Sen. Kelly Ayotte, R-N.H., was in Portsmouth on Monday for a conference on the consequences of the Affordable Care Act. To her left is Rick Pierro, president of 48-worker Superior Controls Inc. of Seabrook. (GRETYL MACALASTER/Union Leader Correspondent)
PORTSMOUTH — Among the many letters U.S. Sen. Kelly Ayotte has received about the Affordable Care Act, she is hard-pressed to think of one that is positive.
She said the correspondence falls into four categories — people concerned about access to the government website, people receiving premium increase notices, hospitals being excluded from the state's health insurance exchange and employers trying to anticipate the changes. (Related story, Page A2.)
On Monday, Ayotte was in Portsmouth for a roundtable on health care with local business owners and people in the health care industry.
The Republican heard from Mike Ambrogi, chief operations officer with Novacure, a medical device start-up company in Portsmouth being hit with the 2.3 percent medical device tax on revenue.
Ayotte said she has co-sponsored about a dozen pieces of legislation so far to address problems with the Affordable Care Act, including legislation to repeal the medical device tax and restore flexibility in health savings accounts. She is also concerned that the law changes the definition of a full-time employee from one who works 40 hours each week to one who works 30 hours, and has co-sponsored legislation to change that.
Ten New Hampshire hospitals are excluded from the exchange, including Frisbie Memorial Hospital in Rochester, which Ayotte planned to visit Monday afternoon. Tom Buchanan, president of the Derry Medical Center, said what is being overlooked is the impact this will have on all the providers connected with those hospitals, as well as patients who need care.
Ayotte said she would vote to repeal the ACA tomorrow, but in the meantime, is trying to get feedback to improve the system as it exists.
She said she sees the legislation as driving up health care costs instead of reducing them. She said above all things, there needs to be more choice.
New Hampshire is one of two states that has one health insurance company involved with the state health care exchange; West Virginia is the other.
Thomas Harte is president of Landmark Benefits, which represents about 300 companies across New England as a health insurance broker.
He said companies of all sizes are seeing their rates increase, some exponentially.
Self-insured companies, such as Goss International, seem to be doing better. Pascal Orliac, vice-president for global human resources with Goss said rates for the 400-employee company in Durham went up about four percent during the recent renewal, which is uncommonly low.
Mark Lane, president of Co-Ed Sportswear in Newfields, said the company used to pay 100 percent of employees' health care plans and provided good coverage. But after years of getting hit with 10, 12 and 15 percent increases, he said the company had to pass on some of that to employees, who now pay 50 percent of premiums.
He said about half of his employees make between $10 and $12 an hour and cannot afford health insurance, even with the government subsidies, and he cannot afford to have every employee on his plan.
He said as a result, some employees are considering just taking the fine and not signing up for health insurance at all.
"I don't blame them. It just doesn't add up for them ... it doesn't add up for us either," Lane said.
Buchanan said the cost of health insurance for young people is "atrocious." He does not think as many young people are going to enroll as the administration would like.
"All the issues raised tells you that this is right now a mess and really impacts people," Ayotte said.
Ayotte noted although website issues at healthcare.gov have been addressed on the front end, they remain on the back end, with no mechanism in place to get subsidies to insurance companies and then to providers.