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Sponsor's Insight - 2-28-11
NH Legislature Takes on Federal Healthcare Reform
No fewer than ten bills were introduced in the state legislature this year taking on the issue of federal healthcare reform. The bills vary in scope from demanding that the state join a lawsuit challenging the constitutionality of the federal law to efforts to facilitate implementation of the federal law in New Hampshire should it withstand legal and political challenges over time. State legislators recognize that the landscape for federal healthcare reform is both uncharted and shifting, and it is likely that many of these bills will be carried over for action next year when more details are known. But, here's an overview of what they are currently considering:
· HB 237, relative to federal mandated health insurance benefits - HB 237 would authorize the Commissioner of Insurance to enforce consumer protections and market reforms set forth in the federal law only if federally mandated health benefits are fully paid for with federal dollars. The bill was heard on February 3rd and is pending before the House Commerce Committee.
· HB 327, relative to health care choice - HB 327 authorizes individuals to purchase health insurance from out-of-state carriers selected by the Commissioner of Insurance and grants rulemaking authority to the Commissioner for purposes of the bill. While this proposal preserves the authority of the Insurance Department to engage in market conduct and solvency examination of all insurers doing business in the state and to engage in dispute resolution, it specificially does not require that out-of-state insurers offer policies that include all state-mandated health benefits. This bill was heard on February 10th and is pending before the House Commerce Committee.
· HB 440, requiring that New Hampshire join the lawsuit challenging federal health care reform legislation, and repealing the authority for state implementation of federal health care reform - HB 440 does exactly what the title states. It passed the House by a roll call vote of 267 to 92 on February 16th and is now pending before a second House committee, the House Commerce Committee, which will hold a public hearing on March 10th.
· HB 489, relative to health information exchange - HB 489 establishes a corporate structure and other parameters for the electronic exchange of health information as required under the federal reform, and deals with certain funding issues. Stakeholders are actively working on proposed changes to the bill and a public hearing before the House Health and Human Services Committee was postponed until March 3rd.
· HB 601, relative to implementation of federal health care reform - HB 601 eliminates an existing "sunset provision" which, if left to stand, would halt the authority of the Commissioner of Insurance to implement federal health care reform as of July 1, 2011 and, instead, requires the Commissioner to obtain approval from an oversight committee, the Legislature, and all other state agencies before enforcing consumer protections and market reforms or adopting rule changes, submitting grant proposals or requests, or engaging in any other implementation activities. This bill was heard before the House Commerce Committee on February 24th. At the hearing, the NH Insurance Department proposed an amendment that would require approval from an oversight committee before it or any other state official or agency seeks to enforce the insurance provisions in the federal law but would not require approval of its actions by the Legislature and other state agencies. The proposed amendment would also clarify certain technicalities related to the oversight committee.
· HB 619, requiring the State of New Hampshire to opt out of the requirement that individuals purchase health insurance contained in the Patient Protection and Affordable Care Act - HB 619 does exactly what the title states. The bill was retained in the House Commerce Committee for action next year since it would direct the Department of Health and Human Services to immediately request a waiver from provisions of the federal law that have not yet been promulgated.
· HB 627, relative to "essential benefits" under federal health care reform - HB 627 invalidates any state insurance mandate that exceeds or offers better benefits than the "essential benefits" package that will be provided under federal health care reform. This bill was heard before the House Commerce Committee on February 24th.
· SB 148, relative to health insurance coverage and directing the Attorney General to join the lawsuit challenging the Patient Protection and Affordable Care Act - SB 148 provides that a resident of New Hampshire shall not be required to obtain health insurance coverage or be assessed a fee or fine for failure to do so, and it directs the Attorney General to join an existing lawsuit challenging the constitutionality of the federal reform law. This bill will reach the Senate floor in the next scheduled session with a recommendation from the Senate Commerce Committee that it pass with amendment.
· SB 162, relative to federal health care reform 2010 - SB 162 is essentially the same as HB 601 (above); however, it also specifies that the proposed approval requirements would apply to the creation of health information exchanges and that it is intended to preserve protections and benefits for New Hampshire residents "notwithstanding the affirmative choice of the [Legislature] not to participate in some or all of the [federal] Act's provisions." This bill is pending before the Senate Commerce Committee where a proposed amendment is anticipated.
· SB 163, relative to the New Hampshire health benefit exchange - This bill is similar to HB 489 (above) in that it seeks to establish a corporate structure and other parameters for the electronic exchange of health information as required under federal healthcare reform. As described by its prime sponsor, the bill begins with model legislation from the National Association of Insurance Commissioners and then takes the "New Hampshire approach" of creating a minimalist, private, and non-profit structure for the health information exchange entity. This bill will reach the Senate floor in the next scheduled session with a recommendation from the Senate Commerce Committee that it be re-referred for action next year.
Understanding these bills requires a basic understanding of provisions in the federal healthcare reform law. The US Chamber of Commerce has a number of materials related to the impact of the federal health reform law on businesses in the healthcare section of its website, including a white paper entitled Critical Employer Issues in the Patient Protection and Affordable Care Act.
*Please Note - the GMCC is not a division or department of the US Chamber and the views of the US Chamber are not necessarily reflective of the GMCC.
Valerie Acres
Sheehan Phinney Capitol Group
vacres@sheehan.com
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