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February 20. 2014 9:09PM

Claremont officials make plea for Anthem to include local hospital

CONCORD — Leaving Claremont's hospital out of the Anthem Blue Cross Blue Shield provider network makes it more difficult to meet the goals of the Affordable Care Act, city officials told a House committee Thursday.

City Councilor and Valley Regional Hospital trustee Charlene Lovett told the House Commerce and Consumer Affairs Committee that health care is transitioning from "sick care to health care" with the keys being greater primary and preventive care.

Instead of more readily available access to health care, which is a goal of the Affordable Care Act, city residents will have a harder time accessing health care because they will have to travel 30 miles to a hospital and primary care practices that are in Anthem's provider network, she said. Anthem is the only insurance carrier offering plans on the state health exchange in 2014.

"The reality is people don't have access to health care," Lovett said, "because they don't have the means to get there."

The committee held a public hearing on House Joint Resolution 12, which would require Anthem to have at least one hospital in every county in the state.

When the insurer's Pathway network was announced last fall, it did not include hospitals in either Coos or Sullivan counties. Since that time, Androscoggin Valley Hospital in Berlin was added to the network.

The resolution's prime sponsor, Rep. John Cloutier, D-Claremont, said Sullivan and Coos counties are the two most rural and poorest in the state and excluding the hospitals have many harmful affects that raise barriers to health care.

With no public transportation and many people without automobiles, traveling to Lebanon, New London or Keene to access health care is more difficult and will mean many residents will not seek care, he said.

He said Valley Regional has made many difficult decisions including closing its birthing center, which means a pregnant woman has to go to another hospital to give birth.

Despite those difficult decisions, Cloutier said, the hospital expects to have a $1.9 million deficit by Sept. 30.

When Anthem announced its network, the company said the narrowed network of hospitals would save about 25 percent on premium costs for those buying policies on the state's exchange.

Officials said the network meets all state Insurance Department network requirements.

Several committee members were sympathetic to Cloutier's resolution but said the real way to address the problem may be through changing network requirements that hospital access must be within 30 miles and 45 minutes travel time.

Committee vice chair Rep. Donna Schlachman, D-Exeter, noted the department is putting together a working group to study network adequacy requirements which have not been revised since 2001.

"That process may be more valuable than a resolution," she told Cloutier.

A resolution does not have the weight of law, but is an expression of the Legislature's wishes. Cloutier said he wants to send a message to Anthem or any other insurer offering policies on the exchange that they should not exclude Valley Regional Hospital from their networks.

Claremont Mayor James Neilsen told the committee eliminating Valley Regional from the Anthem provider network is counterproductive, noting the community college, which the state supports, has nursing and physical therapy programs tied to the hospital.

He said the hospital is the county's second largest employer and excluding it from the Anthem network could mean lost jobs.

And Neilsen said, he has three sons who did not sign up for health insurance.

"It's difficult to see how you can coerce someone to sign up in a community without a hospital they can go to," Neilsen told the committee.

The committee did not make an immediate recommendation on the bill.

garyno@unionleader.com


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