CONCORD, N.H. -- The state will partner with the federal government to operate the new insurance markets required under President Barack Obama’s health overhaul law, according to a declaration letter Gov. Maggie Hassan is sending out this week.
"I think the fear that we have, and we share with many of you, is that if we do not right now tell the federal government what we want control over, we will lose it," Hassan’s legal counsel, Lucy Hodder, told a legislative oversight committee Tuesday. "We’ve lost a lot already, and it’s incredibly important to make sure we’re doing what’s best for New Hampshire residents."
A major component of the federal law requires the creation of exchanges, which are marketplaces that will offer individuals and their families a choice of private health plans resembling what workers at major companies get. States have until Friday to declare whether they are establishing their own exchanges, creating regional exchanges with other states, running exchanges in partnership with the federal government or letting the federal government operate exchanges for them.
New Hampshire lawmakers last session passed a law prohibiting the state from establishing its own exchange, so its decision came down to whether to have a partnership, and, if so, what kind. According to Hassan’s letter, the state will pursue two types: a planned management partnership that would make the state responsible for regulating insurance companies and the plans they offer under the exchanges and a consumer assistance partnership that would involve helping consumers access the exchange.
Taking that route is in keeping with goals set forth by the Legislature, Hassan wrote, which include preserving to the greatest extent possible the state’s insurance regulatory authority.
"Our goal on Friday is to protect New Hampshire’s ability to preserve its authority and help our consumers make the best choices available to them," Hodder told lawmakers.
The letter also specifies that the partnership will not impose a cost on the state’s general fund or create new state programs, that the state may terminate the partnership at any time once it has properly accounted for any federal grant funding and that details going forward are subject to the approval of the legislative committee.
Though Hassan apparently did not need the committee’s approval to send the letter, the committee voted on it anyway Tuesday. Democratic Sen. Peggy Gilmore and the three House members -- Republican John Hunt and Democrats Cindy Rosenwald and Edward Butler -- voted in favor of the declaration, though Hunt said his vote was meant to affirm the committee’s authority and to move the process forward.
Republican Sens. Jeb Bradley and Andy Sanborn opposed it. They voiced concerns about the regulatory burden and sustainability of a partnership and said they worry that the state will be left with paying for costly programs when federal money runs out.
"There are just a huge number of unanswered questions, unknown commitments, unknown costs, possible benefits, potential problems," Bradley said. "I am afraid by moving forward we’re assuming burdens, assuming costs, and that pre-emption will be the norm even in a partnership."