Editorial: A matter of trust

The insurance industry may find out that there's something worse than having to compete with a Medicare-style health plan for working-age Americans. How about yanking its long-standing exemption from federal antitrust laws?

Some lawmakers see a repeal as a good way to inject more price competition and efficiencies into the $2.5 trillion health-care economy.

The head of the Justice Department's antitrust division, Assistant Attorney General Christine A. Varney, told Congress last week that repealing the antitrust law, the McCarran-Ferguson Act, would spur competition and industry reforms.

What really revved up enthusiasm for the idea was the industry release last week of a flawed study on the various health-reform measures under consideration.

The study contended that health-insurance premiums would shoot up under reform, threatening middle-class Americans' coverage. But the study didn't include the value of planned government subsidies for low-income families to buy insurance. Details, details.

President Obama responded through his Saturday radio address by denouncing "deceptive and dishonest ads" and threatening to take away the antitrust exemption.

Nearly 20 years ago, the insurance industry's "Harry and Louise" ads helped sabotage health-care reform. Now it looks as if the industry is at it again, despite pledges to work toward a deal.

As Obama noted, "Every time we get close to passing reform, the insurance companies produce these phony studies as a prescription and say, 'Take one of these, and call us in a decade.' Well, not this time."

Insurers say the antitrust exemption allows them to share market data and best practices. The industry says that benefits consumers by reducing costs. Tell that to other businesses that really have to compete and innovate.

Many insurance markets are dominated by a couple of insurers who boost rates by double digits annually. Indeed, the risk of even less competition led Pennsylvania insurance regulators to oppose the merger early this year of the Philadelphia insurance giant, Independence Blue Cross, and Pittsburgh's Highmark.

The threat of eliminating the antitrust exemption could prompt insurers to rethink their opposition to the so-called public option. (That might be even more likely if the president's aides would stop signaling that Obama may sign a reform bill without a public plan.)

The top industry lobbyist, Karen Ignagni of America's Health Insurance Plans, says insurers still want to reform health care. She has raised valid concerns that the Senate Finance Committee proposal will let young, healthy workers delay buying insurance until they get sick, raising costs for all.

But insurers don't help their cause by spinning other details of the reform bills. While the industry can try to dismiss the antitrust threat as a "political ploy," it would be smarter for insurers to commit to reforms that lower costs and expand coverage.