NH Senate rejects $5.3 million grant for Affordable Care Act consumer education
CONCORD — The Republican-controlled state Senate on Wednesday rejected a federal grant to help consumers understand the Affordable Care Act’s insurance exchange program, but agreed to negotiate with the House on a bill that would have the state align its insurance laws and rules with the ACA.
The House last week passed legislation allowing the state to accept the $5.3 million federal consumer assistance funding, with proponents arguing that the state should prepare its residents for the implementation of the ACA next year and opponents saying it’s a federal responsibility.
The debate in the Senate Wednesday was along party lines, and Republicans eventually prevailed on a 13-11 party line vote, killing the legislation authorizing acceptance of the grant.
The federal dollars were awarded to the state Insurance Department in April, but legislative approval was needed to accept it.
The federal health exchange is to be operational by Jan. 1, 2014, but enrollment begins on Oct. 1.
A joint House-Senate Fiscal Committee had already refused to use $340,000 of the grant to begin work on setting up an education and outreach program. But $5 million remained available.
Sen. Peggy Gilmour, D-Hollis, said the funds were being offered to the state insurance department so it could “assist New Hampshire citizens who qualify for obtaining insurance through a federal marketplace exchange.
“To refuse these dollars will do a very serious disservice to our New Hampshire citizens who will be eligible for assistance to understand how to purchase this insurance,” she said. She noted there is no requirement for a state match.
Gilmour said acceptance of the money would allow the state insurance department to hire a project manager and “assisters” to put into place “an education marketing outreach plan specific to people in New Hampshire.”
But Sen. Andy Sanborn, R-Bedford, said state law says New Hampshire will not have a state-based exchange and so “there is nothing today that would allow us to accept this money.
“The role of the Department of Insurance is consumer protection, not data collection and marketing,” Sanborn said.
Senate Majority Leader Jeb Bradley, R-Wolfeboro, said that with the federal government overseeing the exchange program in New Hampshire, rather than the state, it is a federal responsibility to provide “navigators” for the ACA.
“We don’t need to have the state get involved in what the federal government should do on a federal program,” Bradley said.
After the vote, Gov. Maggie Hassan’s office indicated there is still a chance the grant can be a part of negotiations on the state budget.
Her spokesman, Marc Goldberg, said in a statement, “These federal dollars for consumer assistance are critical for ensuring that the people who know New Hampshire’s health care system best, not the federal government, are the ones working to connect Granite State families, individuals and small businesses with health coverage.
“Rejecting these dollars will hurt our consumers and make it more difficult for them to access health insurance, and the governor will continue to advocate for accepting this grant as the budget process moves forward,” Goldberg said.
The grant authorization had been attached to a bill that revamps requirements for court-ordered placements in shelter care facilities and at the Sununu Youth Services Center.
While that bill died, those provisions can be revived through other bills.The Senate last Thursday killed House Bill 668, which would have the state align its insurance rules with those of the ACA. But the House, anticipating the Senate move, had attached the contents of the bill to another bill a day earlier and passed it to the Senate.
Bradley said last week a conference committee was necessary to address issues recently raised by the insurance department.
Sanborn said after Wednesday’s session that “it’s a technical bill that outlines the responsibility of the state and the federal government as we look to implement Obamacare. We want to make sure we’re doing it correctly.
“We realized very late in the game that there may be a mechanical issue with the operation of that implementation, and so we asked the House to put the contents on another bill to give us time to try to figure out if there really is a problem and if there is, give us time to come (up) with a solution.”
Sanborn said New Hampshire “has very specific laws on how we offer insurance, and under Obamacare, the federal government is bringing in a very specific law of how to implement these insurance plans people buy. There could be some conflict in what the two laws say.
“And if there is conflict, the question is who takes precedence over the other one,” he said.
Republicans Sanborn and Bradley and Democrat David Pierce of Hanover were the senators assigned to the committee of conference. The House had not assigned its conferees as of late Wednesday.