January 25, 2001

Dear Member of Congress:

Amid the political pressures in the last Congress, particularly in relation to health care issues, the House of Representatives passed H.R. 1304, a bill introduced by former Rep. Tom Campbell that would permit physicians to engage in collusive and cartel-like conduct without fear of prosecution under the antitrust laws. In consideration of the strong concerns raised against the House bill, the Senate did not pass this legislation and, indeed, no Senator even introduced a companion measure. The Antitrust Coalition for Consumer Choice in Health Care -- a broad consortium of employers, health plans, health care professionals, and others involved in the purchase, management, and delivery of health care services -- respectfully urges Members of the 107th Congress to strongly oppose any legislation similar to H.R. 1304 that would create broad antitrust immunity for physicians.

In the last Congress, proponents of H.R. 1304 recruited many cosponsors with the simplistic and misleading argument that the legislation was necessary to permit physicians to negotiate effectively with insurers and managed care plans. As the debate over the bill evolved, however, serious flaws in the legislation became apparent.

First, the Federal Trade Commission, the Antitrust Division of the Department of Justice, the Antitrust Section of the American Bar Association, and the American Antitrust Institute opposed the bill on the grounds that it was unnecessary and would contravene sound antitrust law and policy.

Second, the Congressional Budget Office estimated that the bill would reduce federal tax revenues by $3.6 billion over a ten-year period, cause lost wages and fringe benefits totaling $12.4 billion during the same time, increase health insurance premiums by 1.5%, and raise significantly the cost of several federal health care programs such as Medicaid, SCHIP, and FEHBP.

Third, the proposal would materially increase the number of uninsured, and cause employers to restrict the types of health plans that are purchased and reduce the scope of coverage provided.  

Fourth, H.R. 1304 would permit physicians to engage in price-fixing, group boycotts, and other anti-competitive conduct under the protection of unfettered antitrust immunity not subject to oversight by any regulatory agency such as the FTC or the Department of Justice. Such statutory immunity is unprecedented in over a century of antitrust law.

Fifth, the bill would permit doctors to use such anti-competitive tactics to eliminate certain consumer protections from insurance contracts. Contractual protections against "balance billing" - provisions that limit what doctors can charge patients above and beyond what their insurance pays - would be threatened if H.R. 1304 were enacted.

Sixth, diverse groups such as the Consumer Federation of America, National Conference of State Legislatures, Democratic Leadership Council, American Legislative Exchange Council, as well as leading economists and editorial boards (e.g. the New York Times and Chicago Tribune) expressed deep concerns about the bill.

The 107th Congress has an excellent opportunity to ensure that quality health care and sound public policy trump campaign politics by deterring the introduction and consideration of any legislation similar to H.R. 1304.

Sincerely,

American Academy of Nurse Practitioners

American Association of Colleges of Nursing

American Association of Health Plans

American Benefits Council

American College of Nurse-Midwives

American Insurance Association

Arizona Chamber of Commerce

Arkansas State Chamber of Commerce and the Associated Industries of Arkansas

Association of Women's Health, Obstetric and Neonatal Nurses

Blue Cross Blue Shield Association

Central Florida Health Care Coalition

Colorado Association of Commerce and Industry

Community Healthcare Coalition, Inc.

Connecticut Business and Industry Association

Employers Health Care Coalition of Los Angelos

Federation of American Hospitals

Hawaiian Electric

Health Insurance Association of America

Healthcare Leadership Council

Heartland Healthcare Coalition

Idaho Association of Commerce and Industry

Indiana Chamber of Commerce

Massachusetts Nurses Association

Michigan Chamber of Commerce

Minnesota Chamber of Commerce

Missouri Chamber of Commerce

National Association of Childbearing Centers

National Association of Health Underwriters

National Association of Manufacturers

National Association of Rehabilitation Agencies

National Business Coalition on Health

National Retail Federation

Ohio Chamber of Commerce

Pennsylvania Chamber of Business and Industry

Piedmont Health Coalition, Inc.

Pittsburgh Business Group on Health

Premier Inc.

The State Chamber, Oklahoma's Association of Business and Industry

Tennessee Association of Business

Texas Association of Business and Chambers of Commerce

U.S. Chamber of Commerce

Vermont Chamber of Commerce

Virginia Chamber of Commerce

Aetna Inc.

Caterpillar Inc.

CIGNA Corporation

First Health Group Corporation

Guardian Life Insurance Companies of America

Mutual of Omaha Companies

Principal Financial Group

United Health Group

Wausau USA Benefits Inc.

WellPoint Health Networks