NH House approves $5.3M health overhaul grant

CONCORD, N.H. (AP) -- New Hampshire's House took two steps Wednesday toward implementing President Barack Obama's health care overhaul law, voting to accept a $5.3 million grant to help consumers understand the law and attempting to salvage a bill that would align state insurance rules with the federal changes.

The federal grant was awarded to the state Insurance Department in April, but legislative approval is required to accept it. It was tacked onto an unrelated bill Wednesday, approved by the House on a vote of 179-132 and sent back to the Senate. In a 170-113 vote, the House also re-affirmed its support for bringing state insurance rules in line with the federal law. After passing a bill in March, the House added that bill's language as an amendment to an unrelated measure Wednesday as a backup given that the Senate appears poised to kill the original.

Opponents of accepting the grant money argued that public outreach should be left to the federal government. But supporters argued that the community health centers, hospitals and other organizations that know New Hampshire's uninsured population best should play a leading role in educating them about the complicated law.

"It's high time we got off the dime and started helping our citizens learn about Obamacare and how it affects them, what benefits it offers and what the cost of coverage will be," said Rep. Ed Butler, D-Harts Location. "Regardless of what you think about the law, we should be able to agree that all New Hampshire residents deserve to be informed about the changes that are coming."

Under the overhaul law, new insurance marketplaces will offer individuals and their families a choice of private health plans resembling what workers at major companies already get. The government will help many middle-class households pay their premiums, while low-income people will be referred to safety net programs they might qualify for. Enrollment starts Oct. 1 with coverage taking effect Jan. 1. After that, virtually everyone in the country will be required by law to have health insurance or face fines.

New Hampshire opted not to establish its own marketplace and is partnering with the federal government to regulate insurers and provide consumer assistance. But the process has been slowed by persistent disagreements about who has the final say over implementing the law.

Rep. John Hunt, R-Rindge, said he believes the insurance department can't spend any of the grant money, even if accepted, without the approval of the Legislature's Joint Health Reform Oversight Committee. He offered an amendment Wednesday that would explicitly spell that out, but it failed to pass.

Opponents of accepting the federal money argued that the health overhaul law is a federal law that should be explained by federal officials.

"It's not something we have any particular knowledge of," said Rep. Dan McGuire, R-Epsom. "This is something the federal government could do as easily, if not more easily, than we could."

Supporters countered that the public is hungry for information. One lawmaker described being approached by someone who had heard radio ads in Vermont about that state's progress in implementing the law and who wondered when New Hampshire would do the same. Another said her uninsured hair stylist questions her every six weeks about when there will be more information.

"People out there have no idea what's going on, and it's up to us to explain it," said Rep. David Huot, D-Laconia.

Opponents of the second bill cast it as an attempt to move New Hampshire toward a state-operated marketplace.

"Let's not be adopting the Affordable Care Act. It's not New Hampshire's mess, it's the federal government's mess, and we need to stay away from it," said Rep. Pam Tucker, R-Greenland.

Rep. Bill O'Brien, R-Mont Vernon, said instead of a partnership exchange, New Hampshire will end up with a "partnership of confusion." He said the voting for the amendment would be like telling the state's residents to "put on a blindfold and jump off that cliff."

But supporters noted that the same law that prohibits the state from having its own marketplace or exchange also requires the state insurance department to retain as much of its traditional authority as possible.

"We should not be giving away the right to direct our health care insurance processes," Butler said.