At State House, room for negotiation on Affordable Care Act
CONCORD — House Democratic and Senate Republican leaders remained at odds Wednesday over the issue of aligning state insurance regulations with the federal Affordable Care Act.
But a move by the House signaled that there appears to be room for negotiation in the coming weeks.
"It is possible for there to be a discussion in a way to make it possible to satisfy all parties," said Rep. Ed Butler, D-Hart's Location, during a House debate on a measure to have the state work with the federal government on the ACA, also known as "Obamacare."
The GOP-controlled Senate appears set Thursday to kill the original version of that bill.
Anticipating that move, the House, controlled by Democrats, resurrected its bill Wednesday, attaching it to a Senate bill on renewable electric portfolio standards.
The House moved to send the bill to the Senate a second time indicating there is a willingness by both sides to negotiate.
Before the House voted 166-119 to attach the health care bill to the energy bill, and then 170-113 to send the package to the Senate, House speaker Terie Norelli, D-Portsmouth, and Senate President Peter Bragdon, R-Milford, and other leaders of both chambers met on the issue, spokesmen for both sides said.
Norelli's spokesman said after the meeting there was no agreement on whether the state should set up its own health care exchange, as the House wants, or refuse to do so and have the federal government administer its own exchange, as the Senate wants.
He said the two sides agreed only to discuss the issue of small market group insurance.
The Norelli spokesman said both sides agreed to discuss that issue as part of a committee of conference.
But a spokesman for Bragdon was less specific.
The Senate spokesman said the two sides agreed merely not to attach the ACA bill to a bipartisan bill that would overhaul and update the state's corporate laws, as the House originally planned.
The Senate spokesman said, "The Senate cannot comment on how the House will amend bills before them today, or how the Senate will treat those bills when they arrive for our consideration."
Insurance Commissioner Roger Sevigny warned in a recent letter that if the state's market rules are not aligned with ACA during the 2013 legislative session, "the federal government will take over responsibility for enforcing those market rules for the individual and small group markets."
The issue of whether the state should move toward a state-based partnership or allow a federally-run partnership remains an ideological battleground for the divided state leadership.
Current state law prohibits the state from setting up its own state-based insurance exchange but does allow the state to cooperate with the federal government in the creation of a federal exchange.
House Bill 668, which was initially passed on a voice vote by the House in March, not only sought to restore additional state authority on exchanges but also would align state rules with the pending ACA rules on broader aspects of the individual and small group markets.
But Republicans in the Senate, led by majority leader Jeb Bradley and Andy Sanborn, said the bill would move the state closer to creating its own exchange and becoming intimately involved in implementing other components of the ACA.
Bradley said last week the ACA is causing "economic uncertainty" that is preventing businesses from investing in new jobs.
"It's a federal law and so it's a federal responsibility to implement it," Bradley said.
Democratic Gov. Maggie Hassan accused the Senate of putting "ideology ahead of the interests of the people, businesses and families" and of giving away "control of our health insurance market to the federal government."
In Wednesday's debate on adopting the healthcare amendment, Rep. Pam Tucker, R-Greenfield, argued, "The only reason we have this amendment is to establish a state health care exchange."
If passed, she said, "New Hampshire is going to have to take responsibility for the implementation, as well as the costs.
She said a similar program increased some insurance costs in California by 146 percent, and advised, "It's not new Hampshire's mess. This is the federal government's mess. Stay away from it until we know exactly what is in this bill."
Former House speaker Bill O'Brien, R-Mont Vernon, said it was "abusive and disrespectful" to attach the health care bill to an energy bill that has no relationship to the health care issue.
"But it's more abusive to the people of New Hampshire," he said.
Democrat Butler explained, "It's the market rules bill that allow the Insurance Department to implement the Affordable Care Act in New Hampshire."
He called the amendment "critically important to the citizens of our state," and killing it, he said, "prevents our insurance department from providing its oversight function."
"We should not be giving away our right to direct our health care insurance processes," Butler said. "We will be giving up our consumer protection responsibility.
Without the amendment passing, Butler said, "Got a problem with coverage? Call 1-800-WashingtonDC."