New Hampshire Lawmakers Consider Two Proposals to Increase Insurance Access

The New Hampshire Senate has passed two separate bills in recent weeks aimed at increasing access to health insurance -- the first (SB 118) would create a high-risk pool for individuals "to be funded by a surcharge on clients outside the pool," while the second (SB 119) "would allow insurers to charge the small [businesses] higher premiums based on the health of the workers and their families" and would "place ... annual caps" on premium increases, the Manchester Union Leader reports (Paiste, Manchester Union Leader, 5/17). Under the first proposal, all insured residents would pay a 96-cents-per-month fee to fund the high-risk pool, and premiums for pool policies would be capped at 150% of the "average health insurance premium." This measure won unanimous Senate approval and was endorsed by Gov. Jeanne Shaheen (D) at a hearing of the House Commerce Committee on May 16, the AP/Foster's Daily Democrat reports. But the second measure passed by the Senate narrowly, 13-11, and the governor warned that the bill would expose small businesses to dramatic premium increases and "would hurt consumers." Under SB 119, insurers could vary premium rates based on health status by 25% compared to the "average risk group"; by 10% based on geographic location; by 20% based on job type; and by 10% based on tobacco use (Love, AP/Foster's Daily Democrat, 5/17). The measure would also cap overall premium increases at 25%, not including rate changes due to demographic factors (Manchester Union Leader, 5/17). In addition, the bill would "reduce the size of small businesses regulated by the state from companies with fewer than 100 employees to those with 50 or fewer employees," a provision that Shaheen supports.

Who Wins, Who Loses?
Proponents of SB 119 say that recent state laws that guarantee insurance coverage "regardless of health [status]" and restrict insurers' ability to factor demographic variables into rates has led to an "exodus" of health plans from the state. While more than two dozen companies offered insurance to New Hampshire small businesses in the early 1990s, now only two insurers in the state cover 75% of small employers, and only two insurers offer individual policies. Supporters of the legislation say the lack of competition has caused premiums to "skyrocket," and that allowing for variation in premiums would encourage more insurers to return to the state. "If we do nothing, all we are doing is burying our heads in the sand," Senate Majority Leader Gary Francoeur (R), the sponsor of both SB 118 and SB 119, said. But Shaheen said that SB 119 "would hurt consumers and leave some of our smallest businesses at great risk for extreme rate shock." She noted that roughly 50% of state residents are "affected by the health conditions insurers would factor into higher rates." Insurance Commissioner Paula Rogers said, "You'd find winners and losers and it might be you'd find more losers than winners." But local businessman Tim Quick responded, "I hear about winners and losers. Right now, we're all losers" (AP/Foster's Daily Democrat, 5/17).