This week, the Chamber registered its support for the reauthorization of the New Hampshire Health Protection Program - perhaps the most significant healthcare-related legislation of 2016 and beyond.
To understand what is going on with this legislation, you need to turn the clocks back to 2014. New Hampshire and the other states were presented with the option of using federal Medicaid money to pay for the costs of healthcare for people at certain levels just above federal poverty limits. New Hampshire decided to exercise that option, and created the New Hampshire Health Protection Program as the means by which those funds would be administered. This NHHPP is set up so that the beneficiaries of the Program get their care through private health insurance policies. Almost 50,000 people now are receiving access to healthcare under the Program.
So why are we talking about this now? When the law was passed in 2014, there was a sunset date attached to it that says that the law expires on December 31st of this year. The sunset date was put into the law precisely so that the legislature would get a chance to assess the progress of the Program and decide whether it should be reauthorized. And so if the NHHPP is to be kept in place, there needs to be legislation passed this year.
HB 1696 looks to do that, and the Chamber supports this effort. There are several reasons why, from a business perspective, this bill makes excellent sense.
First of all, the NHHPP has a beneficial impact on health insurance costs generally, because the Program reduces the amount of uncompensated care that has to be provided by hospitals. Prior to the time that the Program was created, the people who now have a regular primary care provider as a result of the Program used to receive their healthcare by way of visits to hospital emergency rooms. The hospitals received no reimbursement for that care, and so the costs were passed on to health insurers and ultimately to all the people who pay for health insurance. Thus, uncompensated care was one of the things driving ever-higher health insurance premiums, and by reducing the amount of uncompensated care that the hospitals have to provide, the NHHPP has reduced that upward pressure.
Second, a majority of the people who participate in the New Hampshire Health Protection Program are employed. Because these people now have access to regular healthcare, they are undoubtedly going to be healthier and thus to be increasingly productive at work. One thing that we think is especially important to note in this regard is that participants in the NHHPP have access to substance abuse benefits. At a time when the State and the business community are struggling with the opioid crisis, the fact that this chunk of the New Hampshire work force has access to substance abuse benefits through the NHHPP is clearly a big reason why the NHHPP should be kept in place.
Third, as Speaker of the House Shawn Jasper appropriately pointed out on Wednesday in his remarks at a press conference on HB 1696, the federal money that makes up the great bulk of how this NHHPP is paid for is money that ultimately came from New Hampshire taxpayers, and it makes no sense to leave that money sitting on the table in Washington to be used by the federal government for some other purpose. Since this is in effect New Hampshire taxpayer money, better that the money come back to New Hampshire so that it can provide care for New Hampshire citizens and be injected (so to speak) into the New Hampshire economy.
One of the big questions leading up to the hearing on the bill yesterday was how the non-federal share would be paid for. House and Senate leadership worked with the hospitals and insurance companies to come up with a way to produce those funds through voluntary contributions by hospitals and insurance companies. These payments would produce the several tens of millions of dollars that look to be necessary for this purpose. Because the hospitals and insurance companies benefit from the reduction in uncompensated care, they have the real incentive to make those payments, and the reauthorization would be rescinded if the necessary funds are not produced. So this is an innovative and creative solution that does not require new state taxes or fees, and a tip of the cap to Speaker Jasper, Senate President Morse, and their teams as well, for some real leadership in getting to a resolution on this issue (which we hear was no easy task).
Now, we're not going to sit here and tell you there was no opposition to the bill. Primarily, the opposing arguments were that the federal government should not be spending this money, and that New Hampshire taxpayers will just end up footing the bill. But we are quite satisfied by the fiscal protections that are in this bill, and as we said above, the reality is that the money will be left in Washington unless we bring it back here. It is no mistake that the testimony at the public hearing yesterday was strongly in favor of the bill, and that other Chambers and the BIA also have thrown their support behind the bill. When all is said and done, the opponents of the bill have not come up with another way to provide health care for these 50,000 people other than simply returning them (and all of us) to the effects of uncompensated care in emergency rooms. That just makes no sense.
This is why our Chamber is urging the House HHS Committee and the entire Nashua delegation to pass HB 1696.
