CONCORD, N.H. -- New Hampshire could revisit a state law requiring the federal government to run a health insurance exchange and take on a bigger role through a partnership.
State Republicans opposed implementing the federal health care overhaul law. They helped turn back $1 million in federal money to be used for planning and passed a law banning the state from establishing an exchange to serve as a marketplace for consumers to find insurance.
That could change with the shift in power after the election. Democrats regained control of the House, gained seats in the Senate and retained the governor’s office.
Gov.-elect Maggie Hassan, a Democrat, wants to discuss the state’s options with lawmakers, business owners and others before deciding, spokesman Marc Goldberg said.
"There is bipartisan support for ensuring that New Hampshire has significant input about our health benefit exchange so that it is not solely developed by the federal government," Goldberg said.
Starting Jan. 1, 2014, individuals, families and small businesses will be able to buy private coverage through an exchange in New Hampshire, with most consumers getting government assistance to pay premiums. The exchanges will also help steer some low-income, uninsured people into Medicaid programs.
It is too late to establish a state-based exchange by the 2014 federal deadline, but a partnership is a third option open to New Hampshire.
"If we don’t do a partnership, we still would continue to do what we do now -- form review, consumer protection -- but there would be two sets of regulations doing that. There might be issues of pre-emption. It would be confusing," said Insurance Department attorney Jennifer Patterson.
Retiring Democratic Gov. John Lynch is leaving the decision to Hassan and legislative leaders. Hassan, who will be inaugurated Jan. 3, has until Feb. 15 to send Washington a letter that the state wants a partnership and submit a blueprint outlining how the partnership would work.
A partnership exchange would not require repealing the Republican-passed ban but would require approval from a joint legislative oversight committee that Republicans created as a check against the insurance commissioner from implementing the law on his own.
Insurance Commissioner Roger Sevigny says his agency can prepare the necessary blueprint required for a partnership before Feb. 15 if Hassan and legislative leaders give the OK. If the state wanted to transition to a state-based exchange in 2015, the law allows it, he said.
"So all is not lost. It’s just that it would take more time to get there," he said.
State Rep. John Hunt, a Rindge Republican chairing the committee, said he assumes the Democrats’ pick to be speaker, Rep. Terie Norelli, will appoint new committee members supporting a greater state role in implementing the law. She is expected to be elected to head the House on Dec. 5.
Norelli is open to a partnership.
"The New Hampshire way is to do things with as much input as possible from New Hampshire. At this point, that may mean a federal-state partnership," said Norelli.
Incoming House Republican Leader Gene Chandler wants more information before taking a position, and Senate President Peter Bragdon, R-Milford, said Hassan has not approached him to discuss the issue.
But some Republicans are ready to move forward now that President Barack Obama has been re-elected and the health care law isn’t likely to be repealed.
State Rep. David Hess, R-Hooksett, filed legislation to repeal the state ban and establish a state-based exchange. Hess’ bill is modeled after a Senate bill that died in the face of House Republican resistance.
"We got caught up in our own ideological hang-ups last session," said Hess. "I can’t see a Republican who would rather see the federal government force-feed us with an off-the-shelf plan that would be used in California."
"If New Hampshire is not providing a subsidy, New Hampshire has no business being involved in it," said Hunt. "If consumers have problems getting federal subsidies, what can the state of New Hampshire do about it?"