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H.R. 372: Competitive Health Insurance Reform Act of 2017

Mar 22, 2017 at 1:52 p.m. ET. On Passage of the Bill in the House.

This was a vote to pass H.R. 372 (115th) in the House.

Health care is one of the most contentious and partisan issues on Capitol Hill, but a bill intended to increase competition in the health insurance market passed the House almost unanimously in March.

The context

Most industries are subject to federal anti-trust laws, which prevent any one business within that industry from becoming too large or comprising too much of the market, for fear of price fixing and quality declines for consumers. However, Congress has granted a few exceptions through the years, including for some agricultural cooperatives, labor unions, and even the NFL and NBA for sports leagues. (That’s why there’s only one major football or basketball league in this country.)

Health insurance is one of the few industries granted this anti-trust exemption, going back to a 1945 law. Amid skyrocketing healthcare costs, a bipartisan near-consensus has emerged that this exemption may have outlived its usefulness.

What the bill does

The Competitive Health Insurance Reform Act, H.R. 372, would remove the anti-trust exemption from the health insurance market, once and for all. This would subject insurers to existing federal laws against price fixing and bid rigging, among other things.

Would prices for consumers go down as a result? House sponsors say yes, although the Congressional Budget Office estimated that the effects would be “quite small.” They noted that the bill would result in two countervailing forces: some costs could go down because insurers could no longer price gouge, but some costs could actually increase because insurers could become subject to additional litigation and criminal fines. Overall, the CBO estimated the cost changes as a wash.

What supporters and opponents say

Supporters argue that the bill removes an outdated exemption and could help curtail costs in a skyrocketing cost environment for health insurance.

“Making health insurance companies compete in a free-market will result in huge benefits for hospitals, doctors and most importantly, patients,” House lead sponsor Gosar said in a press release. “History has always shown us that when we put the patient first and demand that health insurance companies compete for their business, premiums go down while quality goes up.”

Although only seven House members voted against the bill, some Democrats remain wary of the Republicans’ talking point that the bill “paves the way for repeal and replace of Obamacare.”

Odds of passage

The bill attracted 20 House cosponsors, all Republicans, and was approved 416–7 by the House in March. Republicans approved the bill unanimously, while Democrats voted in favor 181–7. The bill currently awaits a vote in the Senate Judiciary Committee.


All Votes R D
Aye 98%
No 2%
Not Voting

Passed. Simple Majority Required. Source:

Ideology Vote Chart

Republican - Aye Democrat - Aye Democrat - No
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Cartogram Map

Each hexagon represents one congressional district. Solid hexes are Aye votes.

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Vote Details

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Study Guide

How well do you understand this vote? Use this study guide to find out.

You can find answers to most of the questions below here on the vote page. For a guide to understanding the bill this vote was about, see here.

What was the procedure for this vote?

  1. What was this vote on?
  2. Not all votes are meant to pass legislation. In the Senate some votes are not about legislation at all, since the Senate must vote to confirm presidential nominations to certain federal positions.

    This vote is related to a bill. However, that doesn’t necessarily tell you what it is about. Congress makes many decisions in the process of passing legislation, such as on the procedures for debating the bill, whether to change the bill before voting on passage, and even whether to vote on passage at all.

    You can learn more about the various motions used in Congress at If you aren’t sure what the House was voting on, try seeing if it’s on this list.

  3. What is the next step after this vote?
  4. Take a look at where this bill is in the legislative process. What might come next? Keep in mind what this specific vote was on, and the context of the bill. Will there be amendments? Will the other chamber of Congress vote on it, or let it die?

    For this question it may help to briefly examine the bill itself.

What is your analysis of this vote?

  1. What trends do you see in this vote?
  2. Members of Congress side together for many reasons beside being in the same political party, especially so for less prominent legislation or legislation specific to a certain region. What might have determined how the roll call came out in this case? Does it look like Members of Congress voted based on party, geography, or some other reason?

    One tool that will be helpful in answering this question is the cartogram at the top of the page. A cartogram is a stylized map of the United States that shows each district as an identical hexagon. This view allows you to see the how the representatives from each district voted arranged by their geography and colored by their political party. What trends can you see in the cartogram for this vote?

  3. How did your representative vote?
  4. There is one vote here that should be more important to you than all the others. These are the votes cast by your representative, which is meant to represent you and your community. Do you agree with how your representative voted? Why do you think they voted the way they did?

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