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September 19. 2012 10:21PM

Matthew Thornton plan OK'd as benchmark

CONCORD — New Hampshire will use a local health care insurance plan as the benefit benchmark that all individual and small group plans must provide beginning Jan. 1, 2014.

The Joint Healthcare Reform Oversight Committee voted 5-1 Wednesday to approve the Matthew Thornton Blue’s health insurance coverage as the minimum benefit package all companies participating in the state’s health insurance exchange must offer.

The state has a Sept. 30 deadline to decide on the “essential health benefits” which sets the floor for the health care coverage insurers must offer in the new health insurance exchanges and for individual and small group plans under the Affordable Care Act.

“The Senate stood firmly behind families and businesses that provide health insurance for their employees by voting for the health benefits package that has the lowest cost benefit,” said Senate Majority Leader Jeb Bradley, R-Wolfeboro, and Sen. David Boutin, R-Hooksett, in a joint statement. “We understand how important it is to keep health care costs down in New Hampshire but still provide excellent coverage.”

Bradley and Boutin, along with Sen. Molly Kelly, D-Keene, and Reps. John Hunt, R-Rindge, and Richard Barry, R-Merrimack, voted in favor of the Matthew Thornton package, while Rep. Andrew Manuse, R-Derry, voted against it.

Manuse saw no reason for lawmakers to take any action and instead suggested the responsibility should rest with the federal government, which passed the act, not state lawmakers.

“I’m very uncomfortable involving the state in any of us this,” said Manuse, who sponsored a bill last session to prevent state agencies from working with federal officials in establishing a health insurance exchange for the state. “The federal government passed the Affordable Care Act, not us.”

Insurance companies selling individual and small group policies must offer the benefits once the requirement that individuals have health insurance is enforced beginning January 2014.

The essential benefits cover 10 categories such as hospitalization, prescription drugs, laboratory services, and maternity and newborn care.

Lawmakers had to choose between three plans as the essential benefits benchmark: HMO Blue New England, Matthew Thornton Blue and Government Employees Health Association.

The Matthew Thornton plan is projected to cost $498.79 a person a month, while New England Blue would cost $500 and GEHA $512.70, according to a report by Compass Health Analytics Inc.

If the state does not make a decision, said Jennifer Patterson, an Insurance Department legal counsel, the federal government has already said it would approve the New England Blue plan.

The issues facing the committee were how the plans aligned with state mandates, abortion services and dental coverage.

Hunt noted the federal law runs roughshod over the state insurance laws and mandates. “We have the illusion of choice, but we really don’t have any choice,” he said.

While the Blue New England and Matthew Thornton plans cover almost all state mandates, the GEHA plan does not but does offer dental coverage, which the other two plans do not.

The other issue was abortion coverage.

Paterson told the committee there is one exception to the essential health benefit packages state decides and that is abortion coverage.

Companies are not required to offer abortion coverage as an essential health benefit even if the state approved package includes coverage, she explained. The federal law also does not preempt state laws on abortion, she noted.

Barry wondered if the state could seek a wavier to prohibit abortion coverage, and another committee member suggested a possible waiver from dental coverage if the GEHA plan were chosen, but Bradley said seeking any waiver would be very risky.

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Garry Rayno may be reached at grayno@unionleader.com.



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