Exchanges are the marketplaces where consumers will basically window-shop the various health care policies available in different states.
The Federal government granted each state funds to begin studying and implementing these exchanges, but New Hampshire’s Executive Council gave that money back, nearly $1,000,000.
Republicans, including House Speaker Bill O’Brien, say that the exchanges will simply cost too much to run. He points to the experience of other New England states.
"In fact we look at the Vermont example of trying to set up one of these exchanges and it’s costing Vermont anywhere from 15-20 million dollars a year to basically be the agent of the Federal Government in implementing a takeover of the health care industry. And we’re just not going to be a part of that in New Hampshire."
States that don’t implement their own exchange will have the Federal government set one up for them. That is now the likely outcome for New Hampshire.
And that worries some lawmakers, including Senator Ray White of Bedford. The Republican doesn’t like the Affordable Care Act, but argues that the State should have accepted the money and designed its own exchange. He crafted a bill to do just that, but it died in the Senate.
"So I thought I had a pretty light touch, a minimalistic approach. But there were those who are really my soul mates politically that thought I was way off base with that type of assessment. And said no we should just not play ball in any way, shape or form, that’s a better way to resist this. I felt that was a dangerous course of action."
New Hampshire won’t set up its own exchange, but that doesn’t worry the state’s Department of Insurance Commissioner, Roger Sevigny.
“Although we can’t establish a state-based exchange, we can have a lot to say with regard to how a federally facilitated exchange is established.”
Sevigny and others from the state’s Insurance Department will meet with the state’s Oversight Committee on July 25th to see what tweaks they can make to ensure the system works for New Hampshire.
They’ve got until January 1st, 2014 to figure it all out.