I today allowed HB 601, to become law without my signature.
HB 601 provides authority to the Commissioner of Insurance to continue to implement provisions of the Patient Protection and Affordable Care Act that are important to New Hampshire consumers and will allow the state to avoid defaulting into federal oversight of critical insurances processes like the health insurance rate review process and the managed care external review process. That is why I have let this bill become law.
This legislation also directs the Insurance Commissioner to decline $666,000 in planning grant monies, which were previously accepted by the Fiscal Committee of the General Court and the Governor and Executive Council. Those funds would have allowed New Hampshire to design its own health insurance exchange rather than have the federal government mandate and run a health insurance exchange in New Hampshire.
The constitutionality of the Patient Protection and Affordable Care Act is currently being considered in the federal courts, and the U.S. Supreme Court will ultimately determine whether the law, including the insurance exchange provisions, will be upheld and enforced in all states, including New Hampshire. But under the law now in place, New Hampshire must have an exchange up and running by 2014.
I do not believe that declining these federal planning grant monies is in the interest of New Hampshire consumers because it will impact our ability to design our own health insurance exchange. Even members of the legislature who are opposed to the Patient Protection and Affordable Care Act believe that New Hampshire must be in a position to design its own health insurance exchange. That is the case across the country. There are several governors who are going forward to plan for a state health insurance exchange in their states even though they do not support the Act.
The bill's direction to the Insurance Commissioner to return the planning grant monies also raises significant legal concerns, as the decision to accept or decline these grant monies rests ultimately with the Governor and Executive Council. Because I did not want New Hampshire to default into federal oversight, I am allowing this bill to take effect. I will continue to work, however, with the Executive Council, the Attorney General and the Insurance Commissioner to identify the most effective way to access available federal funds so that New Hampshire is able to implement its own health insurance exchange.