HB 601-FN – FINAL VERSION
HOUSE BILL 601-FN
AN ACT relative to implementation of federal health care reform.
SPONSORS: Rep. Hunt, Ches 7
COMMITTEE: Commerce and Consumer Affairs
This bill establishes an oversight committee to provide legislative oversight, policy direction and recommendations for legislation with respect to the Patient Protection and Affordable Care Act of 2009 Public Law 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Public Law 111-152. This bill requires the insurance commissioner to obtain approval from the oversight committee before implementing any of the federal changes. This bill also directs the insurance commissioner to decline certain exchange planning grant funds and to indicate to the Secretary of the Department of Health and Human Services that the money is to be used to reduce the federal budget deficit.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [
in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eleven
AN ACT relative to implementation of federal health care reform.
Be it Enacted by the Senate and House of Representatives in General Court convened:
264:1 New Chapter; Federal Health Care Reform 2010. Amend RSA by inserting after chapter 420-M the following new chapter:
FEDERAL HEALTH CARE REFORM 2010
420-N:1 Purpose and Scope.
I. The intent of this chapter is to preserve the constitutional integrity and sovereignty of the state of New Hampshire under the Tenth Amendment to the United States Constitution and part I, article 7 of the New Hampshire constitution by creating a legislative oversight committee to supervise the insurance commissioner’s implementation of the insurance reforms required under the Patient Protection and Affordable Care Act of 2009, Public Law 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, including any federal regulations, interpretations, standards, or guidance issued thereunder (hereinafter “the Act”).
II. Further, it is the intent of this chapter to prevent the state of New Hampshire from defaulting into federal oversight regarding the Act by not meeting certain federally-mandated time frames for state implementation of the Act. It is the intent of this chapter to preserve the state’s flexibility by allowing consideration of each state implementation requirement as it arises.
420-N:2 Definitions. In this chapter:
I. “Act” means the Patient Protection and Affordable Care Act of 2009, Public Law 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, including any federal regulations, interpretations, standards, or guidance issued thereunder.
II. “Commissioner” means the insurance commissioner.
III. “Oversight committee” means the joint health care reform oversight committee established in RSA 420-N:3.
420-N:3 Joint Health Care Reform Oversight Committee Established.
I. There is established a joint health care reform oversight committee consisting of 6 members as follows:
(a) Three members of the senate, appointed by the senate president.
(b) Three members of the house of representatives, appointed by the speaker of the house of representatives.
II. The terms of the members shall be for the biennium and shall be coterminous with their membership in the general court. The oversight committee shall elect a chairperson from its membership. The oversight committee shall meet at the call of the chairperson who may call a meeting as often as necessary. The oversight committee shall require 4 members for a quorum.
III. The committee shall provide legislative oversight, policy direction, and recommendations for legislation with respect to the Act as it determines appropriate. The committee shall also review existing rules, bulletins, or policies adopted pursuant to 2010, 243 and may require the repeal of such rules, bulletins, or policies.
IV. The committee shall make a report, together with any recommendations for legislation, to the president of the senate, the speaker of the house of representatives, the chairpersons of the house commerce and consumer affairs and the health, human services and elderly affairs committees and the senate commerce and health and human services committees by December 1, 2011 and annually thereafter.
420-N:4 Implementation of the Act.
I. The oversight committee established under RSA 420-N:3 shall determine all policies within the state of New Hampshire regarding implementation of the Act, as directed by this chapter and by any future law enacted by the general court with respect to implementation of the Act.
II. Before establishing any standard for enforcing or implementing the Act, and before initiating any rulemaking proceeding relating to the Act, the commissioner shall obtain approval for the standard or rule from the oversight committee.
III. The commissioner shall make periodic reports as requested by the oversight committee on the provisions of the Act that have taken legal effect in New Hampshire and on the status of the commissioner’s implementation and enforcement efforts under the Act.
IV. The commissioner shall not implement or enforce any provision of the Act that has been ruled unconstitutional or invalid by the United States Supreme Court.
420-N:5 Authority of the Commissioner. Only with such prior approvals from the oversight committee as are required under RSA 420-N:4, the commissioner shall have authority to:
I. Make, adopt, and amend rules and regulations pursuant to RSA 541-A for, or as an aid to, the administration of any provision of the Act relating to insurance;
II. Apply for any public or private grant funds available under the Act;
III. Apply for any waiver available under any specific provision of the Act;
IV. Adopt and apply standards consistent with the Act for form and rate review of insurance products and any other regulatory oversight functions performed by the department; and
V. Enforce the consumer protections and market reforms set forth in the Act that relate to insurance. This shall not include the medical assistance program under RSA 167.
420-N:6 Consistency. In order to prevent a default to federal regulation and to preserve the state’s status as the sole regulator of the business of insurance within the state, the oversight committee shall have the authority to find, with respect to any specific provision within Title XXXVII, that the provision is inconsistent with and prevents the application of the Act. Upon such a finding, the commissioner may, on a provisional basis, implement this provision of the Act. The commissioner’s authority to implement this provision shall extend only until such time as the general court can take legislative action to amend Title XXXVII as it deems appropriate.
264:2 New Section; Federal Health Care Reform. Amend RSA 161 by inserting after section 10 the following new section:
161:11 Federal Health Care Reform. Before initiation of any rulemaking proceeding or waiver request under Public Act 111-148, as amended by Public Act 111-152, or any federal regulations, interpretations, or guidance issued thereunder, the commissioner shall obtain approval for the rule or waiver request from the joint health care reform oversight committee established in RSA 420-N:3.
264:3 Funds From Exchange Planning Grant Declined. The insurance commissioner shall decline the $666,000 in exchange planning grant funds awarded to the insurance department by the federal Department of Health and Human Services and approved by the fiscal committee of the general court and the executive council for purposes of conducting initial planning activities related to the potential implementation of a state-designed health benefit exchange under the Patient Protection and Affordable Care Act. In declining the funds, the insurance commissioner shall indicate to the Secretary of the Department of Health and Human Services that it is the intent of the general court that the funds not drawn down be used for the purpose of reducing the federal budget deficit.
264:4 Effective Date. This act shall take effect July 1, 2011.
Approved: Enacted in accordance with Article 44, Part II, of N.H. Constitution, without the signature of the governor, July 14, 2011.
Effective Date: July 1, 2011