Another pre-emptive strike

3/24/2006

THE Bush Administration has gotten a lot of political mileage out of its doctrine of pre-emption in foreign policy, the "ready, fire, aim" strategy that has mired the United States in a long and costly war in Iraq.

At the same time, another version of pre-emption, one in which federal laws are given precedence over state laws, is spilling into several other areas of public policy, most recently how health insurance is sold.

Lurking in Congress is legislation that would override minimum state requirements for health insurance policies in favor of minimum national standards that, in all probability, would lead to reduced coverage for consumers.

The winners in this effort - as with virtually every policy the administration promotes - are business and industry. The losers, of course, are the American people and consumer protection laws and regulations set at the state level.

Ohio law, for example, says insurers must offer certain coverage for treatment of alcoholism, mental illness, and kidney dialysis, and for tests of vital importance to women, such as mammograms and pap smears. All managed-care plans sold in the state must include maternity benefits.

What the sponsor of a bill approved by a Senate committee has in mind instead are less costly national standards that he says would prompt insurance companies to sell cheaper policies and make it more likely that small businesses would offer medical coverage to their employees.

Sen. Michael Enzi, Republican of Wyoming, called the vote "the first major step in 15 years to get affordable health insurance for small businesses and working families."

That's a decidedly optimistic view. A lowest-common-denominator standard at the national level could just as well produce the opposite effect - worse coverage for fewer people.

John Garamendi, California's insurance commissioner, warned that the bill will lead to "an ever-increasing number of people who are uninsured and, for those with insurance, the benefit package is certain to be dramatically reduced."

Unfortunately, the insurance industry has demonstrated that it won't offer comprehensive health-care policies at affordable rates unless it is required to do so. That's why states have stepped in.

Insurers, with assent from the White House, are responding by training their powerful lobbying guns on Congress, under the theory that it's easier and cheaper to override laws in all 50 states in a single swipe rather than one by one. That's the beauty, from the industry's point of view, of the doctrine of pre-emption.

The same strategy is being employed by majority Republicans in the areas of food safety and consumer notification of identity theft, and word is bubbling out of Washington that the Food and Drug Administration may attempt to set national drug-labeling regulations by agency fiat.

In all these areas, the convenience and cost to business and industry are deemed by the Republican masters of Capitol Hill to be of greater importance than the health and safety of the American people.

Long-held and cherished GOP principles of local control and states' rights have been sacrificed on the altar of expediency, with officials of the U.S. Chamber of Commerce holding the ceremonial knife.

Call it another pre-emptive strike.