March 24 - House Sides with Anthem in VRH Exclusion from Exchange

This article appeared in the E-Ticker News March 24, 2014

NH House Happenings

By Rep. John Cloutier

House Sides With Anthem In VRH Exclusion From Exchange

Anthem will not even be encouraged to include Claremont's Valley Regional Hospital within the health insurer's provider network at least for the immediate future because of a decision last week by New Hampshire's House of Representatives.

On March 19 by a 197-123 roll call vote, the House defeated House Concurrent Resolution 12, which would have simply requested Anthem to include at least one hospital in every New Hampshire county within its health provider network. Defeat of the resolution followed a recommendation by an overwhelming majority of the House Commerce & Consumer Affairs Committee on a 17-1 roll call vote to reject it. Only Nashua Rep. Kenneth Gidge, from populous Hillsboro County, voted for the resolution in committee. By the way, there are no Sullivan County representatives on the Commerce Committee this term.

Nevertheless, Newport Rep. Virginia Irwin took to the House floor to urge representatives to overturn the committee's rejection recommendation, officially known as ITL or “Inexpedient to Legislate.” In her floor speech, Rep. Irwin decried Anthem's decision last year to exclude 10 out of 26 New Hampshire hospitals, including Valley Regional. She stated that Valley Regional's exclusion was and still is financial burdensome to not only the hospital, but also many Sullivan County citizens, who must now travel as far as 30 miles to get primary health care at other hospitals within the Anthem network such as Lebanon"s Dartmouth Hitchcock, New London Hospital, and Keene's Cheshire Medical Center as well as their affiliated doctors. She also criticized one of the major points made in the committee's ITL recommendation.

That point in the ITL recommendation written on the committee's behalf by Rindge Rep. John Hunt declared that the resolution should be rejected among other reasons because “using county lines as a determination for hospital coverage does not make sense.” Rep. Irwin countered that hypocritical argument by saying that New Hampshire still believes in caring for our state's elderly and disabled citizens in 11 county nursing homes, like Sullivan County Health Care, is a worth-while idea, and has no plans to change this nursing home system any- time soon.

However, Commerce Committee Chair and Harts Location Rep. Edward Butler also defended the rejection recommendation on both the House floor and in a caucus of our fellow House Democrats held just before the floor debate. Rep. Butler said that Anthem was just following federal as well as state laws and regulations in regard to establishing provider networks at affordable premiums as mandated in the state's federally-created health exchange under the Affordable Health Care Act. He added that it would be unfair to change the rules in the middle of the year, even though Berlin's Androscoggin Valley Hospital was quickly added to the Anthem network after its initial decision excluding Valley Regional. Additionally, he claimed that more health insurers besides Anthem should be joining the exchange starting in 2015. Finally, he declared that new Anthem individual policyholders presently outside of the insurer's network could still get emergency room care at excluded hospitals, including Valley Regional. 

Nevertheless, at the same Democratic caucus, I said that Anthem's exclusion of Valley Regional, unless changed, means extra time, money, and gas for many Sullivan County citizens with newly- mandated individual health insurance policies, who must travel further than previously done before for just primary health care. I added that the exclusion also hurts Valley Regional, which is now in a difficult financial situation. Finally, I urged my fellow Democratic representatives to join me in supporting the resolution and ended by declaring, “Win or lose, today the Sullivan County Delegation is going to stand up for constituents and our community hospital!

As House Concurrent Resolution 12's prime sponsor, I was obviously disappointed that the resolution was rejected by both the Commerce Committee and full House. But I know from previous experience that it is very difficult to overturn a nearly-unanimous ITL recommendation from a policy committee on most pieces of legislation. Many of my fellow Democrats did support the resolution, but others did not because the House Democratic Leadership's unofficial position was to support the committee's majority recommendation, though individual Democratic representatives were free to vote their consciences. But I also got a number of Republican representatives to support the resolution, including Lancaster Rep. Herbert Richardson, a resolution co-sponsor, who was most helpful the March 19 floor debate as well as the Feb. 20 public hearing before the Commerce Committee. 

However, I was most pleased that all the representatives in Sullivan County's House Delegation, who were present on March 19, did stand up for our constituents and Valley Regional Hospital by voting for the resolution. One representative, Grantham's Benjamin Lefebvre, was absent because he was previously scheduled for a shift at his firefighting job. But I know Rep. Lefebvre would have voted for it, if he had been in attendance. Anyway, despite the odds and pressure from the leadership of both political parties, the 12 representatives, both Democrats and Republicans, in the County Delegation, stuck together. 

Furthermore, there is still some hope that Valley Regional's exclusion from Anthem"s provider network as well as possible future exclusion from the networks of other health insurers could still be resolved this year with another piece of legislation. That legislation is Senate Bill 380, now being considered by the New Hampshire Senate. Legislation which I actually believe is better than my resolution because it would require every health insurer participating in New Hampshire's health exchange to include at least one hospital in every county in ourstate within its provider network.page6image52920