By Holly Ramer
---- — CONCORD — House and Senate negotiators approved a narrowly drawn bill yesterday, aligning some of New Hampshire’s insurance rules with President Barack Obama’s health care overhaul law.
The state insurance commissioner had argued that a long list of changes were needed to preserve the state’s traditional role in regulating insurance plans and to prevent marketplace disruption and confusion. But opponents of the bill cast the original as an attempt to move New Hampshire toward a state-operated insurance exchange — something specifically prohibited by state law — and said they doubted the insurance department’s claims.
“The question I’m still struggling with is, do we really need to do this?” said Sen. Jeb Bradley, R-Wolfeboro.
The compromise, which still must be accepted by the full House and Senate, replaces the original 15-page bill with three paragraphs. It specifies that insurance companies providing coverage to individuals and small businesses will follow federal regulations in terms of the demographic factors used to set rates.
Those factors include age, tobacco use and geographic location, though the compromise clarifies that New Hampshire will continue to be considered one geographic rating area.
Many other provisions were dropped, including one that sought to reconcile the state’s definition of “employee” and “small employer” with federal definitions, but insurance industry officials said that the compromise addressed the most pressing concerns and that other issues could be resolved later.
Unlike the original bill, the compromise also includes a provision specifying that nothing in the bill should be interpreted as expanding the insurance department’s authority to adopt rules. Bradley and fellow Republican Sen. Andy Sanborn said they worried the department would use an emergency rule-making process to enact parts of the bill that didn’t make it into the final version, and Sanborn has repeatedly accused the department of failing to bring key matters before a legislative committee appointed to oversee the federal law’s implementation.
Rep. Ed Butler, D-Hart’s Location, defended Insurance Commissioner Roger Sevigny, however, saying he has led the department and worked with the Legislature well, despite the strong differences of opinion about the federal law.
“I believe there has been no malintent in what the insurance department has done,” he said. “I believe it has not been political, but to move what they believe their responsibilities are forward.”
Under the overhaul law, new insurance marketplaces will offer individuals and their families a choice of private health plans resembling what workers at major companies already get.
The government will help many middle-class households pay their premiums, while low-income people will be referred to safety net programs they might qualify for.
Enrollment starts Oct. 1 with coverage taking effect Jan. 1. After that, virtually everyone in the country will be required by law to have health insurance or face fines.
While the last Legislature passed a law prohibiting the state from setting up its own markets, or exchanges, Democratic Gov. Maggie Hassan decided in February to have the state partner with the federal government to manage the health plans offered through the markets and to provide consumer assistance.
The decision by the first-term Democrat didn’t sit well with Republicans, who have blocked or slowed several efforts to implement the federal law.