Gov. John Lynch surprised a lot of insiders by signing House Bill 1297, which prohibits New Hampshire from establishing its own health insurance exchange under the federal Affordable Care Act. It would be a mistake to take this as a sign that Lynch opposes either the exchanges or Obamacare.
As John DiStaso noted in his story today, Michael Cannon at the Cato Institute wrote of the news:
"It is becoming apparent even to members of the party that gave us 'ObamaCare' that helping to implement the law by establishing a health insurance exchange is a bad deal for states. It does not speak well of ObamaCare that Democrats are heading for the exits.”
Not so fast.
Gov. Lynch has never publicly expressed support of or opposition to Obamcare. But in January, he did advocate the creation of a state health insurance exchange.
Lynch spokesman Colin Manning said Lynch signed this bill because it was amended to allow the state to cooperate in the establishment of a federal health care exchange -- and because it is probably too late at this point for New Hampshire to create its own exchange. That does not sound like the position of a man who has suddenly turned on Obamacare.
Lynch has tiptoed around the issue since 2009, and he continues to do so:
In his January, 2010, State of the State address, Lynch said, in a clear reference to the Affordable Care Act, which was then being hotly discussed, "Congress should not pass any bill that piles unreasonable new costs on the states..." But his objection was limited to the costs states would bear. However, even when shown that Obamacare would cost New Hampshire millions of dollars in new Medicaid spending, he refused to oppose the law or the Medicaid expansion.
In April of 2011, he supported accepting $1 million from Washington to fund the creation of New Hampshire's exchange.
In July of 2011 he let two bills dealing with exchanges become law without his signature. One, HB 601, let the state work with Washington on some aspects of implementing Obamacare, but directed the HHS commissioner to reject two-thirds of the planning grant Lynch had supported in April. Lynch said he let it become law "because I did not want New Hampshire to default into federal oversight." SB 148 prohibited Granite Staters from being forced to buy health insurance or being fined for not buying it. Lynch let it become law, calling it irrelevant and saying "this legislation would have no impact on the capacity of the state of New Hampshire to block the individual health insurance mandate or the federal assessments for not obtaining insurance."
In October of 2011, Lynch's HHS commissioner asked the Legislative Fiscal Committee and the Executive Council for approval to spend the remaining $333,000 of the planning grant Lynch had supported accepting in April. This sparked another confrontation with legislators who said they had made clear with HB 601 (which Lynch let become law) that they did not want the planning money spent.
In December of 2011, the Executive Council voted to reject the HHS commissioner's request to spend the $333,000 in exchange planning money.
This January, he said in his State of the State speech:
"As we innovate with our health care system here in New Hampshire, we must also consider the impacts of reforms nationally. States like Utah have adopted health insurance exchanges because they benefit businesses and citizens.
"A well-designed health insurance exchange can make it easier for businesses to compare and obtain affordable health insurance. And I certainly don't think we want the federal government to design an exchange for us. That is why must move forward now with designing our own exchange right here in New Hampshire."
Then this week Lynch signed HB 1297, blocking the creation of the state-based insurance exchange he supports. He seems to have signed it because he thought it was the best option at this late date. He certainly did not sign it because he opposes the exchanges or Obamacare.