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Column: Effects of Obamacare on N.H. creates uncertainty

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 recently before the Joint Legislative Fiscal Committee.

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 recently came from Washington.

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.

Bob Odell, a Republican, is the New Hampshire senator representing Antrim, Bennington and Francestown, among other towns.

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