- Associated Press - Tuesday, January 20, 2015

CONCORD, N.H. (AP) - The sponsor of a bill to allow New Hampshire residents to buy health insurance across state lines said Tuesday he wants to increase competition and lower costs, but state insurance officials said his proposal would not accomplish those goals.

Sen. Andy Sanborn, a Republican from Bedford, told the Senate Commerce Committee that if a health plan in another state meets federal requirements under the Affordable Care Act, there’s no reason why New Hampshire residents shouldn’t be able to buy it.

“If it’s good enough for Alabama, it should be good enough for New Hampshire,” he said.

He noted that such cross-border purchases are common when it comes to auto, life or homeowners’ insurance and argued the same should be available in the health insurance market. For example, he said, he should be free to purchase a lower-cost plan that doesn’t include maternity coverage.

“Only in health insurance are we seeing such a restrictive (system) that doesn’t allow people to exercise their free will, to exercise freedom of the marketplace,” he said. “If they are able to find a better product that meets their needs and is more cost effective, shouldn’t they allow to buy it?”

But Insurance Department officials noted that maternity coverage is considered an essential health benefit under the Affordable Care Act and must be included in all plans. And while states do differ in what services they require to be covered beyond the essential benefits, the differences are not particularly wide, said Tyler Brannan, an insurance department analyst. He said New Hampshire’s mandates are not unusual or expensive, he said.

If less expensive insurance was available, it would not include some basic consumer protections, such as an adequate provider network, Brannan said. And it’s not the differences in mandates that account for differences in premium prices among states, he said. Nearly 90 percent of insurance premiums go toward paying hospitals and other providers, he said.

“Until we got up there, all the discussion was about things that contribute very marginally to health care premiums,” he said after the hearing. “The elephant in the room is the network. For a company to come into New Hampshire, the greatest barrier is setting up contracts with health care providers. If an insurance company doesn’t have deals similar to what Anthem or Harvard Pilgrim have, they’re not going to be competitive.”

Jennifer Paterson, the department’s attorney, agreed.

“If you pass this, and you go get that cheap plan in Mississippi or Oregon, you’d have to go get your care in Mississippi or Oregon. If you had a problem with the company, you’d have to go to the insurance department in Mississippi or Oregon,” she said.

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