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Grassroots activism spurs insurance exemption legislation

Washington—The Association delivered a member-driven "ask" to Congress as lawmakers craft health care reform legislation: "Include language to repeal the McCarran-Ferguson Act’s exemption of the health insurance industry from the federal antitrust laws."

ADA officials punctuated the message with an Oct. 15 "action alert" to grassroots dentists whose push for repeal at the May 2009 Washington Leadership Conference energized the ADA's legislative effort to overturn the 64-year insurance exemption.

"Ask your senators to contact Senate leadership and advocate for the inclusion of this repeal provision in the Senate health care reform measure so that insurers cannot engage in price fixing without fear of federal scrutiny to the detriment of consumers and health care providers," said the alert signed by ADA President Ron Tankersley and Executive Director Kathleen O’Loughlin.

Legislation offered in the U.S. Senate would remove the exemption for health and medical malpractice insurers.

"The American Dental Association believes that health care consumers are adversely affected by the McCarran-Ferguson Act exemption from federal antitrust laws," the ADA leaders said. "When insurance companies are permitted to work jointly, consumers are less likely to see as much innovation and variety in the marketplace as they would in an atmosphere of robust competition for their business.

The e-mailed "action alert" asked recipients to click on an embedded link "to write your senators, asking that they support the repeal of the McCarran-Ferguson antitrust exemption as part of health care reform." Within hours, upwards of 1,000 recipients had communicated with the U.S. Senate as measured by Capwiz. Association "action alerts" reach some 22,000 grassroots dentists and dental leaders.

The Association will reinforce the Oct. 15 "action alert" with e-grams to a wider ADA member base. An ADA-convened Insurance Reform Coalition of dental and consumer organizations will follow up with similar messages to a broader advocacy base.

In noting the current activities around McCarran-Ferguson, Dr. Tankersley later commented, "The ADA is delighted to see that in the current environment people have realized that this unjustified exemption does nothing but favor insurance companies at the expense of everybody else. We've been trying to get this on the table for 20 years, and our most recent efforts were initiated by Dr. Paul Gosar, who served as vice chair of the ADA Council on Government Affairs. The issue is gaining traction and that's good for patients and for dentistry."

The Association has long supported repeal of the antitrust exemption for the "business of insurance" and has participated in repeal efforts that generated far less steam in previous Congresses. Interest in the issue in the House of Representatives and the Senate has peaked with the push for health care reform legislation and concomitant attempts to regulate the health insurance industry while extending coverage.

McCarran-Ferguson repeal legislation has been offered in both the House and Senate, and the Senate Judiciary Committee took testimony on the issue Oct. 14.

'"Health insurance monopolies shouldn’t be making health care decisions for patients," Senate Majority Leader Harry Reid (D-Nev.) said in prepared testimony. "No one should come between a patient and their doctor when it comes to making health care decisions. There is no reason why the insurance companies should have exemption from antitrust laws."

Sen. Patrick Leahy (D-Vt.), chief sponsor of the Senate bill, and other senators spoke to the need to "fix this anachronism in the law once and for all." Sen. Russ Feingold (D-Wis.) said, "Since McCarran-Ferguson was enacted, it has become clear that the health and medical malpractice insurers have abused this exemption to the detriment of patients and doctors everywhere."

Christine Varney, the administration’s antitrust witness at the Senate hearing, told Congress, "the Department of Justice generally supports the idea of repealing antitrust exemptions. However, we take no position as to how and when Congress should address this issue." She is assistant attorney general for the Justice Department’s antitrust division. Other statements and hearing information are posted at

The ADA Washington Leadership Conference position paper developed in response to member requests and available on the advocacy page as a PDF file says repeal would benefit consumers and increase opportunities to challenge collective action by insurance companies.

In preparing for the WLC, the ADA Washington Office asked registrants to identify "the one issue you believe we should bring before Congress at this year’s conference." Repeal of McCarran-Ferguson led the list.

During the WLC, grassroots dentists took a repeal message to Capitol Hill in meetings with members of Congress and legislative staff. The Association later convened the Insurance Reform Coalition, and legislation that had languished gained new life.