After a week’s delay following the shootings in Tucson, Republicans in the House of Representatives will kick off their health reform effort overhaul today. Yesterday the House began debating the Republicans’ measure, “Repealing the Job-Killing Health Care Law Act” (H.R. 2).

The bill is expected to pass the House, with the vote falling along partisan lines. The Senate currently has no plans to consider the legislation.

But supporters of repealing the law won’t have to wait long for the next shoe to drop in the House. On Thursday, Republicans plan to pass a resolution directing House committees with jurisdiction over PPACA to begin crafting legislation replacing key provisions of the law with alternative approaches. This will lay the foundation for a lengthy, deliberate process to “repeal and replace” those provisions one by one.

Last week NAHU voiced brokers’ support for the repeal-and-replace strategy. In a letter to House Speaker John Boehner (R-Ohio) and House Majority Leader Eric Cantor (R-Va.), NAHU’s Janet Trautwein urged the lawmakers “to repeal PPACA and put in place more meaningful and sustainable health reform initiatives.

“We believe that PPACA will ultimately do consumers more harm than good, and a fresh approach is needed,” Trautwein wrote. In particular, the letter listed six areas of concern, starting with the medical loss ratio provisions. Also on the list: “inconsistent and arbitrary” implementation of the law; lack of meaningful cost controls; “billions of dollars in new taxes and fees” that will raise the cost of health insurance; “perverse incentives” for employers to drop their health plans once the state exchanges are in operation; and PPACA’s “questionable, double-counted savings” that will add to the deficit instead of reducing it.

The MLR issue, of course, remains the issue of greatest concern to brokers. As Joel Wood, senior vice president of government affairs at the Council of Insurance Agents & Brokers, notes, “We’re already feeling significant impact, particularly in the small group markets, of how disruptive the [MLR] formula will be. What angers us the most about the MLR is that as a cost control, it is actually a perverse disincentive for plans to restrain costs — the bigger the premium, the easier it is to hit the administrative percentage targets.”

Removing the agent/broker compensation piece from the MLR calculation remains CIAB’s “biggest legislative priority” in this session of Congress, according to Wood.

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