Rep. Manuse Senate Testimony on HB 1297, relative to federal health care reform and health care exchanges

I have come before you today to introduce and support HB 1297, which would prohibit New Hampshire from implementing a state health benefit exchange under the so-called Obamacare Act, the federal “health care” overhaul enacted by Congress against popular demand in 2010.

A health benefit exchange is the mechanism the federal Health and Human Services Department would use to enforce the provisions of Obamacare, such as the individual mandate we already said could not be enforced in New Hampshire when we passed SB 148 last year, and the taxes, and penalties the act requires businesses to pay.

The federal health overhaul entices states with the choice to create a state operated exchange or rely on a federal operated exchange. In effect, they are no different; the federal bureaucracy would control either version.

Yet, a state exchange would cost the state an additional $10 million to $30 million a year to run starting in 2015—money we just don’t have—just to pay for state officials to follow the federal government’s orders. Even if we do end up with Obamacare, HB 1297 would save New Hampshire money.

The language of HB 1297 as amended by 2012-1786s is simple and comprehensive. It would be inserted in RSA 420-N, updating the responsibility of the Joint Health Care Reform Oversight Committee to guide the state’s executive branch in protecting New Hampshire from the federal law.

With amendment 2012-1786s, HB 1297 would give state officials guidance on how they should interact with federal agents in the event that the court does not overturn the federal act in its upcoming decision or if the federal act is not repealed by Congress. Specifically, the amended HB 1297 would direct state officials to maintain a free market for health insurance to the best of their ability under the federal law.

On top of this, the language of HB 1297 takes advantage of a flaw in the federal law that relies on states creating their own exchanges. The law did not provide for the contingency that states would refuse to set up exchanges, and because of this, by New Hampshire not creating a state exchange along with other states, it will be more likely that the federal health insurance overhaul would be repealed or amended.

If the court overturns the law or if the law is repealed, most of the changes we’re introducing today would be deleted, but the prohibition on creating a state-run exchange and a new general state policy favoring free-market health insurance would remain in place.

In Conclusion, this bill as amended provides for every possible outcome and maintains the state’s stance against the federal act; yet, it still ensures New Hampshire maintains its ability to regulate health insurance on its own, regardless of what happens next.