A State Insurance Exchange Would Voluntarily Accept Obamacare and Send State Taxpayers the Bill

CONCORD, N.H.—The Republican Liberty Caucus of New Hampshire rebukes the idea that Republicans should remove uncertainty by establishing a state health insurance exchange under the terms of Obamacare, as such a move would voluntarily bind the state under the control of the U.S. Health and Human Services Department while sending New Hampshire taxpayers the bill.

Contrary to arguments from some insurance regulators, insurance companies and industry groups, creating a state exchange will remove New Hampshire’s local control and ensure Obamacare is fully enacted in New Hampshire, whether the federal law is repealed or not. In addition, establishing a state insurance exchange under Obamacare requires the state to pay for the full cost of implementation starting in 2015, which could cost New Hampshire taxpayers anywhere from $10 million to $47 million a year, according to HTMS, a North Dakota health care consulting company.

“The bottom line is that the federal government has created uncertainty by passing an unworkable federal law that depends on states to put in the time and money to fix all of its faults,” said Carolyn McKinney, chairman of the Republican Liberty Caucus of New Hampshire. “The cloud of uncertainty created by President Obama and the Democratic Congress won’t go away just because we accept Obamacare by creating a state health insurance exchange. In fact, these exchanges will distort the market, which will make for even more uncertainty.”

Those arguing for a state insurance exchange have clamored for predictability, but by establishing a state insurance exchange, the only predictable outcome will be that the state will be voluntarily implementing the terms of the Obamacare law that voters soundly rejected in 2010. The mammoth state bureaucracy created would only serve as a nominal state organization, but it would take all of its orders from Washington bureaucrats, who would set the rules for selling insurance plans within the state, thus reducing real competition and increasing the costs of providing health insurance.

What makes matters worse, under SB 163, the N.H. Senate bill that establishes a state exchange, “poison pill” language would eliminate only those sections found unconstitutional by the Supreme Court or repealed by the Congress, but it would leave everything else in place. If the bill passes, it would keep a state health insurance exchange in place even if the federal government fully rejects New Hampshire’s proposal, thus leaving us with a federal exchange plan funded by New Hampshire taxpayers.

The better approach is HB 1297, which would prohibit the state from enacting an exchange and make it harder for the federal government to implement the law. In fact, the more states that opt not to create a health insurance exchange will then send the federal bureaucrats scrambling to come up with one, without the time or funding to create one that will work. If New Hampshire and other states around the country say no to a state health insurance exchange, it all but guarantees that Congress will have to repeal or replace Obamacare, which is what the people want.

“Creating a state exchange voluntarily accepts Obamacare in New Hampshire,” McKinney said. “If we do that, this Republican Legislature will be directly opposing the voters who sent them to Concord to stand up against this federal overreach. These Republicans, and not the Obama Democrats, would be responsible for the consequences of Obamacare in New Hampshire.

“If Republicans act now to definitively reject a state exchange, however; the Republican Legislature stands a better chance of fulfilling the mandate of New Hampshire voters and leading the way toward true health insurance reform,” McKinney said.

For more information about the conclusions reached by RLCNH about state health insurance exchanges under Obamacare, please refer to these studies by the Cato Institute, the Idaho Freedom Foundation, and the Goldwater Institute.


About The Republican Liberty Caucus of New Hampshire
RLCNH, a state chapter of the national Republican Liberty Caucus, was launched in December 2004 to promote and advance traditional Republican Party values, such as low taxes and spending, limited government, individual liberty, personal responsibility, free enterprise and loyalty to the U.S. and N.H. constitutions.