On Wednesday of last week, the Republicans in the United States House of Representatives voted to repeal Obamacare.
On Friday, the Joint Legislative Fiscal Committee of the New Hampshire General Court voted to accept $2 million tied to the federal Patient Protection and Affordable Care Act commonly known as Obamacare.
The Fiscal Committee has 10 members – five house members and five senate members – that approves money transfers between budget lines within departments as well as acceptance of federal and other grants. It also has other responsibilities delegated to it by the legislature including receiving financial and performance audits done on state agencies.
Each month the committee holds a public meeting and every department with an item on the agenda is there to advocate for the transfer or receipt of outside funds. Most of the items are routine, but usually there are a couple that draw attention.
That was true when Commissioner of the Department of Insurance, Roger Sevigny, went to the witness table. A New Hampshire Public Radio microphone was laid on the table to capture every word. This was the moment for a discussion about whether or not the state should accept funds tied to Obamacare.
The first $1 million item will help New Hampshire improve health insurance rate filing requirements, increase transparency, and create an opportunity to compare rate filing details between insurance companies. And, of course, there will be data sent to the federal government on "health insurance premium rate increase patterns."
Improving the review of insurance company rate filings in a more organized manner is a priority of the National Association of Insurance Commissioners (NACI) where Mr. Sevigny has been active and is past president. The federal grant will help New Hampshire use NACI-developed technology to improve our "health insurance rate review and reporting process."
The second $1 million grant related to the new state exchanges that will be part of the implementation of Obamacare. The concept behind exchanges is that they will "allow individuals and small businesses access to bargaining power comparable to that of established larger groups."
States now have a choice as to whether to accept federal money to plan their exchanges or take the alternative route and simply accept whatever exchange plan is developed on a national basis. With the acceptance of the grant, New Hampshire will have resources "to determine how the Health Insurance Exchange can best serve consumers."
Some in the press were looking for a debate about the repeal of the Affordable Care Act (Obamacare) and whether or not New Hampshire should have anything to do with the current law. In the end, the Fiscal Committee voted with little discussion to accept both of the $1 million grants. There was just one dissenting vote.
The rationale for accepting the grants was clear. The money for the health insurance rate review improvement is something the state is trying to do anyway. The federal money simply will help move the process forward and acceptance of the money is no endorsement of the new health care law.
Likewise, acceptance of the $1 million to design a New Hampshire insurance exchange plan made sense, too. The grant will help New Hampshire get ready, if the federal health care plan is implemented, to make an informed choice between having a plan created for our state to meet the needs of New Hampshire or to just accept an exchange agenda coming down to from Washington.
Here is what the Commissioner wrote and then emphasized in his testimony: "Acceptance of this grant does not commit the State of New Hampshire to take any action with respect to establishing an insurance exchange. " Those words were very convincing.
With the Fiscal Committee’s approval the federal dollars can be accepted. There’s another step. Commissioner Sevigny will have to take both of these items to the Governor and Executive Council for approval to spend the money. Checks and balances at work in New Hampshire.
Roger Sevigny is one of the most trusted department heads. He personally visited members of the Fiscal Committee, provided the information requested and used his personal stature to assure Senators and Representatives that accepting the federal money tied to the Affordable Care Act was in no way an endorsement of the law or committed New Hampshire to any future obligation. He is one of the nation’s longest serving insurance commissioners and over the years I think legislators have felt confident in placing their trust in him. That helps make state government work.
I have been appointed to the Fiscal Committee after being off since 2005 when then Senator and now Mayor of Manchester, Ted Gatsas, replaced Tom Eaton (Keene) as Senate President. I noted that 30 percent of the Fiscal Committee now comes from District 8. Legislative veteran Beverly Rodeschin (Newport) has been elected clerk of the committee and Randy Foose (New London) is the Democrat Representative on the committee.
The Fiscal Committee operates differently from any other House and Senate committee. The House members meet separately from Senators for a "pre-Fiscal" meeting a day or two before the monthly meeting led by Jeff Pattison, the Legislative Budget Assistant. A similar pre-Fiscal meeting is held with Senate committee members. Every item is reviewed and as needed Senate or House positions may be agreed to on controversial issues. It helps smooth the process during Fiscal Committee sessions.
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