Health care has not been a major policy issue discussed in the New Hampshire Senate race yet, but it could be soon.
With finalized premium hikes for health insurance expected to be announced in the middle of the general election, this sleeper issue could wake Sen. Kelly Ayotte and Gov. Maggie Hassan up to some hard truths about the current state of health care in the Granite State.
When preliminary premium rates were first announced last month, the increases ranged from a 4.2 percent jump in premium for a Harvard Pilgrim HMO NH Network individual plan to a 60 percent increase for a Minuteman individual plan.
And another blow to New Hampshire health care came this month when Maine’s Community Health Options, one of the five major health insurance providers for the Granite State, announced that it would pull out of New Hampshire in 2017. Community Health Options covered 11,581 people, including group members.
Despite these events, Hassan has remained quiet on health care. She made no statements after the preliminary premium hikes were announced or when Community Health Options said they were leaving the state, a fact that Ayotte has pointed out.
“Community Health Options’ decision to leave our state is just the latest in a pattern of serious problems we’ve seen with Obamacare and troublingly, Gov. Hassan hasn’t even weighed in on the insurer’s exit,” Ayotte wrote in an op-ed published by the New Hampshire Union Leader last week.
“Just a few years ago, she praised the company for expanding to our state, saying it would improve affordability and increase choices for Granite Staters. But now that they’re leaving and limiting choices, she’s gone silent.”
Lucy Hodder, a law professor and director of the Health Law and Policy Program at the University of New Hampshire, said health care has improved overall in New Hampshire since the Affordable Care Act has been enacted.
“There’s been an acceptance of the experiment we are engaged in,” she told NH Journal. “There are more people with health insurance coverage. We are working out the kinks. Premium rates continue to rise, but at a slower rate than before reform. New Hampshire’s experiment has been working really well. The question now is what is the appetite for improvements.”
But Republicans argue the law was always on track for failure and that it could never live up to the promises Democrats made to force it through Congress with no GOP support. Insurance companies are leaving the exchanges because of losses, which means many Americans are left without the options promised when they shop for insurance that they are required by law to purchase.
The health care debate is not unique to New Hampshire. Other reports show how this could be a defining issue in swing-state Senate campaigns.
Politico found that in nine of 11 states with competitive Senate races, at least one insurance provider is seeking to hike their rates by at least 30 percent. There are two such providers in New Hampshire. These increases coupled with the fact that some providers are pulling out of the health exchanges leaving consumers with fewer choices next year, are creating a powerful talking point for Republicans, especially since health care enrollment starts one week before Election Day.
Both Hassan and Ayotte have not released a comprehensive plan for tackling health care in New Hampshire. Their sites have a short section with general information about how health care is important in the state, highlighting various grants and bills they fought for during their respective terms.
In her op-ed, Ayotte said she fought for expanding the use of consumer-directed health plans, removing barriers that restrict the ability of consumers to purchase health care across state lines, and allowing small businesses a greater ability to pool together to negotiate rates with insurance companies.
“I’m committed to finding solutions that will lower costs, increase competition, and expand choice, and I’ve introduced and supported a number of measures to do just that,” she wrote. “Unlike Gov. Hassan, I’m not afraid to call it like I see it.”
On Wednesday, Ayotte introduced the “State Flexibility to Provide Affordable Health Options Act” with other Republican senators to provide a temporary solution by allowing eligible individuals to use a subsidy to purchase health insurance outside of the exchanges.
Senate progressives announced last week they were going to introduce a resolution to build on the ACA by ensuring all Americans have access to a government insurance option, or public option, in addition to coverage options provided by private insurers, something Democratic presidential nominee Hillary Clinton supports.
On Hassan’s campaign website she focuses on her wins of restoring funding for Planned Parenthood and expanding Medicaid.
In an interview with NH1 in August, Hassan also talked about the need to build on the ACA.
“The Affordable Care Act is helping us get people access to preventive and primary care. And because of the Affordable Care Act New Hampshire has its bipartisan New Hampshire Health Protection Program, providing health coverage for nearly 50,000 hard working Granite Staters, including substance abuse,” she said. “Now there are some things we need to adjust or fix in the Affordable Care Act. We need to block the Cadillac tax and the medical device tax.”
Hassan’s campaign did not respond to requests for comment about the premium hikes, Community Health Options departure or her position on a government-run insurance option.
In New Hampshire, besides small Twitter battles between Hassan and Ayotte’s campaigns, the two candidates have not engaged in much debate about health care. That could change when they are scheduled to appear in six debates before the general election in November.
As the incumbent senator, Ayotte has been working on health care on a national level, with a focus on how it could impact New Hampshire residents, while Hassan lauds the bipartisan health care program currently in the state and being involved on a more local level.
Although there is no specific health care debate, the topic could likely come up in their first meeting on Sept. 30 in Conway hosted by the Mount Washington Valley Economic Council.