In New Hampshire, Jeanne Shaheen scrambles to fix her law.
April 10, 2014 6:25 p.m. ET
The political left favors "single payer" health care, but that concept has new meaning in New Hampshire this year as just one insurer was willing to participate in ObamaCare. Thus the spectacle of Democratic Senator Jeanne Shaheen beseeching the feds to save her re-election from her own law.
The Granite State Senator rode the 2008 Obama wave to become the deciding 60th vote for the law's passage, but now Ms. Shaheen must defend the mess it has made of her state's insurance markets. She's cashing in all her government chits amid a statewide uproar as patient access to hospitals and other providers has declined.
The only exchange option afforded to consumers comes from Anthem Blue Cross and Blue Shield, a unit of WellPoint. The insurer built a narrow network that lowered premiums by 25% or 30% while still complying with ObamaCare's other mandates. Limiting choice can generate volume discounts on rates and sometimes better medical performance.
But Anthem's network rollback also illustrates the downsides, all the more so because ObamaCare imposed an artificial monopoly on what had been a functional individual market. Of the 26 in-state acute care hospitals, 10 were booted from Anthem's network (not counting emergency services). Even the state capital of Concord was shut out, and the coverage gaps are wider because so many primary care and specialist practices are now owned by health systems.
The Granite State didn't lack for insurers before. Anthem dominated with 40.7% of all private policies, but strong rivals included Harvard Pilgrim (20.4%), Cigna CI -3.05%(18.7%) and Aetna AET -2.88% (7.8%). Anthem did have a 76% share of the individual market, but aren't the exchanges supposed to increase competition?
Nor is Anthem filling some urgent health-care need. According to a 2013 University of Massachusetts Medical School analysis, 19 of 20 individuals who paid with their own dollars chose preferred provider organization (PPO) plans that cost more than restrictive HMOs but connect patients to a larger variety of doctors and hospitals.
In a January letter to the Health and Human Services Department, Ms. Shaheen let it be known that "I have heard from consumers who have been left without access to the provider with whom they had built a long-standing relationship," and demanded that HHS do something. The feds are obliging and promise a rule by year's end that could outlaw or undermine narrow networks.
The problem is that HHS already polices the "network adequacy" of ObamaCare to supposedly ensure provider diversity and prevent treatment delays. HHS signed off on the Anthem plan, as did state regulators.
Cracking down would limit innovation and abuse discretion-private business would be forced into contacts with other businesses. The far easier and better solution would be to permit many configurations of benefits, networks and price points, so consumers could balance cost versus access.
But for HHS, Occam's razor is only good for suicide. Rather than deregulate, HHS has bribed another insurer to enter the Granite State in 2015. Late last year after intense lobbying by the Democratic New Hampshire delegation, the Massachusetts-based nonprofit co-op Minuteman Health was awarded $66,944,915 contingent on expanding up north. Congresswoman Carol Shea-Porter did the honors of publicly announcing the no- to low-interest loan, not HHS.
Minuteman belongs to a troubled ObamaCare insurance start-up program, which was marked for death in the recent fiscal cliff negotiations. HHS slipped the money through the door one last time before Congress took the lending facility away.
In a February interview with WKXL radio, Ms. Shaheen denied responsibility for the New Hampshire turmoil: "I would have designed it differently had I been designing it. I wasn't the person who was writing the law. Hindsight is 20/20." The truth is that critics predicted exactly what has happened, and she was the one writing the law because without her vote it wouldn't have passed.
Real contrition wouldn't involve clutching the HHS apron strings for special rescue. If Ms. Shaheen means it, she and the 11 other 60th-vote Senate Democrats facing a voter reckoning this fall would join with Republicans to compel the White House to accept major ObamaCare changes.
Former Massachusetts Senator Scott Brown formally declared his campaign to unseat Ms. Shaheen on Thursday, and health care is once again emerging as one of his defining themes. New Hampshire's eccentric politics have trended Democratic. But the state retains antitax and libertarian sympathies, and Mr. Brown has defied political expectations before.
If Democrats had heeded the voters the first time Mr. Brown won in 2010, and slowed down their rush to passage and written a better bill, Ms. Shaheen wouldn't now be having to deceive voters about her decisive role in creating the debacle she now disavows.