Will Republicans and Democrats learn
to get along again?
The budgetary meltdown in April, which marked a new low in
the polarization of Washington, has repercussions on our
insurance agenda—from the most mundane issues to the most
But first, this rant from your lobbyist: Do we really have
to wait until the results of the next election are in before we
can envision big legislative results? Will we ever see
bipartisan “regular order” again? Are the
thoughtful moderates nearing extinction? Has noise permanently
There, I feel better.
On to the mundane. Efforts at overhauling the federal flood
insurance program have for years been akin to Lucy yanking the
football away from Charlie Brown—lots of determination
and good intention but nothing to show for it. As a result,
Congress has continually extended the same program, with its
$18 billion hole, and it’s now set to expire in
The House Financial Services Committee made a good start in
April by passing a reform package that would set the program on
a more actuarially sound path. The Senate Banking Committee,
though, has been off to an extremely slow start, with no clear
path forward on reform.
What does this have to do with the nasty politics of fiscal
reform? It’s no longer clear that the flood program
passes the taste test of insurgent Republicans, such as Rep.
Candice Miller, who is pushing a bill, favored by the Tea
Party, to simply end the federal flood program. She’s not
going to win, but if the program continues to be a big drain on
the Treasury, right-wingers could seize on it as an example of
everything that’s wrong with government. Whether or not
you’re involved in selling flood policies, this is worth
keeping your eye on.
On the much bigger issues, the budget battles demonstrated
how difficult it will be to roll back any major provision of
the healthcare reform law. Republicans were juiced to repeal
the law after the election, and everyone knew that with control
of one half of one third of the government, that effort would
hit a brick wall, which it did. Attempts to defund the
enactment of the law have similarly fizzled.
Defunding the law might sound good, but it doesn’t
change the law. The minimum medical loss fatio (MLR) formula is
the law right now, regardless of whether or not the Department
of Health and Human Services can enforce it.
Frothing-at-the-mouth conservatives want to upend every
element of the law. The 2010 election results may have felt
like a mandate, but Senate Majority Leader Harry Reid, D-Nev.,
still controls his chamber. It still takes 60 votes to get
anything done in the Senate, and Republicans are 16 votes
short. Barack Obama is still the president, the healthcare law
is his signature domestic achievement, and he's running for
re-election on it. Outside of the 1099 issue and perhaps a
couple of other nips and tucks, he’s not about to sign
major reforms to the healthcare law.
Where does that leave us on getting broker comp exempted
from the MLR calculation? Reps. Mike Rogers, R-Mich., and John
Barrow, D-Ga., have introduced legislation in the House to do
so, and it is attracting co-sponsors. We have a shot, albeit an
uphill one, of getting it enacted. But we need to get traction
in the next couple of months.
Anyone in Washington with a stake in health issues (that is,
everyone) wants to tweak the law. Docs, hospitals, drug
companies, medical device companies, labor unions, health
plans, you name it. They all want a fix that they claim is
discreet. Having met with Speaker Boehner’s health policy
advisor a couple of times already this year, I can attest that
she’s heard it all.
Some Republican leaders, notably Budget Committee chairman
Paul Ryan, say they don’t want to do a damn thing to
“improve” Obamacare. For them, it’s all about
2012 and total repeal.