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N.H. PPACA panel members agree that they're stuck

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CONCORD, N.H. (AP) — After months of arguing, New Hampshire lawmakers overseeing implementation of the federal Patient Protection and Affordable Care Act (PPACA) have agreed on one thing Tuesday: They’re at a stalemate.

The joint Health Care Oversight Committee includes three Republicans and three Democrats.

The members have spent a significant amount of time disagreeing about the authority accorded to various players involved in implementing PPACA, including the insurance department, the governor and the committee itself.

Tuesday’s meeting started with the insurance department outlining the state’s role in educating businesses and consumers about the law, then opened up into a wider discussion that included whether the state should have any role at all.

In the end, members acknowledged that, even if they agreed, they couldn’t take any action until the rest of the Legislature sorts out two bills related to PPACA — one would let the insurance department accept a $5 million federal grant to start a consumer assistance program, the other would align the state’s insurance market rules with the federal law.

“Basically we’re at a stalemate,” said Sen. Peggy Gilmore, D-Hollis.

Under PPACA, 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.

While the last Legislature passed a law prohibiting the state from setting up its own markets, or exchanges, Democratic Gov. Maggie Hassan decided in February to have the state partner with the federal government to manage the health plans offered through the markets and to provide consumer assistance.

The oversight committee approved her letter of intent, but Republicans argue it’s not a done deal. Sen. Andy Sanborn, R-Bedford, continues to push for a detailed explanation to spell out how the partnerships would operate, and said the public can’t be educated about a plan that doesn’t exist. And Sen. Jeb Bradley, R-Wolfeboro, again argued that the partnership would violate the state law prohibiting a state-run marketplace.

“The law’s the law, and I think the law’s really clear,” he said. “The more we talk about this, whether it’s planned management, or in-person assisters, the more we are getting to a state-based exchange.”

Democrats argued that there should be a New Hampshire-specific outreach effort that would build upon existing organizations that are already in touch with the uninsured population.

“Come January 1, the Affordable Care Act will go into effect, and if we slow down and do nothing, our citizens will have less information, less access to knowing what’s going on, and less ability to take advantage of the possibilities the Affordable Care Act provides,” said Rep. Ed Butler, D-Harts Location. “It seems to me, the responsibility of our committee ought to be to find a responsible way to move forward. What I hear you saying is, finding a way to prevent us to move forward.”

But Rep. John Hunt said the state had no business providing consumer assistance, rather it should only be responsible for consumer protection, as it is now. He questioned how much help consumers will need given that only one company — Anthem, a unit of WellPoint Inc. (NYSE:WLP) — plans to offer medical insurance plans through the individual and small group exchanges.

“All our Web page would have to say is, ‘Call 1-800-Anthem, have a nice day!’” he said.

Rep. Cindy Rosenwald, D-Nashua, reminded Republicans that they earlier had argued that the committee holds policy-setting authority.

“Either we do or we don’t, I don’t think we can have it both ways,” she said. “Since we’ve said we do have that authority, we should take advantage of that and put our stamp on how we think it should go.”

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