Lawmakers reject Ins. Dept. plan to stabilize Obamacare in NH

Aug. 01--Lawmakers reject Ins. Dept. plan to stabilize Obamacare in NH

By DAVE SOLOMON

State House Bureau

August 01. 2017 4:04PM

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CONCORD -- A plan to prevent the possible collapse of the individual health insurance market in New Hampshire was rejected by a legislative committee on Tuesday, leaving a cloud of uncertainty hanging over the future of coverage for 50,000 Granite State residents.

Members of the Joint Health Care Reform Oversight Committee, consisting of three senators and three representatives, voted 4-2 along party lines to reject a request by the Insurance Department to impose a $32 million assessment on the 72 insurance companies selling health insurance in the state.

Combined with $13 million the state hopes to get from the federal government, the money would be used to create a $45 million high-risk pool to stabilize rates and keep the remaining two insurance companies in the online exchange for individuals not covered by Medicaid.

The committee voted unanimously to apply for the federal money, but defeated a motion by Rep. Edward Butler, D-Hart's Location, to authorize the Insurance Department to proceed with a public hearing and other steps needed to impose the assessment.

Sen. Martha Fuller Clark, D-Portsmouth, voted with Butler, while the four Republicans on the committee -- Rep. John Hunt of Rindge (chair), Rep. Frank Kotowski of Hooksett, Sen. Kevin Avard of Nashua and Sen. Jeb Bradley of Wolfeboro -- voted against.

Gov. Chris Sununu has been against the assessment since it was first proposed two weeks ago, and reiterated that opposition in a letter hand-delivered to the committee on Tuesday.

"It is wrong to create an additional assessment on the backs of Granite Staters who are already struggling to pay exorbitant health care costs," he wrote.

Insurance Commissioner Roger Sevigny had argued in favor of the assessment, pointing out that the federal funding is uncertain and would not be sufficient to prevent premium increases expected to be in the 40 percent range.

Such assessments have been used in the past for high-risk pools, he said. The Insurance Department had scheduled public hearings on the stabilization plan for Wednesday and Thursday, which were cancelled soon after the committee vote.

Time is running out

If the market collapses due to the withdrawal of Anthem and Harvard Pilgrim, Sevigny would have the authority under state law to impose an assessment on an emergency basis for at least one year in the hope of luring companies back into the market, but legislative action would be required for the assessment to go beyond the first year.

The two companies that provide most of the coverage for individuals on the New Hampshire exchange at healthcare.gov have until Aug. 16 to decide if they will offer products in 2018, with enrollment beginning in November.

Executives from Anthem and Harvard Pilgrim would not commit to a return to New Hampshire for 2018, despite a direct appeal from Sununu. "I ask carriers to immediately disclose if they are in or out of the individual market and what a plan would look like," he wrote.

Another key issue for the carriers is whether President Trump will withhold millions of dollars in cost-sharing subsidies that are used to help pay out-of-pocket costs for low-income customers buying coverage under the Affordable Care Act, or Obamacare.

The president has threatened to withhold the subsidies, which he is legally entitled to do under recent court rulings. A decision is expected this week or next. Sen. Jeanne Shaheen, D-N.H., has introduced a bill in the U.S. Senate that would require the cost sharing payments as a matter of law.

"Anthem is weighing the CSR issue very carefully," said Paula Rogers, director of government affairs at Anthem Blue Cross and Blue Shield in New Hampshire. "It seems unresolved. We hear certain things coming out of Washington, but nothing concrete."

"Anthem is still actively discussing our posture here in New Hampshire and has made no decision to leave the market," she said. "The governor wants us to immediately disclose, but I don't have the authority to do that today. It will be known in the next couple of weeks."

'Extraordinary uncertainty'

Matthew Veno, head of government relations at Harvard Pilgrim, was similarly non-committal.

"If we had made a decision, we would have disclosed it immediately," he said. "We're navigating extraordinary uncertainty here that makes it extremely difficult to make informed decisions as a company ... Seeing CSR payments being held hostage to these discussions is particularly troublesome."

Sununu in his letter renewed his call for the Trump Administration to fund the cost sharing reductions "until a sufficient replacement for Obamacare is in place."

Fuller-Clark criticized the committee for failing to provide meaningful encouragement for Anthem and Harvard Pilgrim to remain in the market.

"Without the certainty of funding and the refusal to add an assessment on our state carriers, there's no way for insurance carriers to reduce premiums, despite the fact that insurance assessments in the past have been used to address failures in our healthcare marketplace," she said.In opposing the $32 million assessment, Bradley pointed out that the Insurance Department's own estimates reveal the plan would only lower anticipated premium increases from 40 percent to 35 percent, and said, "That's not my definition of success."

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