Document: 59 L.Ed.2d 261 99 S.Ct. 1067 440 U.S. 205 GROUP LIFE & HEALTH INSURANCE COMPANY, etc., et al., Petitioners,v.ROYAL DRUG al. No. 77-952. Argued Oct. 11, 1978. Decided Feb. 27, 1979. Rehearing Denied April 16, See 441 917, 2017. Syllabus Petitioner Blue Shield, a Texas insurance company, offers policies that entitle the insured to obtain prescription drugs. The may drugs from pharmacy participating in "Pharmacy Agreement" with Shield (in which case must pay only $2 for every drug, remainder of cost being paid directly by pharmacy) or nonparticipating pays full price and be reimbursed 75% difference between $2). offered enter into Pharmacy Agreement each licensed Texas, agree furnish policyholders at each, reimburse its acquiring drug. Respondents, pharmacies, brought this antitrust action alleging three also petitioners, had violated § 1 Sherman Act entering agreements fixing retail prices petitioners' activities caused boycott certain respondents. trial court granted petitioners summary judgment on ground are exempt laws under 2(b) McCarran-Ferguson (Act), because "business insurance," regulated not boycotts within meaning Act. Court Appeals reversed. Held : Agreements insurance" 2(b). Pp. 210-223. (a) Section exempts insurers." 210-211. (b) A primary element an contract is underwriting spreading risk, SEC v. Variable Annuity Life Ins. Co., 359 65, 79 618, 3 640, but involved Agreements, merely arrangements purchase goods services enabling it effect savings. 211-215. (c) involve contractual policyholders. 215-217. (d) legislative history confirms conclusion was understood Congress risk relationship transactions companies their policyholders, no intention disclosed entities outside industry. Moreover, time Act's enactment health-care plans such as those were considered constitute all, difficult assume Congress, contrary contemporary view, could have Even if did consider aspects however, still does follow phrase. 217-230. (e) This result consistent principle exemptions construed narrowly. 231-233. 556 F.2d 1375 (CA5 1977), affirmed. Keith E. Kaiser, San Antonio, Tex., petitioners. Joel H. Pullen, Richard A. Allen, Cambridge, Mass., United States, amicus curiae, support Mr. Justice STEWART delivered opinion Court. respondents, 18 owners independent pharmacies Federal District against Group Health Insurance known (Blue Shield), doing business Antonio. complaint alleged Act, 15 U.S.C. 1, fix pharmaceuticals, Shield's deal thereby constituting unlawful group boycott. challenged Stat. 34, amended, 61 448, 1012(b), "regulated [Texas] law," "boycotts" 3(b) 1013(b).1 415 F.Supp. 343 (W D Tex.). Fifth Circuit reversed judgment. Holding question 2(b), appellate reach other questions decided court. 1375. We certiorari intercircuit conflicts phrase Act.2 2 * If selected has entered therefore pharmacy, required pharmacy. If, hand, selects Agreement, non-participating he charged then reimbursement $2. Texas. Under agrees prescription, pharmacy's amount drug prescribed. Thus, can afford distribute less than markup profitably participate plan.3 4 issue before us whether correct concluding these correct, examination laws.4 Whether illegal entirely separate question, now us.5 II 5 As stated last Term St. Paul Fire Marine Co. Barry, 438 531, 541, 98 2923, 2930, 57 932,6 starting point involving construction like any statute, language statute itself. Chip Stamps Manor Drug Stores, 421 723, 756, 95 1917, 1935, 44 539 (POWELL, J., concurring). It important, therefore, observe outset statutory here scope laws. exemption insurers": 6 "The purport make States supreme regulating all ; refers persons who subject state regulation, 'regulating insurance.' do many things paramount federal regulation; when they engaged 'business insurance' apply." National Securities, Inc., 393 453, 459-460, 89 564, 568, 21 668. (Emphasis original.) 7 Since law define decision fall ordinary understanding phrase, illumined light found structure history. Cf. Ernst Hochfelder, 425 185, 199, n. 19, 96 1375, 1384, 47 B 8 elements policyholder's risk. "It characteristic number risks accepted, some losses, losses spread over so enable insurer accept slight fraction possible liability upon it." G. Couch, Cyclopedia Law 1:3 (2d ed. 1959). R. Keeton, 1.2(a) (1971) ("Insurance arrangement transferring distributing risk"); Richards, (W. Freedman 5th 1952).7 9 significance indispensable recognized 640. That several corporations, representing themselves "life companies, variable annuity contracts sale interstate commerce. commissioners States. Purchasers entitled fixed return, pro rata participation investment portfolios companies. Thus policyholder receive substantial sums decisions successful, very little not. One presented Act.8 held insurance, even though actuarial prognostications mortality. Central Court's holding premise "the concept 'insurance' involves risk-taking part company." U.S., 71, S.Ct., 622. guarantee income, placed annuitant none company. Ibid. concluded, annuities "no true risks, one earmark commonly been conceived popular usage." Id., 73, 623 (footnote omitted). German Alliance Lewis, 233 389, 412, 34 612, 619, 58 L.Ed. 1011 ("The indeed said fundamental object—is loss wide area possible"). 10 really dispute critical determinant identifying insurance. Rather argue risks. brief: 11 "In Securities Exchange Commission 623, 640 (1959), 'earmark' described 'underwriting risks' exchange premium. Here possibility that, during term policy, suffer financial arising drugs, financially unable In consideration premium, assumes agreeing insureds Participating Pharmacies needed filled insured. short, present here—the payment premium promise indemnify happening specified contingency." 12 fallacy position confuse obligations policies, insure will period coverage, serve minimize costs incurs fulfilling obligations.9 benefit promised premiums cover except charge prescription.10 So long kept, basically unconcerned made pharmacies.11 13 thus Shield. By maximum effectively reduces total maximize profits. Such cost-savings well sound practice, inure ultimately form lower premiums, insurance."12 14 legally indistinguishable countless keep low level Suppose, example, company large chain whereby stores operated chain. justification agreement would administrative bulk-purchase savings resulting obtaining company's needs single dealer. might reflected insurance"? Or suppose should decide acquire order further meeting acquisition surely insurance." 668.13 C Another aspect relates enacting concerned with: 16 insured, type policy issued, reliability, interpretation, enforcement—these core Undoubtedly, relate closely status reliable insurers too same class. But whatever exact term, clear where focus was—it policyholder." supra, 460, 568. 17 "between insured." They distribution nonetheless affect "reliability, enforcement" "relate insurers" exempted area.14 argument, proves much. 19 At most, demonstrated passed But, sense, impact ratemaking, insurer. manager different enterprise responsibility terms "reliability" "status insurer" interpreted broad sense urged almost included plainly language, companies." III 20 fully confirmed enacted 1945 response South-Eastern Underwriters Assn., 322 533, 64 1162, 88 1440. indictment defendants conspired rates commissions, coerce noncooperating insurers, agents, insureds. successfully demurred industry commerce regulation Commerce Clause.15 On direct appeal, judgment, commerce, intended coverage. concern wake legislation ensure continue ability tax regulate insurance.16 §§ 2(a) Act,17 neither case. secondary applicability industry.18 Months announced, proposed totally Clayton Acts introduced Congress.19 Less weeks after actual decision, House Representatives bill provided blanket laws, restoring existed Underwriters.20 22 rejected approach.21 Instead exemption, "shall applicable" unless law. applicable event acts boycott, coercion, intimidation. To allow adjust industry, imposed 3-year moratorium.22 After expiration moratorium July 1948, clearly "to extent State law."23 23 making conduct law, intend overrule case.24 While power reaffirmed, established longer create partial Perhaps more significantly, section, whole, embody rejection laws—a prevailed decision. 24 References strongly suggest early Reports stated: theory according hazard, experience, averages. These factors control insuring producer manufacturer factors." H.R.Rep.No.873, 78th Cong., 1st Sess., 8-9 (1943).25 S.Rep.No.1112, 2d (1944); 90 Cong.Rec. 6526 (1944) (remarks Rep. Hancock). 25 Because widespread view underwrite informed responsible way without intra-industry cooperation, both representatives cooperative ratemaking efforts passage preceded introduction Senate Committee report submitted Association Commissioners November 1944.26 views NAIC particularly significant, based bill.27 emphasized smaller enterprises life accurately, concluded: 26 "For reasons subcommittee believes mistake permit require unrestricted competition contemplated apply business. prohibit com bined statistical rate-making purposes backward step development progressive regard necessary labor itself recently necessity concert collection data rate Columbia Rating Act." A4405 (emphasis added). 27 enumerated seven specific practices apply.28 Each concerted activities. None providers reduce policyholders.29 28 floor debates focused simply exempt. Senator Ferguson, explaining purpose bill, 29 "This permit—and I think fair say permit—rating bureaus, session we allowing rating. What saw wrong authority States; believe rights rating bureau. convinced members legislature cannot open do, shall chaos. There failures, failures always losses." 91 1481 (1945). 30 theme remarks Senators indicated protected 1444 1485 Sen. O'Mahoney); 485 Taft).30 President Roosevelt, signing regulation. He "Congress private fixing, Antitrust forbids, willing affirmative States." S. Rosenman, Public Papers Addresses Franklin D. 1944-45 Vol., p. 587 (1950).31 slightest suggestion case, mass insurance."32 31 corporations organized providing medical hospitalization g., Jordan 71 App.D.C. 38, 107 239 (1939); California Physicians' Service Garrison, 155 P.2d 885 (Cal.App.1945), aff'd, Cal.2d 790, 172 (1946); Commissioner Banking Community Service, 129 N.J.L. 427, A.2d (1943); ex rel. Fishback Universal Agency, 87 Wash. 413, 151 P. 768 (1915).33 Similarly, prepaid health-service either them requirements code Rorem, Enabling Legislation Non-Profit Hospital Plans, Contemp.Prob. 528, 534 (1939).34 makes certainly definition broader meaning, perception organizations highly significant ascertaining congressional intent. 32 Assn. illustrative plans. nonprofit corporation provide various supplies annual implement plan, contracted physicians, hospitals, others, services. groups compensated exclusively Health. contracting directly, able member separately. somewhat similar insurance: 33 "Whether indemnity there party subjected contingent future events assumption binding another. most loosely conceptions . elements. Hazard essential equally shifting incidence. 35 "Although Health's creating security illness accident, truly quantity well-rounded, continuous service members. fact function consumer cooperative. functions organization identical latter primarily, exclusively, principally getting rendered purchasing economies operation." App.D.C., 44, 46, F.2d, 245, 247. supplied part; footnotes omitted.)35 36 Indeed, Cross historically taken seeking avoid taxation.36 historical majority decisions, advance-payment medicalbenefits insurance."37 next impossible thought (even companies) third parties set phrase.38 IV 37 settled narrowly construed. Abbott Laboratories Portland Retail Druggists 1305, 537; Connell Construction Plumbers Steamfitters, 616, 1830, 418; FMC Seatrain Lines, 411 726, 93 1773, 620; McKesson Robbins, 351 305, 76 937, 100 1209. doctrine limited implicit applies equal force express exemptions. 11-12, 1313 (the Nonprofit Institutions Act); 733, 1778 (§ Shipping 316, 943 Miller-Tydings McGuire Acts). 38 Application appropriate wholly analogous contexts, entity forfeits acting nonexempt parties. held, agricultural Capper-Volstead loses conspires Case-Swayne Sunkist Growers, 389 384, 621; Borden 308 188, 60 182, 84 181. consistently union employers impose wage scale bargaining units. Ramsey Mine Workers, 401 302, 313, 658, 665, 64; Workers Pennington, 381 657, 665-666, 85 1585, 1590-1591, 626.39 39 pharmacists insurer's costs, control—whether automobile body repair shops landlords.40 extended coverage companies."41 precisely what do. 40 For reasons, 41 Affirmed. 42 BRENNAN, whom THE CHIEF JUSTICE MARSHALL, POWELL join, dissenting. 43 33, 1011-1015, renders inapplicable "boycott" exception includes ("provider agreements") petitioner benefits owed today holds disagree: challenge drug-benefits conclude provider negotiated carry out business, part. Before considering analysis, forth background 45 459, 668 (1969), sheds words S.Rep.No.20, 79th Sess. (1945); H.R.Rep.No.143, (1945), U.S.Code Cong.Serv. 1945, 670. while largely silent matter,2 indicate deliberately chose broadly. draft bills narrow range practices, instead general became law.3 46 statute's enactment, developed provides guide purpose: reaction 1440 (1944). Prior assumed, leading '[i]ssuing transaction commerce.' Virginia, Wall. 168, 183, 357 (1869). Consequently, rest Underwriters, Clause, particular, them. reacted quickly [, being] about inroads tradition product concern. Its quite first section; declared 'the continued taxation public interest.' 1011. shortly afterward, '[o]bviously Congress' broadly give existing systems taxing Prudential Benjamin, 328 408, 429, 66 1142, 1154, 1342 (1946). attempt turn back clock, assure dealing remain regulation." 458-459, 567. 48 538-539, 2928-2929, 932 (1978); 6524 (Cong. Walter) ("[T]he designed restore quo Nation occupied Supreme legislated [in ]"). 49 continuation goal,4 evidence reasonably relevant our mean viewed today. 50 "We realize evolving institution. Common knowledge tells forms greatly changed generation. And undertake freeze concep[t] mold [it] fitted passed." 622, (1959). 51 logical common "insurance" present, new determination analysis proximity "insurance," setting counts, 52 start ground. Neither Court, ante, 230 37, nor policyholders—as distinguished pharmacies—is Whatever merits scholastic argument technical transfers distributes sum certain—the premium—against uncertain contingency illness, calculated correctly, ill above Mehr Cammack, Principles 31-32 (6th 1976). An important health "pays" (drugs dispensation), rather cash. "freeze fitted" passed, reason falls inquiry understandings constituted 1930's 1940's time.5 53 Fortunately, logic yield result. cash indemnities. However, although specifically available 1940's, hospital cash—were available. 54 service-benefit originated 1929; 1939. Eilers, Regulation Plans 10, (1963) (hereinafter Eilers). 1940, 4,500,000 people communities covered related hospital-benefits C. 1-2 (1940) Rorem I). During collective bargaining, unions demanding approach Law, (1974) Law). year enacted, million enrolled programs, comprising 61% market. Hearings Education Labor, Program, pt. 173 Eilers 19; 11. 55 system preserve. Led New York 1934, 1939 which, relieving reserve obligations, supervision departments insurance.6 (1939) II); N. Sinai, O. Anderson, M. Dollar, 48-49 (1946) Sinai); Comment, Plans: Some Legal Economic Aspects, Yale L.J. 162, 174 (1943). apparently issuance stock mutual Nine acted authorized operation requirements. II, 532. legislation.7 period, (NAIC), directors played major role drafting Act,8 model govern Proceedings NAIC, 75th 226 id., 76th 250, (1945).9 56 plan well-recognized treated programs 1939, adopted incorporating hospitalization-benefits Columbia, supervisory hands Superintendent Insurance. H.R. 6266, H.R.Rep.No.1247, 11224 (1939). hearings approved debated Shield-type alternatives national Congressmen frequently referring "insurance." pp. 55, 83, 108, 172, 2, 558 (1946).10 logically historically, sufficiently least procure delivery contracts, druggists "provider agreements." adopting Solicitor General, insurance."11 contends "underwriting [is] 212,12 "[a]nother Ante, 215. insureds, excludes fails prior FTC Casualty 560, 78 1260, 1540 (1958), advertising unilateral act underwriting, abundantly numerous horizontal technically regarded among conspicuous illustration, see, e. 1481, 1484 (1945) Sens. Pepper Ferguson), see concedes respecting despite failure fit formula. 221 224-225, 32. limit concession Compelling actually 12, 3, supra. vertical relationships sales agencies 535, 1164, (1944), object discussion House, 6538 Cong. Celler) expressly A4406 (NAIC 4(b)(5)). Again, transactions, inconsistency own theory. 224-225 32.13 limitation ignores pervasive regulation—prevailing passed—of whose "distinctive feature," I, 228 needed. adoption policies: "A guaranteed through hospitals." 62 proposed, requiring "full approval hospitals commissioner." 250 proposal contents armed considerable agreements.14 incorporated care treatment [its subscribers]." objective inescapable. 63 Logic compels conclusion. kind becomes service-benefits meet promises subscribers.15 obtains policy; issued" "enforcement." comes explained "relationship insured," "other [that] class." "[s]tatutes aimed protecting [the insurer/insured] relationship, indirectly, " composed experts dictionary editors. use "underwriting" common-sense connoting thereto.16 knew strain effectuate policies' commitments sought anti-trust 65 remaining constitutes Respondents contend necessary, issue, druggist dispense payment, dispensed. "markup." With Appeals, respondents half bargain fulfill obligations. Those fulfilled binds requested second agreement, reimburses druggist, assertedly irrelevant policyholder. alternative pharmacist his usual (minus policyholder). limits freezes $2, "fixed" price. From fixed-price "anticompetitive," Respondents' contradicted here, "fixes" markup. usually amounts paying charged. 64. typical payments department insurance.17 1937 Pennsylvania "all [service-benefit plan] hospital, shall, times, Department." Pa.Laws 378. Therefore, insurer/provider fee preserve, exclude ambit exemption; good including 67 Nor respondents' claim "anticompetitive" violations otherwise anticompetitive abeyance, pending final anticompetitive, alone basis excluding nature protect anticompetitive; extinguished finding activity violates all. 68 circle unconvincing, addition history, circle. First, utilized affects reliability. definitely factor Proctor Farm Mutual Automobile 182 U.S.App.D.C. 264, 561 262 (1977). True, determinative, argued innumerable agreements, lease offices, cost. contract, mere incidental connection assumed policy. integral rate-setting process, correlation necessarily high. rates, measurably enhanced formulas providers.18 reliable. Travelers Western Pennsylvania, 481 80, 83 (CA3 1973) (quoting Commissioner). close nexus fiscal reliability speaks inclusion generally U.S.App.D.C., 271-272, 269-270. 69 reason, basic elements, supports perform function. true, contends, conventional notions include unpredictable assumed. Traditional achieve end ceilings utilizing deductibles. 222 know how often become ill, exposure illness. uncertainty, reduced. attempts advance price, market fluctuates. minimizes variance "payoff" variable, probability occurrence remains unknown. examined carefully, General: "spread[ing] widely reduc[ing] chance events." Of course, chance" since fluctuate "markup" fixed, manageable proportions.19 70 "pay[s] be," hypothesized 1381, run grave bankruptcy. expose unknown liability, increase incorrect assessment occur. lead premiums. fiscal-reliability problem solved placing dollar benefits. cash-indemnity full-service-regardless-of-price bargained.20 relate[d] V process deciding inherently case-by-case problem. advocated carries line-drawing problems. once provider-agreement line crossed "business." compel me cross. hold (1) policy21 cost, (2) "prediction."22 kinds reached case.23 72 suggest, come proviso. Given facts others market, pressured go along, voluntarily joined Government Brief 6. effort satisfy immunize conspiracy joining it. Parker Brown, 317 341, 351-352, 307, 313-314, 315 Antonio agreed am called exclusive tenuously beyond exemption's protection. 270 n.10, 268 10.24 73 Finally, insurance"25 establish enjoy demonstrate State, 1013(b). issues. Accordingly, reverse remand proceedings.26 part: hereby declares interest, silence barrier "Sec. 2.(a) person therein, "(b) No invalidate, impair, supersede imposes Provided, June 30, 1890, October 15, 1914, September 26, Trade 3.(a) Until 1936, Robinson-Patman Anti-discrimination thereof. Nothing contained render coerce, intimidate, intimidation." 33-34, 448. conflict Third, Fourth, Circuits. Frankford Greater Philadelphia, 554 1253 1977); Anderson Medical 551 304 (CA4 curiae brief useful illustration Agreement: "Suppose customary X 'participating' 'non-participating' $10.00, wholesale (or cost) $8.00. buys A, $2.00. receives $2.00 $8.00 $10.00 total. B, $6.00 (75 percent $2.00) $4.00 take steps reimbursement. "If $5.00 situations unchanged. $7.00." law" 3(b). 932. axiomatic nevertheless perfectly legal. urging affirmance probably violate recognizing here. Webster's International Dictionary English Language 1289 (unabr.2d 1958) defines as: "Act insuring, assuring, damage event; whereby, stipulated consideration, undertakes another peril, document .." 1933 Investment Company 1940. securities "annuity" exist. Assume, credit commercial bank off monetary claims. Despite "necessary" deductible drugs." "Blue Pharmacy. obligated two dollars ($2.00) regardless presence absence arrangement. minimizing maximizing profits, Shield." 1381. points brief, distinction reduction. reducing widely, Arizona Director approved, pursuant merger chain, conceptually "which breach assurance return prescription. categories affected indirectly referred policies. 357, "[i]ssuing commerce." 2-3 Cong.Serv.1945, constitutionality questionable. Report "Inevitable uncertainties followed handing down Southeastern "[Y]our committee urgent need immediate expression respect respective Already refused, threatened refusal comply regulations, so, subsequently unconstitutional keeping precedent-smashing executives civil criminal actions misappropriation funds." added.) text preserve operates free fear Clause attack. Act—to repeated insistence dissenting read right traditionally correct—and infra. attack Clause. freed spite not, 3270, 1362, nothing wise impair 6565 failed Conference pass vetoed President. 1087 Also opposition exemption. 8482 years 1443 McCarran). Ferguson); McCarran, Control Insurance: Moratorium Expired A.B.A.J. 539, 540 (1948). dramatically following McKellar Ferguson: "Mr. McKELLAR. understand supposed rendering recent Is correct? FERGUSON. No." 478 (exchange recognition solely A4403-4408 483 O'Mahoney). list enacted. finally "broadly." Precisely opposite true. versions (1943), business," amendment 6561 proponent amendment, Representative protection 3270: "But asserts investments, reinsurance, capital requirements, items nature. insisted bringing attention House. you 3270 stands home your friends ask safeguard answer truth indictment." defeated. 6562 (not anything remotely resembling case) perceived 3270. eventually follows narrower practices. pattern entire characterized continual narrowing original states "compelling explanation" lack fire Post, 234 2. input types "because aware chaotic condition exists time." 484 Ferguson). Commissioners, drafted Association, exempting background, mention them, suggests "sheds light" 234. went mainly resolved charged, agents' commissions rates. emerge commissions. regarding practice. 4444, months subsequent activities, traditional agents: 4(b). "On March 1946, provisions making, establishing, using methods, bond forms, rules inference drawn existence agents selling lines together presumably removes absence, conferred dealings agents. definition. Transactions agent, unlike intra-industry; agent sells why Part III-D, Cleveland Ebright, 142 Ohio 51, N.E.2d 929 few cases Act; See, Michigan Sharpe, 339 Mich. N.W.2d 638 (1954); Corp. 101 R.I. 708, 227 105 (1967). argues "regulation preserve." 240. statutes typically operate specify 1935 Ill.Laws, 621 ("An Incorporation non-profit Corporations"); Mich.Pub.Acts 109 incorporation corporations"); 1938 N.J.Laws ch. 366 concerning establishment, maintenance plans"); ("Providing Hospitalization, Inc."). therefrom designated therein." change creates heretofore exist Columbia." S.Rep.No.1012, Moor, 445 (D.C.1938). courts statutes. Sharpe proposition sufficient not—for opinion. Attorney General Biddle's testifying Joint Hearing Subcommittees Committees Judiciary 3269, 41-42 thrust American 519, 326, 434 justified AMA health-maintenance "trade" Based Biddle expressed already proper. seems clear, testimony believed statement accepted Congress. Bailey characterization, pointing Bailey, "group movement." (Indeed, precise (1939).) inferred Members purchased later witnesses hearing discussing Labor 1606, 172-176 (1946), shared let Weller, Exemption Language, History Policy, 1978 Duke 587, 624 174. commentator effectiveness "[I]nsurance fond expressing amazement Blues something else, 'pre-payment plans.' incredulity save courts. upheld so-called 'outrageous' opinions adherents." Denenberg, Definition Insurance, J.Ins. 319, (1963). medical-benefits Cal.Stats., 882, amended 1941 311; Conn.Pub.Acts, 150; Ill. Laws, 1936 Miss.Gen.Laws, 177; Pub.Acts, 109; N.J.Laws, 719. 226-227, 34. legislatures Pharamacy Many diverse composition boards directors, books records inspected, invest funds, liquidate merge, agreements. Provider facets similarly regulated. companies," arguably explicitly approach, implicitly practice cases, 668, Commissioner, 1591 omitted): "[A] multi-employer unit pursuance interests seek employers. behavior. shown conspire eliminate competitors liable conspiracy." principled rationally extend furnished policyholders—such doctors, lawyers, like. assuming drawn, ignore likely serious consequences. Recent studies concluded physicians dominate incentive interest schedules highest level. domination resulted rapid escalation detriment consumers generally. Skyrocketing Care Costs: Role Subcommittee Oversight Investigations Interstate Foreign Commerce, 95th 4-34 (1978) Michael Pertschuk, Chairman, Commission). state-action 315. provides: [15 seq.], Law." 3(b), 1013(b), chapter parties, coupled discuss establishes negative third-party is, compelling explanation noted (1969); (1978), infra, 236-237. much accordingly abuses 1091-1092, 1479 6449-6455, 6527 1362 indemnities, provision explains debates. indicates intent arbitrarily "any rules." 4(b) debate limiting following: "MR. PEPPER. Would better legitimatized, identified statute? O'MAHONEY. Senator, endeavored best my induce committees write prevail Senate." challenges obscure version 222-223 29. Closer short surrounding reveals Representatives' expressions confusion meant. Reps. Sumners, Hobbs, Fernandez). quarrel statement, 220, 24, respects, Underwriters. principal differences pre-South-Eastern post-McCarran-Ferguson detract oft-repeated regulatory schemes South-Eastern, intimidate violating "commerce" hence unregulated problem, survived revived McCarran-Ferguson. Ferguson mind answered "no" McKellar's cited 220 asking re-establish stood South-Eastern. revealed quotation Ferguson's McKellar. subsection (b), bottom page intimidation, 4(a) suspend application insofar until dates meantime thinks done discrete holdings state-regulated boycotts, pre-existing explains, "total" 218-219, 21. bills, transactions. objected. nonboycott exempted, determined unconditionally. 568 [and] issued [are] "). Ala.Acts 544; 386; 698, 1412 (District Columbia); Ga.Laws, 690; Iowa Acts, 222; Ky.Acts, 23; Me.Acts, 149; Md.Laws, 224; Mass.Acts, 409; N.H.Laws, 80; 366; N.M.Laws, 66; 1934 N.Y.Laws, 595; Leg.Acts, 154; 378; R.I.Acts, 719; S.C.Acts 296; Tex.Gen.Laws, 123; Vt.Laws 174; Wis.Laws, 118. F. Hedinger, Social Device Financing Costs (1966). additional were: Ariz.Sess.Laws, (1st Spec.Sess.); Fla.Laws, 19108; Kan.Sess.Laws, 259; 1940 La.Acts 267; Minn.Laws, 53; Neb.Laws, 43; N.C.Pub.Laws, 338; 1943 N.D.Laws, 103; Tenn.Pub.Acts, 98; Va.Acts, 230; W.Va.Acts, 8. Debate arose 225-230. Most ruled stock, reserve, 101. addition, meant special taxation. feasibility socially beneficial. rulings inappropriate plans, "nonprofit," guarantees insurer—potentially adequate substitute reserves 135-136, 239. courts, Cross-type organizations, attempted surmount barriers effectuation deemed arguing jurisdiction commissioners, bound (1943) (hospital insurance); McCarty King County Corp., Wash.2d 660, 175 653 (same). commentators questioned soundness Note, Problems Health, Harv.L.Rev. 809, 815 governing States' "a differing 534; Sinai 48. vast statutes, "other" (primarily taxes), commissioner. Mexico Statute, State's Code adding section "Non-Profit Plans." particular law." accord statements 243. everyday art, word Messages Presidents Message Recommendations H.R.Doc.No.120, President, H.R.Doc.No.380, 9, view. 33. "Underwriting," argues, means Amicus Curiae Brief). "underwriting." Holtom, Underwriting Practices (1973). distinguish insurer/agent former "wholly intra-industry" 225 32, tautology. "intra-industry" 296. 67-68; 48-49. extensive, commissioner corporation, ibid.; contain difficulties insurer, 67; made, 68. negotiating drug-coverage policy's kept. Motor Vehicle Manufacturers 10-11. pharmacies. whereupon normally hesitation. minus deductible. bargained minimal occurs—a out-of-pocket payment. cash-reimbursement inevitably ceilings, again distinguishing full-coverage discussion, 252, 20. errs reading "variable annuity" remained occurred. key effectuated transference 621. transferred trading certainty 49. 123. modern 106-107. aggressive controlling 417 1104, 1106 (ED Pa.1976), (CA3), cert. denied, 860, 186, 133 (1977); Michigan, Ins., 77-R-101 (Mar. Illinois, Dept. 1607 (Apr. 8, 1977). explain Government, requires formulas. 1395u, 1395x(v) (Medicare). outlays. "bargained for" literal sense. origins 1967 collective-bargaining Auto largest domestic manufacturers. Petitioners test subverted unrelated immunity, difficulty "sham" honored. Eastern Railroad Noerr Freight, 365 127, 144, 81 523, 464 (1961); Transport Trucking Unlimited, 404 508, 92 609, 642 (1972). independently suffice, capable (1977), aff'g 406 (DC 1975), pending, 77-580; Doctors, Inc. 557 1001 1976), 431 Pa.1975); 1104 Pa.), 1976-1 Cases ¶ 60,884 Va.); 80 361 774 (WD Pa.1972), 414 1093, 94 724, 550 suspect 249. Rather, unnecessary, cross boundary intimate question. analogies 231-232, inapt. rule "exempt" immunity prove—that Reference helpful matter, "engaged production products farmers, planters, ranchmen, dairymen, nut fruit growers." 388, 291 result, nonfarmers Broiler Marketing 436 816, 2122, 728 (1978). emphasizes, written "insurance extends Hence, automatically vitiate "analogy." reference 626 (1965), 232 39, complete here: [read 'insurer'] [pharmacy] [a pharmacies] [o]ne [pharmacies] [insurer] poor analogy stress yet footnote, Pennington virtually complained Here, uniform suspected compete demanded was, drive brethren, joined. circumstances exemption: "Unilaterally, employer adopt vigorously union. gear demands wages weakest units pay. maintain union-employer indirect 665 n.2, "narrowly" construe accordance actively discriminates confining full-service via places obstacle path latter. 40, consequences costs. force, note conduct. directed legislature, modify repeal McCarran-Ferguson, Referral legislators one-sided painted far increasing effective reduction Council Wage Price Stability, Employee Benefits: Management Sponsored Innovations Controlling Cost, Fed.Reg. 40298, 40305 (1976). "there level" overlooks vital originate expertise labor" combine "reduce services." "incentive" operating direction. 18, potential outweighs positive effects properly

Category: 7