Revision: April 3, 2012, midnight
HB 1297 – AS AMENDED BY THE HOUSE
8Mar2012… 0527h
2012 SESSION
01/04
HOUSE BILL 1297
AN ACT relative to federal health care reform and health care exchanges.
SPONSORS: Rep. Manuse, Rock 5; Rep. Lambert, Hills 27; Rep. Sorg, Graf 3; Rep. Itse, Rock 9; Rep. Peterson, Hills 19; Rep. Ingbretson, Graf 5; Rep. Groen, Straf 1; Rep. Jennifer Coffey, Merr 6; Rep. O’Brien, Hills 4; Sen. De Blois, Dist 18; Sen. Forsythe, Dist 4
COMMITTEE: Commerce and Consumer Affairs
This bill clarifies the implementation of certain provisions of the Patient Protection and Affordable care Act.
This bill also prohibits the state of New Hampshire from planning, creating, or participating in a state health care exchange.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
8Mar2012… 0527h
12-2538
01/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twelve
AN ACT relative to federal health care reform and health care exchanges.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Federal Health Care Reform; Purpose and Scope. Amend RSA 420-N:1 to read as follows:
420-N:1 Purpose and Scope.
[I.] The intent of this chapter is to preserve the constitutional integrity and sovereignty of the state of New Hampshire under the Tenth Amendment to the United States Constitution and part I, article 7 of the New Hampshire constitution by creating a legislative oversight committee to supervise the insurance commissioner’s [implementation] administration of the insurance reforms required under the Patient Protection and Affordable Care Act of 2009, Public Law 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, including any federal regulations, interpretations, standards, or guidance issued thereunder (hereinafter “the Act”).
[II. Further, it is the intent of this chapter to prevent the state of New Hampshire from defaulting into federal oversight regarding the Act by not meeting certain federally-mandated time frames for state implementation of the Act. It is the intent of this chapter to preserve the state’s flexibility by allowing consideration of each state implementation requirement as it arises.]
2 Federal Health Care Reform; Consistency. Amend RSA 420-N:6 to read as follows:
420-N:6 Consistency. In order to [prevent a default to federal regulation and to preserve the state’s status as the sole regulator of] protect the state’s rights and responsibilities to regulate the business of insurance within the state, the oversight committee shall have the authority to find, with respect to any specific provision within Title XXXVII, that the provision is inconsistent with and prevents the application of the Act. Upon such a finding, the [commissioner may, on a provisional basis, implement this provision of the Act] oversight committee shall make a recommendation to the legislature. The [commissioner’s] commissioner and any other state official in any agency, department and subdivision and any government in New Hampshire shall not have authority to implement this provision [shall extend only] until such time as the general court can take legislative action to amend Title XXXVII as it deems appropriate.
3 New Section; Prohibition. Amend RSA 420-N by inserting after section 6 the following new section:
420-N:7 Prohibition. The state of New Hampshire and all of its agencies, departments, and subdivisions and any government in New Hampshire shall not plan, create, participate in or enable a state exchange for health insurance including, but not limited to, the exchange requirements of the Act. In addition, the state of New Hampshire and all of its agencies, departments, and subdivisions and any government in New Hampshire shall not contract with any private entity to plan, create, or enable a state exchange for health insurance including, but not limited to, the exchange requirements of the Act.
4 Effective Date. This act shall take effect upon its passage.
LBAO
12-2538
Amended 04/02/12
HB 1297 FISCAL NOTE
AN ACT relative to federal health care reform and health care exchanges.
FISCAL IMPACT:
The Department of Health and Human Services states this bill, as amended by the House (Amendment #2012-0527h), will have an indeterminable fiscal impact on state expenditures and revenue. There will be no fiscal impact on county and local expenditures or revenue.
METHODOLOGY:
The Department of Health and Human Services states this bill prohibits state employees of any branch from working to implement a state-based health insurance exchange as provided for under the Patient Protection and Affordable Care Act of 2010 (ACA). The ACA mandates that each state operate a health insurance exchange. States may choose between a state-based exchange or a federally operated exchange. The Department states the federally operated exchange is the default for states that choose not to implement a state-based exchange. The Department indicates the bill does not prohibit work on a federal exchange and assumes the bill may result in implementation of a federal health insurance exchange in New Hampshire. The Department is not able to calculate the cost or benefit resulting from employing a federal exchange instead of a state exchange.
The Department of Insurance states this bill have no fiscal impact on insurance premiums or the insurance premium tax base.