Should New Hampshire turn over the regulation of health care insurance plans that will be offered through a federally mandated exchange to the federal government?
That was the question before the Jt. Legislative Fiscal Committee on Friday.
Under the new Affordable Care Act, often referred to as Obamacare, exchanges in each state will be electronic marketplaces for individuals and small businesses to research and select options for coverage. Most of the premiums for policies offered through the exchange will be subsidized at different levels based upon income.
The key provision of the item on Friday was authorization for the New Hampshire Insurance Department to accept $409,690 to be spent between now and June 30 to establish a management plan for regulatory oversight of insurance policies companies will offer through the new exchange.
Complicated? Yes, and that is why some of the 10 members on the Fiscal Committee did not support the item. They were concerned that all the rules from Washington have not been determined and that some uncertainty existed about the overall Obamacare implications for New Hampshire.
An alternative view is that Obamacare is going into effect. The Supreme Court has determined it is the law of the land. And New Hampshire should do all it can to protect its rights and secure its sovereignty as the new national program is rolled out.
There will be a health insurance exchange in each state. New Hampshire, by passing House Bill 1297 last year, prohibited the state from creating its own state run exchange. Governor Maggie Hassan recently asked the federal government to enter into a partnership arrangement for New Hampshire’s exchange but as understood, it will be created and run by the federal government. Conditional approval of the Governor’s request came from Washington on Thursday.
Given that approval, the state can have oversight of the insurance companies in the exchange only if we have a plan management to do that. And that is contingent on taking the initial $409,690 to do that.
Commissioner Roger Sevigny appeared before Fiscal Committee emphasizing that approving the acceptance of the plan management money had nothing to do with creating an exchange and that because of HB 1297 there will be no state based exchange.
The Commissioner emphasized that his department was simply asking permission to continue its "traditional role" overseeing health insurance products offered in New Hampshire. Using a memorandum of understanding, the federal government will delegate its authority to the state and New Hampshire will make sure the insurance products offered meet federal standards.
This will make sure that all policies sold in the commercial market or through the new exchange will be overseen by the same people. Otherwise, we would have dual regulation, some regulation by Washington and some by Concord.
The goal is to protect consumers, estimated to be 58,000, who will be getting their insurance through the exchange.
Whether you hate or love Obamacare, its implementation has consequences for the state and consumers. It seems reasonable and responsible to protect New Hampshire consumers by having our own Department of Insurance oversee the companies selling health insurance through the exchange. That is what we have been doing for decades on the commercial side. Why not treat policies in the exchange the same way?
In the end, a bi-partisan group of seven House and Senate members voted to accept the $409,690 federal grant. There were three opponents.
Discussions of insurance are often confusing to most of us. That is why we rely on agents and other professionals to help us sort through things. The new federal program is complex and thus confusing. And the issue of overseeing insurance products in the exchange is just one of many tough issues that New Hampshire government will have to deal with over the next couple of years.
My office is on the third floor of the State House, the same floor as the gallery for Representatives Hall. As I was leaving the State House on Thursday evening, I peeked into the House Finance Committee public hearing on the budget. I could tell the fast falling snow outside had held down attendance.
The Finance Committee Chair, Representative Mary Jane Wallner (Concord), told me there were about 75 citizens who braved the storm to testify and maybe 150 to 200 in attendance overall. The public hearing process is the citizens’ opportunity to be heard. This is simply a reminder the Finance Committee will be in Claremont at the Sugar River Valley Regional Technical Center on Mar. 18 starting at 5:00 p.m.
While national reports on Friday heralded new job creation and upticks in some housing statistics, revenue for New Hampshire general and education trust funds in February was off goal by 13.1 percent. We can handle that because February at $81.8 is the smallest revenue month of the fiscal year.
March on the other hand is our biggest month for revenue. The revenue plan is to take in $589.5 million this month. I will not say budget watchers are showing anxiety but we all know a 13.1 percent shortfall from the nearly $600 million revenue goal would be a budget disaster. The state is already behind revenue plan more than $30 million with just four months to go to the June 30 end of the current fiscal year.