Democrats in the U.S. House of Representatives have orchestrated what they hope will be a small victory in this session's health debates: getting a limited repeal of health insurers' antitrust exemption. Medical liability insurers have been included with health insurers in previous versions of this legislation, but they may not appear in the final bill that Democrats intend to put forward for a vote.

The Democratic leadership is clearing the way for a new bill from a pair of House freshmen. One of them, Rep. Tom Perriello, D-Va., told BestWire the primary focus of the bill is health insurance. His bill "is not trying to get into the property/casualty area," though he added that the legislation is not yet finished and no final call has yet been made on medical liability.

"We'll reach final decision on that here in the near future," Perriello said. "It's possible those would be done as two separate bills."

Though the legislation was meant to be introduced this week in the House, Capitol Hill has been largely shut down by the pair of snow storms that have besieged the East Coast. The lawmakers are scheduled to return to work on Feb. 22. Perriello, who is sponsoring the bill along with Rep. Betsy Markey, D-Colo., predicted the bill would be ready to go by then.

The legislation -- marking a limited repeal of the McCarran-Ferguson Act of 1945 -- will be two pages long, the lawmaker said. "It's a simple bill," he said, adding he intends for it to be "pure" and direct, without some of the compromises that have been worked into previous efforts during this session.

According to the office of House Majority Leader Steny Hoyer, this new bill will be allowed to bypass the committee process and be thrust into a fast floor vote. The leadership has decided to use this version instead of an existing bill introduced in September by Rep. John Conyers, D-Mich., chairman of the House Judiciary Committee. Conyers' version had already passed through committee and had been the basis of the antitrust repeal that appeared in the health reform bill that passed the House.

As somebody new to politics, Perriello said he wanted "to have something that's a clean bill, with no carve-outs or exceptions. ... For me, it's very important that is does not include some of the previous loopholes that have been included in this process."

Melissa Shelk, the American Insurance Association's vice president for federal affairs, said her organization has been urgently trying to explain to people on Capitol Hill the distinctions between health and medical liability insurance. "We've been trying quite hard for the last couple of weeks," she said. And the AIA is also trying to make another central point: "Passage of this for medical malpractice is likely to cause a contraction in the industry and less competition."

Health insurers have been similarly opposed to their component of the legislation. Karen Ignagi, president of chief executive of America's Health Insurance Plans, sent a letter to Conyers in October, referring to that lawmaker's antitrust bill. "We believe that health insurers have not been engaging in anti-competitive conduct and that McCarran-Ferguson does not provide a shield for such conduct. Thus, the bills attempt to remedy a problem that does not exist," she wrote. She contended that the bill would also lead to "increasing legal uncertainty," a point that AHIP has repeatedly argued in recent months.

(Jesse A. Hamilton, Washington bureau manager: Jesse.Hamilton@ambest.com)