A proposal to fund a new state health care bureaucracy with what critics are calling a stealth fee or tax is setting off alarm bells in Concord.
Groups ranging from the Business and Industry Association to Granite State Taxpayers are declaring their opposition to SB 128, aimed at funding a new children’s behavioral health bureaucracy. They’re particularly concerned because the proposal has not been considered by the House, but has been stuck into the state budget by the Senate.
“This bill is an attempt to create more bureaucracy and regulation that will impact everyone who pays insurance,” said Executive Councilor John Stephen.
Buried inside the Senate’s budget proposal, SB 128 is the result of a study that sought to identify gaps in coverage for children’s behavioral health services. In 2016, the state launched its Families and Systems Together program (FAST Forward) to provide families with wrap-around mental health services for their children.
While New Hampshire Medicaid covers FAST Forward, private insurance carriers often only cover part, not all, of the wrap-around mental health services, says the bill’s sponsor Sen. Regina Birdsell (R-Hampstead.) The result is $2 million in care that taxpayers have to pick up.
“I’m trying to take care of those kids and families who need the wrap-around care that’s insurance companies aren’t covering.”
According to Jenny O’Higgins, a policy analyst with New Hampshire Health and Human Services, 20 percent of the families enrolled in the program have private insurance.
The annual cost to DHHS to cover children in the program who come from families that aren’t enrolled in Medicaid is roughly $2 million.
John Reynolds, state director of New Hampshire’s chapter of the National Federation for Independent Businesses (NFIB), warns that, however noble the motives, the legislation will mean higher costs for small businesses. He points to the accompanying legislative analysis indicating that the bill “would exert upward pressure on premiums and increase costs for self-funded plans, including the state employee health plan and municipal pooled risk management programs.”
“Health care costs are front of mind for NFIB members,” Reynolds added. “Small business owners have ranked the cost of health insurance as their number one problem in each edition of NFIB’s Small Business Problems & Priorities for nearly 40 years.”
The Business and Industry Association of New Hampshire has also spoken out against the bill.
In a letter to House leadership, BIA Vice President of Public Policy Natch Greyes noted the House never held a public hearing on the matter and cited the $2 million-plus in costs cited in the bill’s analysis that would be passed on to policyholders and businesses.
“While this alone is concerning, insurers have pointed out repeatedly that the bill language does not specify the total cost to insurers, nor does it explain how that cost will be apportioned,” Greyes wrote. “When asked, DHHS did not provide copies of the information from the entities to insurers, nor have the insurers been provided with specific data regarding the children with commercial health insurance who ‘use services’ at the care management entities.
“As such, insurers cannot be certain that their estimates are accurate, but do know that the cost would be a pass-through to health insurance members and employers.”
During the Feb. 10 Senate Health and Human Services Committee hearing on SB 128, Sabrina Dunlap, senior director of government relations for Anthem Blue Cross Blue Shield, said providers were “caught off guard” by claims that they were a “drain on the program” as “FAST Forward is a DHHS program administered through two care management (NFI North and Connected Families NH) entities.”
Neither is in network with any commercial insurance carriers, Dunlap added.
When insurance company representatives warned her legislation would mean higher prices, Birdsell quipped, “When don’t you raise prices?”
The Granite State Taxpayers organization is also sounding the alarm on this legislation. A GST member told NHJournal the group is irked by the fact that the House never held hearings “on this very consequential bill.”
The organization’s website features a post outlining its opposition to the proposal.
“This type of major policy initiative needs to be heard in the appropriate House Committees,” they write. “The Senate did not want to send this over to the House for scrutiny, because both the Senate HHS Committee and Finance Committee voted this bill out on a unanimous basis, but then on the Senate floor, it got tabled.
“There is no question this is intended to be placed in HB2, the New Hampshire budget bill.”
That’s exactly what happened Tuesday as the Senate Finance Committee voted 6-2 to advance the budget package.
That’s bad news for Granite State small businesses, critics say.
“Any increases to premiums would increase the corresponding premium tax dollars collected,” according to the fiscal note attached to the legislation. “However, a significant rise in health insurance premiums could also cause consumers to purchase cheaper, less benefit-rich plans or forgo the purchase of health insurance altogether, which could have a negative impact on the premium tax collected.”
Stephen says the legislation is a good intention gone wrong.
“We don’t need more dedicated funds,” he told NHJournal. “We need to reduce spending in this state. This is exactly why our insurance rates go up.”
