Senate panel backs health exchange

While presidential candidates were crossing New Hampshire on Tuesday getting in their last points about health care, the Senate Commerce Committee was acting on three major pieces of health-related legislation.

Without a word of debate, the Senate unanimously voted to set up a Health Insurance Exchange, even though the House of Representatives is opposed to anything to do with the Patient Protection and Affordable Care Act, or Obamacare, as it is known by many of its opponents.

Senate Bill 163 would create a "hybrid" exchange, governed in different aspects by a nonprofit stakeholder board of directors, the Insurance Department and the Department of Human Services for determining eligibility for subsidies.

It would allow a Senate-House joint committee to pull the plug on any aspect of the exchange if federal health reform were to be overturned, partially or wholly. But it falls short of a sudden automatic repeal, which backers said would disrupt the local market.

Sen. Ray White, R-Bedford, introduced the bill despite his opposition to federal health reform because he said the state needs to retain regulatory control if is implemented. But the House is considering a bill that would forbid state employees from even working on an exchange.

The committee also pretty much gave up on a bill that would forbid the state from increasing the federal minimum standard of coverage for a subsidized plan offered by the exchange – often referred to as "the floor."

White said that's because the federal government threw a "curve ball" by issuing guidance that suggests it won't provide a floor at all and leave it up to the states to come up with their own.

White amended SB 627 to leave the determination of any floor to the aforementioned joint health care reform oversight committee. The committee passed the amendment, though Sen. Matthew Houde, D-Plainfield, might offer a floor amendment next week that would clarify that the Legislature has the last say on any joint committee recommendation.

The committee also reversed itself and now narrowly favors allowing businesses and individuals buy out-of-state health insurance.

Last week, the panel voted to kill SB 150, which would allow just that, but Sen. Russell Prescott changed his vote after being mollified by an amendment introduced by sponsor Sen. Andy Sanborn.

But White still objected to any legislation that would put local insurance carriers at a disadvantage, and Houde worried that this would result in a "race to the bottom" in terms of what a policy would cover.

"My health insurance went up 38 percent last year and 17 percent this year," said Sen. Sanborn, who said that buying health insurance, should be like buying auto insurance. "As a business owner, we are reaching that level when we can no longer afford insurance for our employees. This is the No. 1 issue facing businesses across the state." — BOB SANDERS/NEW HAMPSHIRE BUSINESS REVIEW