From the Associated Press:
CONCORD, N.H. (AP) – New Hampshire Gov. Chris Sununu is asking Congress to give states as much flexibility as possible to design their own health care systems as part of the federal effort to repeal and replace the Affordable Care Act.
“We urge Congress to untie the hands of the States,” the Republican governor wrote in a Wednesday letter to U.S. Senate Majority Leader Mitch McConnell. “Let us have the flexibility to design a New Hampshire system for New Hampshire citizens.”
I attempted to locate the letter, but it is nowhere to be found on Sununu’s official government website. (So much for New Hampshire having a transparent government).
So based on what the Associated Press has reported, I have to say that Sununu’s plan to replace Obamacare is just more of the same.
In other words, Sununu’s plan, again based on the Associated Press reporting, is to replace Obamacare with Sununucare. More particularly “design[ing] a New Hampshire system for New Hampshire citizens” means shifting powers from the federal bureaucrats and regulators to State bureaucrats and regulators. So instead of a myriad of byzantine federal rules and regulations we would have a myriad of byzantine State rules and regulations.
But what about the “New Hampshire Advantage”? It’s a myth with healthcare as with so much else. The New Hampshire healthcare market was a disaster even before Obamacare because of heavy and ubiquitous State regulation. From a 2011 Union Leader editorial:
… Senate Bill 711, which became law in 1994. It introduced “community rating” to the state’s health insurance market. It forbade insurers in the small-group market (businesses with fewer than 100 employees) from denying coverage based on pre-existing conditions and certain demographic factors. And they were allowed to charge the old only three times what they charged the young.
That law drove 21 insurers out of the state. New Hampshire went from having 26 health insurers in 1994 to only five just eight years later. A study by the Rhode Island legislature, conducted 12 years after SB 711 passed, concluded that the bill was what drove those insurers out of state, and that it also raised the cost of insurance for younger, healthier residents while lowering it for older and sicker ones.
In addition, there were a plethora of mandates in effect in New Hampshire prior to Obamacare. For example, all health insurance policies had to cover bariatric surgery. These mandates, of course, raise the cost of insurance and force consumers to buy insurance that they do not want and/or do not need.
I’m sure the response of the Sununu administration and the GOP establishment to my trip down memory lane would be along the lines of things will be different because the GOP is in charge now. Well, the GOP also controlled all branches of government in 1994 when SB 711 was passed. And things haven’t gotten any better – despite GOP control of the legislature the past two sessions, the legislature passed Obamacare Medicaid Expansion and then renewed it.
It’s a safe bet that the “New Hampshire system for New Hampshire citizens,” will be a system designed by lobbyists and insiders for the benefit of their clients and donors.
And even if Sununu were somehow able to prevent the lobbyists and insiders from designing the “New Hampshire system,” he is not going to be Governor forever. At some point, power will change hands.
The solution is not to replace Obamacare with Sununucare. Empowering healthcare consumers is the solution and one of the ways to do that is to have a true national health care market by allowing consumers to purchase health care across State lines. States should be forbidden from issuing mandates and regulations and federal mandates and regulations should be limited to those that are broadly supported and will not unreasonably raise the cost of health insurance.
A true national healthcare market will force insurance companies to compete with each other, which will result in better choices for consumers. In other words, just as school-choice, which Sununu says he supports, will improve the quality of education by forcing schools to compete for students, health-insurance-choice will improve the quality of health insurance.