CONCORD, N.H. (AP) — When it comes to rolling out the Patient Protection and Affordable Care Act (PPACA) in New Hampshire, a lot remains up in the air, and there’s a lot of confusion on the ground, according to members of a committee appointed to advise the state.
The Health Exchange Advisory Board, whose members represent consumers, health care providers, insurers and businesses, held its monthly meeting Friday, where they learned that the next step in implementing PPACA will be getting permission next week from the Legislature’s Fiscal Committee to accept federal grant money.
Until that funding is approved, the state can’t move forward with setting up a consumer assistance program to help individuals explore their options under PPACA, Insurance Commissioner Roger Sevigny told the group.
“The meaningful work is yet to begin,” he said. “We at the department have not spent a whole lot of time to developing a whole lot of things in regards to consumer assistance because we didn’t know if it would be approved, we didn’t know if we’d get the grant, and we still don’t know if the fiscal committee is going to allow us to accept it. We don’t have the resources to be spending a whole lot of time on things we don’t know about it.”
Under PPACA, middle-income people will be eligible for tax credits to help pay for private insurance plans purchased through a new marketplace, or exchange, while low-income people will be steered to safety-net programs such as Medicaid. Enrollment begins Oct. 1 for coverage that takes effect Jan. 1, the day when a mandate that nearly all Americans carry health insurance kicks in.
Because a state law prohibits New Hampshire from building its own marketplace, the state will have a federally run system, though the state will partner with the federal government to regulate insurers and provide consumer assistance. But many details have yet to be worked out.
Committee member Scott Baetz, who owns a Web development company in Windham, said the consumer assistance program must reach out to businesses as well as individuals. Some business owners he’s talked to are so confused they’ve thought that there was going to be a physical marketplace where they’d have to go to purchase insurance, rather than the online portal that is planned.
“There is a tremendous misunderstanding about how this is going to work,” he said. “I’d like to suggest that when we talk about this, we need to recognize that from all of walks of life, professionals and otherwise, there is just a complete lack of understanding of where we are headed.”
Several board members said the consumer assistance program should focus on spreading simple messages to people about where they should turn for further information, rather than overwhelming them with too much information all at once. Otherwise, “a lot of people will pull back and won’t make the call because they’re so stressed out about it,” said Lisa Morris, director of the Lakes Region Partnership for Public Health.
Russ Grazier, a musician and director of the Portsmouth Music and Arts Center, said he agrees that the initial public outreach should be simple, and said it makes sense to educate people in stages, giving them time to understand one element before moving on to the next. But he worries that there won’t be time to do that.
“We’re fighting the clock on being able to do something like that,” he said. “I just get concerned that the conversation is going to go on and on and on and action is not going to happen soon enough.”