. Speaker, Democrats held some 79-plus hearings. We had 181 
witnesses-plus. We had hundreds of hours of hearings. We held 
thousands, I might imagine, of townhall meetings. We didn't hold one 
here and one there. I myself held 11 townhall meetings.
  We continue to hear from not only the consumers, but the rural 
hospitals, the major hospitals, the senior citizens, and particularly 
those senior citizens on dealing with the cost of prescription drugs.
  I am proud to say that we saved the dastardly Medicare part D by 
closing the doughnut hole, which is closed today, so that seniors under 
the Affordable Care Act do not fall into an abyss, a deep ocean, and 
have to, in essence, not take their drugs because they don't have 
enough money.
  An effective regulatory framework is needed to shape this complex 
environment--and this is a word to the administration--to help 
safeguard consumers, help keep costs under control, and help make a 
full range of healthcare services. But our country's long experience 
shows that we cannot expect a healthcare system to run effectively on 
market competition alone. Markets can and do fail when proper 
regulation is lacking.

                              {time}  1515

  So the goodness of this bill has to go along with--a good example is 
recognizing what happens in the ACA's provision, banning insurance 
companies from denying coverage of preexisting disease--we had to help 
them along--preexisting conditions. We had to help them along. You have 
to help them along to be a good steward of the insurance that the 
American people need.
  This is a key consumer protection that the free market demonstrates 
time and time again that it could produce and needed to do. That is 
where regulation and the antitrust laws come in to protect consumer 
choice. Let me go back and say that it could not produce on its own. It 
is a per se violation of antitrust laws for competing companies to 
agree to divide markets or to fix prices. The other sectors in the 
healthcare supply chain are already subject to antitrust laws, and it 
will be beneficial to the healthcare marketplace and to consumers if 
the healthcare industry joins them. That is why I said this bill is a 
thoughtful, important bill to dealing with the complex issues of 
insurance and health care.
  I am sad to say that tomorrow, as we celebrate the Affordable Care 
Act, we will be looking toward Thursday, where we will be, in essence, 
debating a bill that takes 24 million people off of health insurance, 
period. 24 million will lose their coverage. Tax giveaways will 
continue again to the top 1 percent. That will be $600 billion in tax 
breaks to the rich and big corporations. In fact, the Republican bill 
gives $2.8 billion to 400 of the richest families in America.
  Then to add to the downside, the Affordable Care Act was known to 
create more jobs. Unfortunately, this will see 2 million jobs destroyed 
and lost. Families will be paying more for less. Young people will be 
hit with a millennial penalty. And we don't know if this formula that 
they have still stops the 50- to 64-year-olds from paying higher 
premiums. Women lose comprehensive care, middle-aged Americans pay the 
age tax, seniors see Medicaid and Medicare weakened, preexisting 
conditions and disabilities may suffer, and it does not reduce the 
deficit as the ACA does.
  My final point, if I can, we are glad to come to the floor and honor 
Mr. Conyers for this important bill and support H.R. 372. I believe 
this legislation before us does a lot more good than it does harm, but 
I hope that we can, in a bipartisan manner--maybe even in a nonpartisan 
manner--reflect on what is needed to really insure the American people 
and we can work with the Affordable Care Act, which has all of these 
positive elements, and move this country forward through competition 
and health care that saves lives.
  Mr. Speaker, overall, the proposed legislation, as well as previous 
attempts by the Judiciary Committee to repeal the McCarran-Ferguson 
Act's antitrust exemption for health insurance, does not raise new or 
pressing issues.
  Opponents of repeal assume problems that cannot be documented, unlike 
the very tangible and real economic and competitive costs that will be 
incurred if the exemption is allowed to continue.
  As the Justice Department has explained, where there is effective 
competition, coupled with transparency, in a consumer-friendly 
regulatory framework, insurers will compete against each other by 
offering plans with lower premiums, reducing copayments, lowering or 
eliminating deductibles, lowering annual out-of-pocket maximum costs, 
managing care, improving drug coverage, offering desirable benefits, 
and making their provider networks more attractive to potential 
members.
  Other current enforcement tools and regulatory policies already in 
place address competition issues at the state and federal level to 
police health insurance competition.
  In this and numerous other ways, effective regulation can promote 
improved health care delivery and improved cost control, by ensuring 
that all insurance companies are required to follow certain basic 
consumer-friendly ``rules of the road.''
  It might be argued that increasing the federal government's role in 
regulating health insurance, through expanded antitrust enforcement, 
would appear to conflict with proposed reforms to delegate more 
responsibility to state governments.
  However, the additional risks of adding new regulatory uncertainty, 
increasing boundary-testing litigation, and distracting policymakers 
from more important ways to reduce health care costs and improve health 
care competition suggest that further caution and delay on this front 
is inadvisable given present circumstances and conditions.
  But let us not fool ourselves into thinking that the legislation 
before us is a panacea that will lead to affordable, accessible, high 
quality health care for all Americans.
  If that worthy goal is the objective sought, then the best way to 
achieve it is to retain and strengthen the Affordable Care Act and 
abandon the misguided effort of House Republicans to repeal this 
landmark legislation and replace it with their Pay More For Less Act, 
masquerading as the American Health Care Act.
  The Affordable Care Act has significantly improved the availability, 
affordability, and quality of health care for tens of millions of 
Americans, including millions who previously had no health insurance at 
all.
  Americans are rightly frightened by Republican attempts to repeal the 
ACA without having in place a superior new plan that maintains 
comparable coverages and comparable consumer choices and protections.
  It is beyond dispute that the ``Pay More For Less'' plan proposed by 
House Republicans fails this test miserably.

[[Page 4546]]

  The Republican ``Pay More For Less Act'' is a massive tax cut for the 
wealthy, paid for on the backs of America's most vulnerable, the poor 
and working class households.
  This ``Robin Hood in reverse'' bill is unprecedented and breathtaking 
in its audacity--no bill has ever tried to give so much to the rich 
while taking so much from the poor and working class.
  This ``Pay More Get Less'' bill represents the largest transfer of 
wealth from the bottom 99% to the top 1% in American history.
  This Republican scheme gives gigantic tax cuts to the rich, and pays 
for it by taking insurance away from 24 million people and raising 
costs for the poor and middle class.
  In addition, Republicans are giving the pharmaceutical industry a big 
tax repeal, worth nearly $25 billion over a decade without demanding in 
return any reduction in the cost of prescription and brand-name drugs.
  To paraphrase Winston Churchill, of this bill, it can truly be said 
that ``never has so much been taken from so many to benefit so few.''
  The ``Pay More Get Less'' plan destroys the Medicaid program under 
the cover of repealing the Affordable Care Act Medicaid expansion.
  CBO estimates 14 million Americans will lose Medicaid coverage by 
2026 under the Republican plan.
  In addition to terminating the ACA Medicaid expansion, the ``Pay More 
Get Less'' plan converts Medicaid to a per capita cap that is not 
guaranteed to keep pace with health costs starting in 2020.
  The combined effect of these policies is to slash $880 billion in 
federal Medicaid funding over the next decade.
  The cuts get deeper with each passing year, reaching 25% of Medicaid 
spending in 2026.
  In short, the Republican ``Pay More Get Less Act'' represents a clear 
and present danger to the financial and health security of American 
families, and to the very stability of our nation's health care system 
overall.
  Mr. Speaker, the health care marketplace is complex in how it 
operates and how it motivates providers, insurers, and consumers.
  An effective regulatory framework is needed to shape that complex 
environment, to help safeguard consumers, help keep costs under 
control, and help make a full range of health care services available.
  But our country's long experience shows that we cannot expect a 
health care system to run effectively on market competition alone; 
markets can and do fail when proper regulation is lacking.
  A good example is the ACA's provision banning insurance companies 
from denying coverage of preexisting conditions.
  This is a key consumer protection that the free market demonstrated 
time and again that it would not produce on its own.
  And that is where regulation and the antitrust laws come in to 
protect consumer choice.
  It is a per se violation of antitrust law for competing companies to 
agree to divide markets or to fix prices.
  The other sectors in the health care supply chain are already subject 
to the antitrust laws, and it will be beneficial to the health care 
marketplace, and to consumers, if the health insurance industry joins 
them.
  For these reasons, I believe the legislation before us does more good 
than harm and, accordingly, I urge my colleagues to join me in 
supporting H.R. 372.
  Mr. GOODLATTE. Mr. Speaker, I am prepared to close, so I reserve the 
balance of my time until the other side closes.
  Mr. CONYERS. Mr. Speaker, I yield myself such time as I may consume.
  In closing, I want to reiterate my support for this measure, H.R. 
372. Now, I don't know what is happening on the other side, but many of 
its leaders voted against a substantively identical version of this 
bill in 2010, and that was including Speaker Ryan, Health and Human 
Services Secretary Tom Price, Committee on Ways and Means chairman 
Kevin Brady. They voted against a substantively identical version of 
this bill. I don't want to impugn motives that I don't know about, but 
maybe if you support H.R. 372, you are going to be making the 
Affordable Care Act, ACA, better. So I want to thank my friends on the 
other side for helping us out. This is great. We passed something like 
this a few years ago, and we were very proud that it was an 
overwhelming vote.
  This is a very important step forward. The Affordable Care Act is not 
going to be affected in any kind of negative way, and that is why I am 
eager to join with those who are going to be voting for H.R. 372. I 
thank my friends on the other side for supporting H.R. 372 as well.
  Mr. Speaker, I yield back the balance of my time.
  Mr. GOODLATTE. Mr. Speaker, I yield myself such time as I may 
consume.
  Our health insurance industry is in a dire situation. Premiums and 
deductibles are skyrocketing, hundreds of percent in some cases. In the 
State of the gentleman who is the chief sponsor of this bill, the State 
of Arizona, there has been a more than 100 percent increase in just the 
last year.
  In 2017, the national State average of insurers participating in 
Federal exchanges dropped to four, down from six the previous year. 
Five States will only have one insurer providing plans on their Federal 
exchanges this year. It is time to reverse this trend. The Competitive 
Health Insurance Reform Act is an important step in restoring 
competition to the health insurance industry and will help to set the 
foundation for additional essential reforms that must follow.
  I say to the gentleman from Michigan (Mr. Conyers), the ranking 
member of the committee and my friend, I appreciate very much working 
with him on this legislation, but I would also say to him that this 
legislation, as bipartisan as it is, cannot save the Affordable Care 
Act. It is drowning. It is denying people coverage. Its costs are going 
up so much that somebody who likes it this year will not be able to 
afford it next year.
  The promise that if you like your health insurance you will be able 
to keep it was never true, and it is still not true with ObamaCare. The 
promise that if you like your doctor you can keep your doctor was never 
true. The promise that health insurance premiums would go down under 
ObamaCare has been proven to be totally false. Instead, what we have 
done is we have denied the American people the right to choose for 
themselves what access to health care that they need and can afford.
  We have denied the American people the freedom to decide whether or 
not they want to purchase a product that is mandated upon them by the 
Federal Government. That is wrong. It has got to change. That is why we 
are taking action this week--including the Competitive Health Insurance 
Reform Act, but certainly not only the Competitive Health Insurance 
Reform Act--to return a patient-centered healthcare system to the 
American people, one that reconnects them with their healthcare 
providers, one that will make sure that they have the maximum amount of 
choice and the maximum amount of access to real, affordable health 
insurance and quality health care in America. I support this bipartisan 
legislation. I urge my colleagues to do the same.
  Mr. Speaker, I include in the Record three letters in support of H.R. 
372.

                                                  Small Business &


                                     Entrepreneurship Council,

                                    Vienna, VA, February 27, 2017.
     Hon. Paul A. Gosar,
     House of Representatives,
     Washington, DC.
       Dear Representative Gosar: The Small Business & 
     Entrepreneurship Council (SHE Council) and our nationwide 
     membership of small business owners and entrepreneurs support 
     the ``Competitive Health Insurance Reform Act of 2017'' (H.R. 
     372). Perhaps more than any other group, small business 
     owners understand the need for increased competition in the 
     health insurance marketplace. Indeed, it is the actions of 
     entrepreneurs that bring down costs, enhance innovation, and 
     boost quality in a competitive marketplace. H.R. 372 is a 
     common sense and long-overdue step to repeal special-interest 
     exemptions to federal antitrust laws for health insurance 
     companies.
       These exemptions have existed for more than 70 years, and 
     were initially instituted to help newly formed insurance 
     companies deal with data sharing. Given the dramatic changes 
     in the industry over these past many decades, such special-
     interest treatment is no longer warranted.
       Considering the government-imposed distortions within the 
     health care industry as a result of the Affordable Care Act 
     and other regulatory restrictions, full-blown review and 
     reform of health care policies focused on expanding 
     competition, and consumer choice are needed. That includes 
     foundational changes, such as, in the case of H.R. 372, 
     removing special-interest treatment that could reduce or 
     retrain competition.
       In order to bring down health insurance costs and utilize 
     the models and technologies

[[Page 4547]]

     of our modern economy to drive value and innovation within 
     this sector, entrepreneurs need a system that allows for such 
     freedom and creativity. Your bill is an important step in 
     bringing down artificial barriers that are preventing much 
     needed innovation and competition. Thank you for your 
     leadership on this important issue. Please let SBE Council 
     know how we can help you advance H.R. 372 into law.
           Sincerely,
                                                   Karen Kerrigan,
     President & CEO.
                                  ____



                        American Dental Association,

                                Washington, DC, February 24, 2017.
     Hon. Bob Goodlatte,
     Chairman, House Committee on the Judiciary, Washington, DC.
     Hon. John Conyers, 
     Ranking Member, House Committee on the Judiciary, Washington, 
         DC.
       Dear Chairman Goodlatte and Ranking Member Conyers: The 
     dental professional organizations listed below, as members of 
     the Organized Dentistry Coalition, are writing to express our 
     strong support of H.R. 372, The Competitive Health Insurance 
     Reform Act.
       H.R. 372 would authorize the Federal Trade Commission and 
     the Justice Department to enforce the federal antitrust laws 
     against health insurance companies engaged in anticompetitive 
     conduct. It would not interfere with the states' ability to 
     maintain and enforce their own insurance regulations, 
     antitrust statues, and consumer protection laws. Because 
     states vary in their enforcement efforts, the impact of 
     repeal on health insurance companies would differ from state 
     to state. This is no different from the situation faced by 
     other businesses.
       The bill is narrowly drawn to apply only to the business of 
     health insurance, including dental insurance, and would not 
     affect the business of life insurance, property or casualty 
     insurance, and many similar insurance areas.
       Passage of H.R. 372 would help interject more competition 
     into the insurance marketplace by authorizing greater federal 
     antitrust enforcement in instances where state regulators 
     fail to act. When competition is not robust, consumers are 
     more likely to face higher prices and less likely to and less 
     likely to benefit from innovation and variety in the 
     marketplace.
       On behalf of our member dentists and their patients, we 
     urge you to cosponsor H.R. 372, The Competitive Health 
     Insurance Reform Act.
       Please contact Ms. Midi Walker with any questions.
           Sincerely,
         American Dental Association; Academy of General 
           Dentistry; American Academy of Oral and Maxillofacial 
           Pathology; American Academy of Pediatric Dentistry; 
           American Association of Endodontists; American 
           Association of Oral & Maxillofacial Surgeons; American 
           Association of Women Dentists; American Society of 
           Dentist Anesthesiologists.
                                  ____

                                                   March 21, 2017.
       Dear Representative: The undersigned organizations urge 
     your support for H.R. 372, the ``Competitive Health Insurance 
     Reform Act of 2017.'' This bill takes an important step in 
     bringing consumers the benefits of competition under the 
     antitrust laws, in the way health insurance is offered, 
     marketed, and sold.
       The rules of competition apply to every other part of the 
     health care system, health insurance is an aberration. The 
     antitrust laws are a key to making sure that the free market 
     works for consumers, and the insurance industry should not be 
     left out.
       Congress created this antitrust exemption almost by 
     accident, in the midst of the Second World War--when 
     attentions were rightly directed elsewhere--in the wake of a 
     Supreme Court decision clarifying that the antitrust laws did 
     apply to insurance. It started out to be a temporary three-
     year breathing spell, to allow insurers to familiarize 
     themselves with the antitrust laws and adjust their practices 
     to the accepted rules of competition. Instead, a few poorly-
     understood words added in conference committee turned the 
     temporary delay into an unintended exemption from those 
     rules.
       It is long since time to correct that error. Among other 
     experts who have called for doing so, the Antitrust 
     Modernization Commission, established in 2002 by legislation 
     authored in this Committee, singled out this exemption for 
     particular skepticism as to any justification for it. While 
     we would ultimately like to see this antitrust exemption 
     removed for all insurance, focusing on the health insurance 
     industry now is a logical and important positive step to take 
     at this time.
       We note that the proposed manager's amendment would 
     preserve the antitrust exemption in ``safe harbors'' for four 
     described activities--(1) compilation of historical loss 
     data, (2) development of what is known as a ``loss 
     development factor'' to fill holes in the historical data, 
     (3) some actuarial services, and (4) some standardization of 
     policy forms. In our view, the most effective way to remove 
     this exemption is to do so cleanly, without new safe harbors. 
     Further, the kinds of insurance industry activities commonly 
     described as the justification for these particular safe 
     harbors do not raise antitrust issues, as they are described. 
     Nonetheless, we believe these safe harbors, as written, do 
     not significantly risk inadvertently immunizing 
     anticompetitive conduct that would violate the antitrust 
     laws, and therefore that they do not diminish the beneficial 
     purpose and effect of the bill.
       There is also another set of ``safe harbor'' antitrust 
     exemptions imbedded in the definition of ``business of health 
     insurance (including the business of dental insurance)'' in 
     the new subsection 2(c)(3)(B)(ii)(I) as added by the bill. 
     They include a number of types of benefits referenced in the 
     Internal Revenue Code as ``excepted benefits.'' While the 
     lead-in to (3)(B)(ii) characterizes these as types of 
     property-casualty insurance, there are three that by their 
     terms in the Internal Revenue Code do not fit within what is 
     considered property-casualty insurance, and that consumers 
     would consider to be types of health insurance.
       Among these are hospital indemnity insurance, 26 U.S.C. 
     9832(c)(3)(B); coverage for a specified disease or illness, 
     26 U.S.C. 9832(c)(3)(A); and an open-ended ``such other 
     similar, limited benefits as are specified in regulations,'' 
     26 U.S.C. 9832(c)(2(C). This last one is found in the same 
     Internal Revenue Code provision that lists dental coverage as 
     an excepted benefit, meaning that the ``similar'' benefits 
     that could be potentially excluded by regulation--and thereby 
     get an automatic antitrust exemption--could be anything 
     similar to a category such as dental coverage--which might be 
     any kind of specified benefit.
       While there may have been justification for excepting these 
     categories of benefits from federal regulatory requirements 
     such as portability under the Affordable Care Act--which is 
     what 26 U.S.C. 9832(c) is in reference to--that does not mean 
     it makes sense to exempt them from the antitrust laws. The 
     bill recognizes this for dental coverage, and explicitly 
     takes the cross-reference to it out of the safe harbor, to 
     ensure that it is covered by the bill. We hope that, as the 
     bill moves forward, the three new antitrust exemptions in the 
     cross references described above will also be removed, so 
     that these types of health-related insurance coverage will 
     likewise be subject to the antitrust laws.
       We remain strong supporters of the Affordable Care Act, 
     which has significantly improved the availability and 
     affordability of health care for many millions of Americans, 
     including millions who previously had no health insurance. We 
     would be very concerned by any move to repeal the Affordable 
     care Act without having an effective new plan already figured 
     out and in place that maintains comparable coverages and 
     comparable consumer choices and protections. Such a move 
     would be a grave threat to the financial and health security 
     of American families, and to the very stability of our 
     nation's health care system overall.
       At the same time, we also strongly support bringing the 
     antitrust laws into play in this important sector of the 
     health care marketplace. That marketplace is complex in how 
     it operates and how it motivates providers, insurers, and 
     consumers. An effective regulatory framework is needed to 
     shape that complex environment, to help safeguard consumers, 
     help keep costs under control, and help make a full range of 
     health care services available. Our country's long experience 
     shows you can't expect a health care system to run 
     effectively on competition alone.
       But consumers will benefit from also having effective 
     competition, at all levels in the supply chain. Even the best 
     regulatory framework works better where competition, within 
     the bounds of that framework, gives businesses a market-
     driven incentive to want to improve service while holding 
     down prices and providing better value. Regulation and 
     competition both work best when they can work hand in hand.
       As the health care marketplace evolves, having the 
     antitrust laws apply will give health insurers competition-
     based incentives to improve the way they provide coverage to 
     consumers, with higher quality, better choice, and more 
     affordability. Better competition will help bring insurer 
     incentives better in line with benefiting consumers.
       As the Justice Department has explained, where there is 
     effective competition, coupled with transparency, in a 
     consumer-friendly regulatory framework, insurers will be 
     spurred to compete against each other by offering plans with 
     lower premiums, reducing copayments, lowering or eliminating 
     deductibles, lowering annual out-of-pocket maximum costs, 
     managing care, improving drug coverage, offering desirable 
     benefits, and making their provider networks more attractive 
     to potential members.
       Competition will be beneficial to consumers in the health 
     insurance marketplace just as it is everywhere else in our 
     economy.
       We urge your support for H.R. 372.
           Respectfully,
     George P. Slover,
       Senior Policy Counsel, Consumers Union.
     J. Robert Hunter,
       Director of Insurance, Consumer Federation of America.

[[Page 4548]]


     Linda Sherry,
       Director of National Priorities, Consumer Action.

  Mr. GOODLATTE. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to House Resolution 209, the previous question is ordered on 
the bill, as amended.
  The question is on the engrossment and third reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.


                           motion to recommit

  Ms. ROSEN. Mr. Speaker, I have a motion to recommit at the desk.
  The SPEAKER pro tempore. Is the gentlewoman opposed to the bill?
  Ms. ROSEN. I am opposed to the bill in its current form.
  The SPEAKER pro tempore. The Clerk will report the motion to 
recommit.
  The Clerk read as follows:

       Ms. Rosen moves to recommit the bill (H.R. 372) to the 
     Committee on the Judiciary, with instructions to report the 
     bill back to the House forthwith with the following 
     amendment:
       At the end of the bill, add the following:
       (c) Protecting Affordable Health Care for Older 
     Americans.--Section 3 of the Act of March 9, 1945 (15 U.S.C. 
     1013), commonly known as the McCarran-Ferguson Act, is 
     further amended by adding at the end of subsection (c), as 
     added by subsection (a), the following:
       ``(4) Paragraph (2) shall not apply to an issuer in the 
     business of health insurance (including the business of 
     dental insurance and limited-scope dental benefits) if the 
     issuer varies the premium for any health insurance by age in 
     a manner so that the premium for an individual who is 55 
     years of age or older is more than 3 times the premium for an 
     individual who is 21 years of age or younger.''.

  Ms. ROSEN (during the reading). Mr. Speaker, I ask unanimous consent 
to dispense with the reading.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Nevada?
  There was no objection.
  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Nevada is recognized for 5 minutes in support of her motion.
  Ms. ROSEN. Mr. Speaker, this is the final amendment to the bill, 
which will not kill the bill or send it back to committee. If adopted, 
the bill will immediately proceed to final passage, as amended.
  Mr. Speaker, last night, in an effort to secure more votes to pass 
the so-called American Health Care Act, the GOP made another last-
minute attempt to modify its replacement plan for the Affordable Care 
Act--a replacement that I can only describe as a disastrous piece of 
legislation--by offering a short-term fix to try and regulate the 
massive rise in premiums that Americans over the age of 50 are expected 
to incur under their current plan.
  H.R. 372 is a measure that simply ends health insurance antitrust 
exemption. What is ironic is that the proposed legislation is being 
messaged by the GOP as a bipartisan bill, a no-brainer. But Republicans 
have never lifted a finger to end the antitrust exemption. For years, 
Congressman John Conyers and the Democrats have advocated ending health 
insurers' special treatment.
  The reality is, while this is an unobjectionable bill on its own, 
H.R. 372 has nothing to do with reversing the extraordinary damage that 
the GOP plan will unleash on this country. The fact is this will not 
help us solve the fundamental issues underlying the GOP's repeal-and-
replace bill. Yet, instead of fixing what we know is not working under 
the current law, the GOP has offered this Band-Aid to help mend a bill 
that needs major surgery. H.R. 372 is simply a complement to help fix 
our healthcare system, not an alternative.
  One of the worst aspects of the GOP's repeal is the fact that it 
implements an age tax. Americans over the age of 50 will be forced to 
pay up to five times more than what young Americans would pay for 
coverage. In my district alone, we have roughly 89,000 people between 
the ages of 50 and 64 who would see their premiums and the cost of 
their insurance rise significantly.
  I recently heard from one of my constituents within that age bracket. 
He is a retired firefighter who served our country for 29 years and is 
now disabled. So after many years of service, Ted is worried that if 
the GOP plan becomes the new law, he and his wife would be kicked off 
their insurance plans simply because their insurance would become 
unaffordable.
  If this is what the GOP has offered to fix their disastrous repeal, 
then I am sad to say, my friends, you have missed the mark once again. 
According to the Congressional Budget Office, if the GOP repeal is 
enacted, 14 million Americans nationwide will be kicked off their 
insurance coverage by the end of this year alone.
  So let me be clear. The problem with the GOP repeal is that as 
Americans age, they get less and less coverage. We need to protect 
those Americans who are fast approaching their Medicare-eligible years 
but who, for now, are still bearing the heaviest cost of private 
insurance.
  My motion to recommit makes this possible by turning this Band-Aid of 
a bill into something that actually helps drive down costs for older 
Americans. It does this by allowing insurance companies to take part in 
the bill's safe harbor protections only if they charge individuals over 
55 less than three times as much as younger Americans. Since insurance 
companies consider these safe harbors critical for their survival, this 
will reverse one of the worst parts of the Republican health plan, 
allowing insurance companies to charge older Americans five times or 
even more for health insurance.
  I call on my colleagues on the other side of the aisle to show that 
they aren't tone deaf and that they haven't lost touch with the needs 
and wants of their constituents, and I urge my colleagues to vote in 
favor of the motion to recommit so that we can protect our seniors and 
the most vulnerable of Americans among us.
  Mr. Speaker, I yield back the balance of my time.
  Mr. GOODLATTE. Mr. Speaker, I claim the time in opposition to the 
motion.
  The SPEAKER pro tempore. The gentleman from Virginia is recognized 
for 5 minutes.
  Mr. GOODLATTE. Mr. Speaker, the McCarran-Ferguson Act was originally 
passed to leave the regulation of the business of insurance with the 
States and to allow insurers to engage in certain procompetitive 
collaborative activities.
  This legislation limits significant uncertainty and unnecessary 
litigation that would likely result from a broader McCarran-Ferguson 
repeal through the use of safe harbors for such historically 
procompetitive collaborative activities, specifically the collection 
and distribution of historical loss data, the determination of loss 
development factors, the performance of actuarial services that do not 
involve restraints of trade, and the use of common forms that are not 
coercive.
  Absent these safeguards, insurers will likely disengage from certain 
proconsumer collaborative activities, eliminating or impeding smaller 
insurers from competing and disincentivizing larger insurers from 
exploring new products and markets. This will lead to further market 
consolidation and fewer product choices, the impact of which will 
eventually be borne by the consumer.
  These narrow safe harbors create a presumption that certain 
procompetitive activities can continue while maintaining regulation and 
oversight to the extent any activity crosses over into a restraint of 
trade. As a result, insurers can continue to engage in proconsumer 
business practices, and will be encouraged to provide a diverse range 
of offerings at fair and reasonable prices.
  There is no reason to make an exception to these safe harbors. 
Therefore, I oppose the motion. I urge my colleagues to reject this 
motion to recommit and to support the underlying bill.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. Without objection, the previous question is 
ordered on the motion to recommit.

[[Page 4549]]

  There was no objection.
  The SPEAKER pro tempore. The question is on the motion to recommit.
  The question was taken; and the Speaker pro tempore announced that 
the noes appeared to have it.
  Ms. ROSEN. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

                          ____________________