Was it a good idea to let New Hampshire’s health insurers use workers’ health history in setting rates for the state’s smallest businesses?
Republicans Craig Benson and Charles Tarbell say the jury is still out on whether insurance will be more affordable in the long run as a result.
But Democrats John Lynch and Paul McEachern vow if they’re elected governor to repeal the small business insurance law enacted last year that allows insurers to use demographic information.
“Of all the sins committed by the last Legislature, (the law) was the most grievous,” McEachern said. “It destroyed the principle of insurance, that is, to spread the risk.”
The four gubernatorial contenders outlined their views on the law and other health care issues in a recent survey by The Associated Press. Nowhere are their differences greater than over changes enacted last year to the insurance law governing small businesses.
The law is intended to promote competition for health insurance contracts sold to small businesses and ultimately to give the businesses more choices at better prices. The law allows insurers to consider health, location and type of business — not just workers’ ages as was done in the past. The law also changed the small group size from 1-100 workers to 1-50.
Critics say health insurers have used the law to “cherry pick” healthier workers — and businesses with younger workers — and to charge businesses with older, sicker workers exorbitant premiums.
“This law is bad for workers, bad for small business owners and bad for New Hampshire’s economy,” said Lynch. “As governor, I would repeal it.”
But Benson, who lobbied for the law, insists it is too soon to tell if the changes will help small businesses over time.
“The realities were that health insurance premiums were increasing at a rate of 15-25 percent per year for everyone prior to the passage of (the law),” he said. “Something needed to be done to address this problem for small business.”
Benson said insurance companies should be allowed to charge more for smokers “since we know that smokers cost the health system more than nonsmokers.”
“Going backward will not result in lower health insurance costs,” he said.
Tarbell, Benson’s primary opponent, believes the law’s impact on insurance costs needs to be closely monitored.
“A state policy ought to err on the side of broadly sharing the risks and not giving special advantage to some groups at the expense of others,” he added.
Candidates from the two parties also differ on the future of a popular government-backed health insurance program for children.
The Healthy Kids Program offers free or subsidized health coverage for uninsured children. The state and federal government pick up the cost for the poorest children. Families with a little more income pay $25 to $45 per child monthly (up to a monthly maximum of $135) for subsidized coverage. Families whose incomes are even higher can buy coverage for $115 per month per child.
Critics say the income guidelines are too generous. For example, a family of four with an annual income of $56,550 can pay $45 per month per child for coverage.
“In general, providing health insurance coverage to the most needy children in the state is good public policy, however the Healthy Kids Program has expanded beyond this policy role,” said Benson.
Current income guidelines “diverts scarce resources away from the truly poor among us,” he added. Benson said the program should seek greater financial support from private industry instead of taxpayers.
Tarbell noted the state faces a serious budget shortfall that precludes expanding the program but “it should not be cut for those in need who have come to rely on the coverage and for whom no other options are available.”
Lynch and McEachern both support strengthening the program and point to generous federal support the program gets as reason to do so.
“We need to make sure that every child in New Hampshire has access to health care,” said Lynch. Children with ear aches and vision problems don’t learn in school, he added.
“The cost and availability of health care is the single most important domestic issue facing the next president,” said McEachern. “The Healthy Kids Program is an oasis in this landscape.”
There is more unanimity over whether citizens should be allowed to buy cheaper medicine from Canada. Three candidates support lifting federal prohibitions against it.
Only Tarbell said citizens should obey the federal law against importing the drugs. The choice is between allowing better access through lower prices or fewer new drugs because drug companies won’t be able to afford research, he said.
Though he supports the idea, Lynch said it isn’t a long-term solution nor is an Internet link to a Canadian pharmacy Benson posted on the state’s web site.
But McEachern applauded “Benson’s efforts to raise the profile of the high cost of drugs imposed on the nation by the drug cartel.”
“There is no more powerful special interest than the drug industry,” said McEachern.
Asked how they would improve Medicaid recipients’ access to care, Benson, Lynch and Tarbell stressed the need to reduce paperwork which would cut costs to the state and providers. McEachern said payments to doctors should rise with inflation.
“Simply trying to ‘tweak’ and fix the state Medicaid program is not a good long-term solution,” added Benson, who said that in looking at reforms: “Everything is on the table.”
Copyright 2004 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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