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Garry Rayno's State House Dome: More debate over ACA exchanges
The conflagration's catalyst was Anthem Blue Cross Blue Shield's decision to limit the number of hospitals in its provider network for the plans it will offer on the exchange.
Anthem's limited network will disrupt health care for some of the people using the exchange if their local hospital and doctors are not in the network, but not for most people who have health insurance through their employers or through government programs such as Medicare and Medicaid.
The law says: "No New Hampshire state agency, department, or political subdivision shall plan, create, participate in or enable a state-based exchange for health insurance under the act, or contract with any private entity to do so," but also says, "State agencies or departments may interact with the federal government with respect to the creation of a federally facilitated exchange for New Hampshire."
The law itself allows the commissioner to maintain their traditional authority "to the extent allowed under (the ACA)."
The Insurance Department said under state law it has the independent authority to review plans to determine whether they meet state and federal standards, including plan details, rates and network adequacy.
The state reviews plans for both state and federal standards and makes a recommendation to the CMS, but the federal agency makes the final determination as to whether the plans meet federal and ACA requirements, the department said.
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Which Is Better? Expanding Medicaid eligibility can be seen in a new light after Anthem revealed last week its Pathway network includes only 16 of the state's 26 hospitals.
If the state decides to use the private insurance carriers for those between 100 and 138 percent, it would have to pick up the cost for the co-pays, deductibles and whatever else the private insurance doesn't cover that Medicaid does.
ROADS AND BRIDGES: The two-year state operating and capital budgets are in place, so it must be time for the biennial update of the state's 10-year transportation improvement plan.
The Governor's Advisory Commission on Intermodal Transportation began holding a series of 25 meetings across the state last week to gather input from the public, elected officials and local government staff.
The House and Senate make their recommendations by the end of June.
Much of the plan is focused on projects in the federal highway system, such as the widening of Interstate 93 from Salem to Manchester. There is about $145 million to $155 million a year allocated in federal highway funds to the state.
That is why some lawmakers are working to come up with a smaller gas tax increase that might be able to pass the House and Senate next year.
Senate Bill 152 would have allowed one casino in the state and allocated a little less than half of the money generated by gambling for roads and bridges. The bill was killed by the House.
Purple Heart Plates: After four years of trying, Sen. Lou D'Allesandro of Manchester persuaded his fellow lawmakers to allow the widows of Purple Heart license-plate holders to retain their husband's or wife's plates until they die or no longer register an automobile.
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