As Committee Chairman Patrick Leahy (D-Vt.) explained at the hearing, the health insurance industry — unlike any other private industry in the country — is allowed to engage in price fixing, bid rigging and market allocation, all of which would violate the law if any other sort of company did it. Last month Leahy introduced the Health Insurance Industry Antitrust Enforcement Act of 2009, which would repeal the antitrust exemption for health insurance and medical malpractice insurance providers. Sens. Harry Reid (D-Nev.), Dianne Feinstein (D-Calif.), Russell Feingold (D-Wis.), Charles Schumer (D-N.Y.), Richard Durbin (D-Ill.), Arlen Specter (D-Pa.) and Al Franken (D-Minn.) are co-sponsors.

Although Lawrence Powell, a professor at the University of Arkansas, testified on behalf of the Physician Insurers Association of America in support of continuing the antitrust exemption, even he struggled to explain why it makes sense. He repeatedly said that allowing insurers to share data on losses and costs of claims helps insurance companies price their services accurately and competitively. But as Leahy made clear in his questioning, his legislation would not prohibit such data-sharing. That led Powell to stumble and say that while he’s “not an attorney,” his understanding was that insurance companies would have to file a request to pool data, which would impose additional costs.

But Robert Hunter, Director of Insurance for the Consumer Federation of America and former Federal Insurance Administrator under Presidents Ford and Carter, saw it differently. In his view, the antitrust exemption, intended initially to be temporary but made permanent during closed-door conference committee sessions of Congress more than 50 years ago, must be repealed to overcome the insurance industry’s anticompetitive practices that have led to higher prices and reduced services. “It is high time that insurers played by the same rules of competition as virtually all other commercial enterprises operating in America‘s economy,” he testified.

According to Hunter, health insurance companies have been able to consistently pay less on claims by agreeing to lower the amounts they reimburse doctors and hospitals for services; adopting similar clauses in their contracts that limit their liability in unfair and abusive ways; agreeing to cut back coverage to certain places, and using similar claims processing systems designed to systematically underpay claims.

As Hunter testified, federal authorities have recommended eliminating or cutting back the antitrust exemption for health insurers and medical malpractice insurers on at least four different occasions after studying it. But Congress has never taken that step, presumably due to the power of the insurance industry lobby.

With the soaring cost of health care now in the spotlight, this may finally be the right time.

Even as House lawmakers are celebrating their remarkably swift move to infuse the popular cash for clunkers program with additional funds, some lawmakers and environmentalists are warning that extending the program is premature without knowing what it even does.

Of the $1 billion committed under the initiative — which offers drivers up to $4,500 to trade their gas-guzzlers for more fuel efficient vehicles — the Obama administration has released data on the trades surrounding less than $69 million. Without further information about what models are being scrapped, what models are being sold, and the environmental benefits of the swaps, critics worry that the program might be failing in its stated goals of reducing emissions and a reliance on foreign oil.

“A billion dollars has been spent on a program that could conceivably be a disaster for the environment, and without even waiting to see where that money went, they’re throwing more money into the pot,” said Daniel Becker, director of the Safe Climate Campaign, which advocates for better fuel efficiency. “This whole thing is a blind experiment. Congress is making fact-free decisions.”

Launched just this week, the cash for clunkers program has already blown through its initial $1 billion in funding — money that was projected to last though October. House lawmakers rallied with rare speed Friday to pump an additional $2 billion into the program, just hours before they departed for a five-week recess.

Supporters of the program, lining up behind Michigan’s powerful delegation, argue that it offers a slew of economic and environmental benefits befitting both the recession and the threat of climate change. On the House floor before the vote, Speaker Nancy Pelosi (D-Calif.) called the extension “a very positive, bipartisan initiative to help our auto industry, to help consumers, to grow our economy, to do it in an environmentally sound way.”

The House vote was 316 to 109, with 77 Republicans favoring the bill and 14 Democrats opposing it.

Among those 14 Democrats was Rep. Earl Blumenauer (Ore.), who said afterward that he felt “uncomfortable” voting to extend a young program around which so little is known. “We don’t know actually what we’ve been getting,” Blumenauer said in a phone interview. “We want to see the data.”

He’s not alone with that request. On Friday, Sens. Dianne Feinstein (D-Calif.) and Susan Collins (R-Maine) sent a letter to Transportation Secretary Ray LaHood urging the administration to release more data to inform Congress’ next move on cash for clunkers. While the program has proven itself to be an effective catalyst for vehicle sales, the lawmakers wrote, “Congress needs this data in order to determine if the fleet modernization program delivered significant fuel economy gains and oil savings.”

The skeptics have some reason to be wary. The latest official DOT figures indicate that, through Tuesday, less than $69 million of the initial $1 billion had been spent to facilitate roughly 16,350 vehicle sales. About 62 percent of those purchases were for new cars — a good sign in the eyes of environmentalists interested in minimizing the number of trucks and SUVs on the road. But until further analysis reveals what trades were encouraged by the subsequent $931 million, some lawmakers and public interest groups oppose the additional funding.

Lena Pons, policy analyst at Public Citizen’s Congress Watch Division, said the popularity of the program comes as little surprise. Who, after all, wouldn’t want a $4,500 gift from Washington? But popularity is no indication that the program is meeting its stated goals. “Before appropriating any additional funds,” Pons said in a statement, “Congress should study whether the program is working.”

The Senate is expected to take up the cash for clunkers extension next week, and already a small, bipartisan contingency is threatening to block the proposal. On Thursday, Feinstein and Collins issued a statement arguing that any renewal of the program “must go further in advancing the goals of better fuel efficiency and greater emissions reductions.”

“We will not support any bill that does not meet these goals,” the senators said.

On Friday, they got some more backing when Sen. John McCain (R-Ariz.) announced his intention to filibuster the bill.

There are also concerns, both on and off Capitol Hill, about the source of the funding. The $2 billion was siphoned from stimulus funds earmarked for a federal loan program encouraging the use of environmentally friendly technologies.

After the House vote, President Obama gave a short speech vowing to work with Congress to replace that funding sometime “down the road.”

Under the current program, drivers can get between $3,500 and $4,500 when they trade in their gas-guzzling cars, trucks and SUVs for new vehicles with better fuel efficiences. Yet the efficiency thresholds were set so low that consumers can trade in their old clunker for a brand new clunker — a boon for the automakers and dealers, but hardly a way to reduce the greenhouse gasses that contribute to global warming.

“They weren’t set very high,” Blumenauer said of the mileage guidelines, “so it wasn’t getting the worst of the worst off the roads.”

Feinstein and Collins, along with Sen. Charles Schumer (D-N.Y.), have sponsored a competing bill that sets stricter fuel efficiency thresholds for the newly purchased vehicles. The lawmakers say their proposal would result in oil savings that trump the existing program by more than 30 percent.

When the initial $1 billion program passed the Senate in June, Feinstein told reporters that Senate Majority Leader Harry Reid (D-Nev.) had given her “absolute assurance” that any extension would be altered so that the fuel efficiency requirements were more stringent. With the House leaving town, however, Reid’s office indicated Friday there’s little chance that Senate leaders will alter the House-passed bill, particularly with Obama urging quick passage of the existing extension.

That’s bad news in the eyes of environmentalists, who worry that the program is following the path of a similar initiative in Germany, which went from a 1.5-billion-euro program to a 5-billion-euro program in just six months.

“This is turning into a methadone program for addicted automakers,” Becker said. “They have no incentive to turn it off.”

Reid explains that Stevens, 85, is a throwback from another era who didn’t get the upper-chamber’s tougher new rules that have tightened in recent years.

“It’s a different world we live in,” Reid told Politico, “and Stevens did not understand that.”

That’s pretty generous on Reid’s part. While technical rules may have changed, the underlying problem here is that Stevens allowed a local rainmaker with political interests to remodel his home at — at best — a steep discount. He also took other gifts from him, like a high-end massage chair and a new car for his daughter.

Even if Stevens didn’t know that there’s a rule about disclosing this unethical behavior, he should have certainly known the underlying behavior was unethical, if not illegal.

And by all accounts Stevens did know it was illegal. A telephone call caught on an FBI wiretap from 2006 between Stevens and Veco CEO Bill Allen captured the longest-serving Republican saying if the men were ever caught “we might have to pay a fine and serve a little time in jail.”

If there’s an argument why Stevens shouldn’t go to jail, it’s not that he was clueless.

Senate Majority Leader Harry Reid (D-Nev.) told reporters in the Capitol that Senate rules dictate that Burris must have the signature of both Illinois Gov. Rod Blagojevich (which he has) and that of Secretary of State Jess White (which he doesn’t) as the first step in the process. That rule, added Assistant Senate Majority Leader Dick Durbin (D-Ill.), dates back to 1884, and has “never been waived in the history of the United States Senate.” It’s a rule “not easily challenged or changed,” Durbin said.

The Illinois Supreme Court is expected to hear arguments today or tomorrow on the question of whether White, who has refused to certify Burris’ appointment, has the legal authority to do so. The court’s decision is expected to follow shortly thereafter.

“We’re hoping that they act on it in an expedited fashion,” Durbin said.

Not that White’s signature would guarantee that Burris would gain his seat. Reid said that that signature is “vital,” but other steps would follow.

“Then we’ll reassess where we are,” Reid said.

Burris, for example, is slated to testify under oath before Illinois state legislators tomorrow afternoon on his appointment — a hearing that Washington Democrats will be sure to scrutinize closely.

Reid said that Senate leaders might tap the Rules Committee to investigate the appointment, adding that the full Senate will also need to vote to approve Burris’ seating.

Both Reid and Durbin also downplayed the claims from some lawmakers — notably from Illinois Rep. Bobby Rush (D) — that the decision not to seat Burris yesterday was racist.

“A lot of people have tried to make this a racial issue,” Reid said, “but Roland Burris did not, and will not.”

“I do not know where that came from,” a Reid spokesperson wrote moments ago.

Reid and Sen. Dick Durbin (D-Ill.), the Democrats’ No. 2 figure in the upper chamber, are meeting with Burris now, with a press conference to follow. Stay tuned…

Senate Majority Leader Harry Reid (D-Nev.) said he was “stunned” by the news, while Sen. Carl Levin, (D-Mich.), chairman of the Senate Armed Services Committee, said the lower-than-expected withdrawal number is indication that the surge didn’t work.

Levin’s full statement:

This small reduction in troop levels in Iraq and the continued apparent rejection of any timetable for further reductions is simply a continuation of the Bush administration’s open-ended commitment in Iraq. It takes the pressure off of the Iraqi leaders to take the political steps essential to ending the conflict.

Iraqi politicians have failed to take advantage of the reduction in violence to reach a political settlement, which was the stated purpose of the surge. Saying the surge has worked when it hasn’t accomplished its stated purpose sends the wrong message to the Iraqi government.

In the meantime, the U.S. taxpayers continue to pay for reconstruction projects and economic development projects and even for the salaries of the so-called Sons of Iraq militia — at the same time that the Iraqi government has a surplus of $80 billion in oil revenues that should be used to pay for their own reconstruction and development.

The good news is that Bush will be in charge of such decisions for just four months more. The bad news is that Democrats haven’t been any better at pulling the troops home even as they’ve controlled the purse-strings with their congressional majority.

Can you say: war without end?