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NH mandates insurers cover contraceptives
New Hampshire has a state insurance mandate for contraceptives similar to the federal one that has generated so much controversy over the past few weeks.
And that's why some Catholic institutions here, including New Hampshire Catholic Charities and Saint Anselm College, currently provide such coverage for their employees.
RSA 415:18-i mandates that any company that provides group health insurance must cover all prescription contraceptive drugs and devices approved by the U.S. Food and Drug Administration.
The mandate has been in effect here since Jan. 1, 2000, after the Legislature passed it with bipartisan support the previous year.
Unlike the federal mandate, there is no so-called “conscience exemption” under the New Hampshire law to allow churches not to provide coverage that goes against their religious beliefs.
Tyler Brannen, health policy analyst for the state Insurance Department, explained the mandate applies to insurance companies, not to employers. “The Insurance Department doesn't regulate employers,” he said.
And he said it would not apply to employers who are self-insured, which includes some of the state's large employers, such as hospitals. “They're not subject to the mandate,” he said.
Catholic Medical Center is self-insured, according to Morgan Smith, spokesman for the Manchester hospital.
So is the Diocese of Manchester, said Kevin Donovan, director of communication for the Roman Catholic Diocese.
Asked how New Hampshire Catholic Charities deals with the insurance mandate, Nick Boudreau, the agency's director of communications, said in an email: “We've created self-insured dental and prescription plans for our employees. Although we are required to provide access to contraceptives, we won't pay for them.”
Boudreau explained that while contraception is included in the health plans offered to employees, as required by state law, Catholic Charities doesn't pay for the prescription itself. “The individual covers the complete cost out of pocket,” he said.
Barbara LeBlanc is assistant vice president for college communications and marketing at Saint Anselm College. She said the college president, the Rev. Jonathan DeFelice, O.S.B., told her, “We comply with the law, but it's not because we like it.”
Still, she said, “We do comply with New Hampshire law, and that does mean that right now we cover contraceptives as any other pharmaceutical with a co-pay. It's treated as any other drug and in fact often has medical uses apart from contraception.
“We also cover sterilization as a surgical procedure,” LeBlanc said. “Again, sometimes it has medical uses. We treat it as a surgical procedure with the appropriate co-pays.”
Dr. William E. Fahey, president of The Thomas More College of Liberal Arts in Merrimack, noted while more than two dozen states have similar mandates, New Hampshire is one of only a few that do not also have a conscience exemption. “I'm ashamed of this as a citizen of New Hampshire,” he said.
Fahey last week sent an open letter to members of the New Hampshire delegation, criticizing the Obama administration's previous decision not to broaden the religious exemption for such coverage beyond churches. Sen. Kelly Ayotte, R-N.H., read from his letter on the Senate floor and spoke against the policy.
On Friday, President Obama announced a change in that policy; the mandate to provide contraception coverage will be moved from employers to insurance companies. Employees of church-related institutions that do not want to provide such coverage will be able to obtain contraceptives directly from their health insurance companies free of charge.
Fahey said he was “pleased” to see that the administration was willing to reconsider its position. But he said he's not convinced the proposed solution is the fix that's needed.
“I think this will put people into a situation of what in Catholic theology is called ‘material cooperation,'” he said. That means while employers may ostensibly choose not to cover contraceptives, their insurance companies will certainly include the cost of providing it to employees that ask for it in what the company charges for premiums, Fahey said.
“To me this just seems to be a shell game,” he said.
Fahey on Friday co-signed a letter with other college officials criticizing the latest administration plan.
Brannen said it's too early to tell what the changes on the federal level will mean for New Hampshire's mandate.
But the issue is certain to come up if House Bill 309 becomes law. That measure, which was amended by the House and comes up for a hearing in the Senate Health and Human Services Committee on Feb. 23, would set up a committee to review all insurance mandates here.
The committee would also be tasked with reviewing the “essential benefits” section of the Patient Protection and Affordable Care Act — frequently referred to as “Obamacare'' — to compare those with New Hampshire's own mandates.
The legislation that created the New Hampshire mandate passed the Senate, 14-9, back in 1999, with support from more Democrats than Republicans.
It passed, 243-85, in the House on a roll call vote. Legislative records show that 120 Republicans, 121 Democrats and two independents voted in favor.
And that's why some Catholic institutions here, including New Hampshire Catholic Charities and Saint Anselm College, currently provide such coverage for their employees.
RSA 415:18-i mandates that any company that provides group health insurance must cover all prescription contraceptive drugs and devices approved by the U.S. Food and Drug Administration.
The mandate has been in effect here since Jan. 1, 2000, after the Legislature passed it with bipartisan support the previous year.
Unlike the federal mandate, there is no so-called “conscience exemption” under the New Hampshire law to allow churches not to provide coverage that goes against their religious beliefs.
Tyler Brannen, health policy analyst for the state Insurance Department, explained the mandate applies to insurance companies, not to employers. “The Insurance Department doesn't regulate employers,” he said.
And he said it would not apply to employers who are self-insured, which includes some of the state's large employers, such as hospitals. “They're not subject to the mandate,” he said.
Catholic Medical Center is self-insured, according to Morgan Smith, spokesman for the Manchester hospital.
So is the Diocese of Manchester, said Kevin Donovan, director of communication for the Roman Catholic Diocese.
Asked how New Hampshire Catholic Charities deals with the insurance mandate, Nick Boudreau, the agency's director of communications, said in an email: “We've created self-insured dental and prescription plans for our employees. Although we are required to provide access to contraceptives, we won't pay for them.”
Boudreau explained that while contraception is included in the health plans offered to employees, as required by state law, Catholic Charities doesn't pay for the prescription itself. “The individual covers the complete cost out of pocket,” he said.
Barbara LeBlanc is assistant vice president for college communications and marketing at Saint Anselm College. She said the college president, the Rev. Jonathan DeFelice, O.S.B., told her, “We comply with the law, but it's not because we like it.”
Still, she said, “We do comply with New Hampshire law, and that does mean that right now we cover contraceptives as any other pharmaceutical with a co-pay. It's treated as any other drug and in fact often has medical uses apart from contraception.
“We also cover sterilization as a surgical procedure,” LeBlanc said. “Again, sometimes it has medical uses. We treat it as a surgical procedure with the appropriate co-pays.”
Dr. William E. Fahey, president of The Thomas More College of Liberal Arts in Merrimack, noted while more than two dozen states have similar mandates, New Hampshire is one of only a few that do not also have a conscience exemption. “I'm ashamed of this as a citizen of New Hampshire,” he said.
Fahey last week sent an open letter to members of the New Hampshire delegation, criticizing the Obama administration's previous decision not to broaden the religious exemption for such coverage beyond churches. Sen. Kelly Ayotte, R-N.H., read from his letter on the Senate floor and spoke against the policy.
On Friday, President Obama announced a change in that policy; the mandate to provide contraception coverage will be moved from employers to insurance companies. Employees of church-related institutions that do not want to provide such coverage will be able to obtain contraceptives directly from their health insurance companies free of charge.
Fahey said he was “pleased” to see that the administration was willing to reconsider its position. But he said he's not convinced the proposed solution is the fix that's needed.
“I think this will put people into a situation of what in Catholic theology is called ‘material cooperation,'” he said. That means while employers may ostensibly choose not to cover contraceptives, their insurance companies will certainly include the cost of providing it to employees that ask for it in what the company charges for premiums, Fahey said.
“To me this just seems to be a shell game,” he said.
Fahey on Friday co-signed a letter with other college officials criticizing the latest administration plan.
Brannen said it's too early to tell what the changes on the federal level will mean for New Hampshire's mandate.
But the issue is certain to come up if House Bill 309 becomes law. That measure, which was amended by the House and comes up for a hearing in the Senate Health and Human Services Committee on Feb. 23, would set up a committee to review all insurance mandates here.
The committee would also be tasked with reviewing the “essential benefits” section of the Patient Protection and Affordable Care Act — frequently referred to as “Obamacare'' — to compare those with New Hampshire's own mandates.
The legislation that created the New Hampshire mandate passed the Senate, 14-9, back in 1999, with support from more Democrats than Republicans.
It passed, 243-85, in the House on a roll call vote. Legislative records show that 120 Republicans, 121 Democrats and two independents voted in favor.