After several years of instability, the same three companies plan to continue offering health insurance in New Hampshire next year through the marketplace created by the Affordable Care Act.
In 2014, the first year of former President Barack Obama's health overhaul law, Anthem was the only participating insurer in New Hampshire, and it faced criticism for its narrow provider network. The number of insurers has fluctuated since then, with five companies in 2015 and 2016, four in 2017 and three this year: Anthem Blue Cross and Blue Shield of New Hampshire, Harvard Pilgrim Health Care and Ambetter from New Hampshire Healthy Families.
Those same three have applied to continue offering coverage in 2019, according to the Department of Insurance. Together, they propose offering 17 plans for individuals and 12 for small groups. That's two more individual market plans than this year and twice as many for the small group market.
All 26 of the state's acute care hospitals are included in at least one of the insurance company's networks, and most are in all three. Both Ambetter and Anthem have statewide networks in the individual market, while Harvard Pilgrim's network excludes Carroll County.
About 11.8 million people signed up for coverage this year through HealthCare.gov and state insurance markets, according to an Associated Press count in February. That was only a slight dip from the previous year despite President Donald Trump's disdain for "Obamacare," and multiple attempts by the Republican-led Congress to repeal it. The Trump administration also cut the sign-up window in half, slashed the ad budget, and suddenly stopped a major subsidy to insurers, which triggered a jump in premiums.
Starting in 2019, Congress has repealed the law's unpopular requirement that most people carry health insurance or risk fines from the IRS. That's expected to embolden some healthy people to go without coverage, which would raise premiums for those left behind. More recently, the Justice Department said in a court filing this month that it will no longer defend key parts of law, including widely-supported provisions that guarantee access for people with medical problems and limit what insurers can charge older, sicker adults. The insurance industry warns that millions of Americans would be harmed if such protections are struck down, causing premiums to go even higher.
In New Hampshire, insurance companies have until June 29 to submit final rates for the next enrollment period, which starts in November.
—Holly Ramer, Associated Press