The U.S. Senate bill that would take broker compensation out of the medical loss ratio equation hasn't moved in the more than two months since it was introduced. Not surprising given recesses and outings by top administration officials to discuss broader issues, like the budget, in front of Senate committees. But what are the chances of this bill gaining any ground in the 113th Congress?

"It depends on how rocky the rollout [of ACA's exchanges] is in October. If the rollout is really rocky, I'd imagine that more expansive modifications will take priority," says Scott Harrington, professor of health care management and business economics and public policy at The Wharton School at University of Pennsylvania. "There will be a tendency to not pass narrow legislation."

Sens. Mary Landrieu (D - La.), Johnny Isakson (R - Ga.), Mark Begich (D - Alaska) and Lisa Murkowski (R - Alaska) introduced the MLR bill, S.650, in late March. Spokespersons for Landrieu and Isakson said they have no update on the bill moving to hearing in the Senate Small Business Committee, which Landrieu chairs. John Greene, VP of congressional affairs at NAHU, helped craft the bill and says there will be a hearing, but the next step is for Landrieu and Isakson to build more bipartisan co-sponsorship.

"No one's going to do anything until they see the evidence," Greene says, referring to forthcoming information on the carriers that will be on the federal public exchange and other unknowns from the Department of Health and Human Services, like rate data. "And the situation in different states will change."

Greene is working now to lay the foundation for a similar broker-friendly MLR bill in the House of Representatives. He says the first step is working with the Congressional Budget Office, because that group's assumption is that the MLR regulation has held premiums down. Previous broker-friendly bills on the MLR were introduced in the 112th Congress. However, the Senate bill in the last session never went to hearing.

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