CHARLOTTE, N.C.—As a freshman attendant at the American Legislative Exchange Council Spring 2012 summit, I was assigned to the Commerce, Insurance and Economic Development Task Force, which aligns somewhat with my position on the N.H. House Commerce and Consumer Affairs Committee. We considered model legislation bills on insurance, occupational licensing, food safety and labor, several of which could have a future in New Hampshire law. Fellow N.H. Rep. Gary Daniels, who is chairman of our N.H. House Labor Committee, served as chairman of the Commerce Committee in Charlotte.

Strangely, ALEC assigned health insurance legislation to a Health and Human Services Task Force, so I felt torn between the two meetings since the entire reason I joined the House Commerce Committee in New Hampshire was to address health insurance issues, particularly with Obamacare. The way things turned out, however, I was able to straddle both conferences and learn from both, and I have some interesting things to report from my experiences today.

Before I get started, for those who don’t know, ALEC is a national organization of elected state legislators and private sector lobbyists who meet to advance the Jeffersonian principles of free markets, limited government, federalism and individual liberty through a series of periodic summits where members of the public-private partnership work to develop policies and model legislation for advancing these principles. I paid for ALEC membership out of pocket at the cost of $50 a year.

It’s also important to note that my trip expenses to the ALEC Task Force Summit today was reimbursed by private donors, and not by taxpayers. Nevertheless, I minimized expenses for donors as mentioned in my previous post by flying down and back on the same day without a hotel night’s stay and by splitting my cab with Rep. Daniels on the way back to the airport. Besides Rep. Daniels and me, N.H. Reps. Jordan Ulery, Ken Weyler, Andy Renzullo and Kris Roberts were also in attendance.

Morning Workshop

Before legislators went their separate ways into issue task forces to develop and approve model legislation, we attended a morning workshop featuring reports of three issues of imminent importance to the several states:

The EPA’s power grab

The first session focused on the report “Economy Derailed: State-by-State Impacts of the EPA Regulatory Train Wreck,” by Todd Wynn, available via www.RegulatoryTrainWreck.com. Wynn explained how the U.S. Environmental Protection Agency is trampling states’ rights with newly proposed Mercury and Air Toxics Standards, which violate a federal law that reserves such environmental regulation to the states. He noted an estimated $500,000 to $6 million annual benefit from the regulations at the cost of about $10 million per year. By driving up energy costs to this extent, the federal government is killing jobs and stripping hard-earned money from families that are finding it increasingly difficult to get by, he said.

Besides the newly proposed standards, Wynn noted several other federal programs that have killed jobs and economic opportunity by raising energy costs without any measurable benefit. These included the Utility MACT, Boiler MACT, the Cross State Air Pollution Rule, Cooling Water Intake Regulations, Coal Ash Regulations and Greenhouse Gas regulations, among others.

The weakest economic recovery ever

The second session focused on ALEC’s report, “Rich States, Poor States: A Guide to Economic Prosperity,” by Jonathan Williams, available via www.alec.org. Williams noted that the United States is currently experiencing the weakest recovery ever seen, largely due to excessive government spending, disproportionate public sector growth over private sector growth, a lack of transparency and accountability in government departments and agencies receiving taxpayer funding, unfunded pension liabilities that now approach $4 trillion nationally, and excessive taxes.

Williams said states such as California and Hawaii showed negative population growth despite their idyllic weather due to their excessive government regulations and higher tax burdens. New York and Pennsylvania lost more people than any other states due to their growing regulatory and tax burdens. States with smaller governments and lower tax and regulatory burdens, such as Texas, Florida, South Carolina, Georgia, Arizona and Utah, had positive population growth.

In the report, New Hampshire is ranked 34^th in economic health among the states and 28^th in its general outlook rank going forward, but it was positively mentioned for its “live free or die attitude,” particularly in regard to its success without a personal income or sales tax.

Williams said that states such as New Hampshire without a personal income tax fare better overall than states that have a personal income tax. For example, states without a personal income tax experienced 59 percent growth in Gross State Product verses 42 percent growth in GSP for states with a personal income tax. Likewise, states without an income tax had 81.53 percent tax receipt growth verses states with the tax that had 44.88 percent tax receipt growth. Additionally, states without an income tax showed 5.36 percent job growth verses the negative 1.68 percent job growth seen in income tax states.

The looming Obamacare disaster

The third session focused on the looming economic disaster headed toward the states from the passage of Obamacare. Christie Herrera covered a lot of ground with her presentation, “From the States to the Supreme Court: ALEC’s Health Care Freedom Initiative,” noting that 14 states, including New Hampshire, have already adopted ALEC’s model legislation, which was based on Arizona’s Proposition 106. Essentially, the law prohibits individual mandates that require citizens to buy health insurance as well as the taxes or fines imposed on citizens who don’t comply with the individual mandate. New Hampshire’s version of the initiative was passed into law last year as SB 148, a bill I vigorously supported. A total of 30 states are currently working on versions of the law, and only 6 states have not discussed it.

Herrera explained that Obamacare, technically called by the misnomer, “The Patient Protection and Affordable Care Act of 2010,” is bad for Americans because it forces individuals and businesses to purchase a government-defined insurance product or pay a fine equivalent to $95 or 1 percent of their personal income or $3,000 per year, per employee. She asked rhetorically what business would hire an additional person who would automatically cost it $3,000 for health insurance, or more?

Herrera also highlighted the act’s 20 new or increased taxes on families and businesses that would increase the cost of health insurance by $1,303 for the average family.

Next, she explained how 18 million more Americans would be forced onto the broken Medicaid system by the Act. Medicaid recipients are already the most prevalent users of emergency rooms for non-emergencies because they can’t find doctors willing to accept Medicaid and work for less than the cost of doing business. So in effect, Obamacare is going to make the problem with emergency room overuse worse across the country. The increased cost to New Hampshire taxpayers will be about 24.3 percent from the additional Medicaid users under the Act.

Finally, Hererra noted how the states’ best defense against Obamacare was to prohibit the implementation of a state health benefits exchange, which was the bureaucratic mechanism used by the federal Act to enforce many aspects of the new law, including the individual mandate. She mentioned my bill in New Hampshire, HB 1297, which would do just that. So far, 20 states, including New Hampshire, have either not acted on the implementation of an exchange, have actively killed exchange legislation or have prohibited the implementation of an exchange. Another 11 states are still talking about what to do. Only 19 states have actually implemented a state exchange.

Lunch Meeting: Government’s Driving Record

For lunch, the Commerce, Insurance and Economic Development Task Force featured David Hartgen’s report, “Are Highways Really ‘Crumbling’?: 20-Year Trends in Road Condition,” a study supported by the Reason Foundation. Hartgen’s latest public annual report can be read at the Reason Foundation’s Web site. In general, Hartgen supported the idea that highway access is essential for economic progress, but importantly, he noted that several keys legislatures should follow to ensure a better road system and lower costs:

• Ensure stable, adequate funds, with low diversion of costs or debt payments;
• Use professional management and oversight of highway systems with modern data systems that monitor how spending ties to real improvements;
• Focus on maintenance instead of new construction and devise realistic plans that can be achieved within the envisioned time frame;
• Monitor local roads and bridges;
• Complete projects based on a lifetime benefit/cost analysis; and
• Use a competitive bidding process and good engineers to get the most bang for the buck.

Over the last 20 years, Hartgen noted that national trends show improvement with rural interstate and primary highways, and that urban congestion problems are improving, while highway fatalities are down to 1.09 fatalities per 100 million miles from 2.16 fatalities per 100 million miles. However, locally owned bridges are in worse shape than state-owned bridges, he said, and local-level roads are deteriorating. During the period, New Hampshire’s highways improved on four measures, while the money dispersed for highways remained about the same.

Commerce, Insurance and Economic Development Task Force Meeting

The Commerce Task Force considered and adopted 11 pieces of model legislation during its afternoon session, and I personally contributed language to three of the model bills. Two of the model bills; namely, the “Election Accountability for Municipal Employees Act” and “The Public Employees Decertification Elections Act,” already passed the House in New Hampshire this year in a different form, but that bill, HB 1645, was referred to Interim Study in the Senate.

Four bills considered during the session are worth filing in New Hampshire next year:

• The Occupational Licensing Relief and Job Creation Act (ALEC version)
  “Occupational licensing increases unemployment by about 1 percent, raises prices by about 15 percent and offers no incremental consumer protection over a competitive market,” according to bill writer Lee McGrath at the Institute for Justice. “This Act ensures that an individual may pursue lawful occupation free from unnecessary occupational regulations, and protects against the use of occupational regulations to reduce competition and increase prices to consumers. When enacting future occupational regulations, this Act requires state legislatures to find real harm, and select the least-restrictive regulation to address that harm. The Act also protects entrepreneurs by shifting the burden to the government to show in court and administrative hearings that it is enforcing occupational laws for health-and-safety reasons, and not solely as a barrier to entry.”
• The Provisional Licenses for Ex-Offenders Act
  “This bill,” written by Mark Levin of the Texas Public Policy Foundation, “allows certain ex-offenders to obtain a provisional, or probationary, occupational license if they are otherwise qualified. Research indicates that a person who has been law abiding for at least five years is at a low risk of re-offending. Also, according to the Federal Bureau of Prisons, ex-offenders who are employed are three-to-five times less likely to reoffend.”
•  The Financial Accountability for Public Employee Unions Act
  “This Act,” written by Paul Kersey of the Mackinac Center for Public Policy, “increases transparency and accountability to taxpayers by requiring public employee unions to annually file an independent audit of all expenditures attributed to the costs of collective bargaining, contract administration and grievance adjustment.” While not the model legislation adopted by ALEC, this language, particularly the language in bold may be more comprehensive and potentially useful and appears to be the source language for the model legislation.
• Food and Nutrition Act
  “The Food and Nutrition Act,” written by Rep. Cheryl Grossman of Ohio, “preempts towns, counties and other political subdivisions from enacting regulation in regards to food service establishments based upon or regarding food nutrition information, customer incentive items, and a restaurant’s designation as quick-service, fast food, casual dining or sit-down service.” If New Hampshire were to adopt a law like this, it should also add the text of my effort in Section 3 of HB 1650 from earlier this year.

Health and Human Services Task Force Meeting

The HHS Task Force considered and adopted 5 pieces of model legislation during its afternoon session, and while I was not a member of this Task Force, I joined the meeting as soon as my own Task Force was completed and picked up a packet of the model legislation.

One of the model bills; namely, the “Health Care Price Disclosure Act,” written by Ariz. Sen. Nancy Barto as SB 1384, resembled a bill sponsored by N.H. Rep. Seth Cohn and me this year; namely, HB 1590, requiring the disclosure to patients and prospective patients of the charges for medical procedures. Perhaps Sen. Barto’s language and approach may help advance a New Hampshire bill next year?

Also of interest were the following pieces of Legislation, which should be filed in New Hampshire next year:

•  The Charity Health Care Tax Credit Act, by Georgia Sen. Judson Hill
  “This Act provides state tax credits for individuals ($1,000/year), families ($2,500/year), and nonprofit charity organizations (up to 75 percent of income tax liability) who provide health care services to the uninsured.” Clearly, since New Hampshire doesn’t have an income tax, this bill would have to be adopted for the state, but businesses that pay profits taxes and enterprise taxes may benefit from a law like this.
• The Zarephath Charity Health Care Act, by Alieta Eck of the Association of American Physicians and Surgeons
  “This Act provides full malpractice immunity for medical professionals who volunteer at least four hours per week, for four consecutive weeks, at a non-governmental free clinic that provides charity care to the poor.”

Afterward

After the Task Force meetings concluded, I attended a reception at the Nascar Hall of Fame, where I had interesting conversations with representatives and senators from South Dakota and Michigan. The South Dakotans noted that a good portion of the laws they pass are in response to federal rules and regulations in an attempt to preserve the state’s sovereignty and resist the federal takeover. The Michigan legislators spoke about Right to Work and other free market bills that they’ve been working on. Overall, it was interesting to discuss the various state systems of government around the country. I also had conversations with legislators from Arizona, Ohio, Washington State, Maryland, Oklahoma, Indiana and North Carolina.

My trip home that evening was uneventful, unlike the trip down that morning, and I moved through airport security with ease, sans backscatter scanners or pat downs. I wish all trips were that easy.

CHARLOTTE, N.C.—My wife told me that I’d be subject to more scrutiny at the airport today on my way to the American Legislative Exchange Council’s (ALEC) 2012 Spring Task Force Summit in Charlotte, N.C. Because I had bought my airline tickets less than a week before the event and because I chose to fly down and return on the same day to save on hotel costs and minimize the time away from my family, she said that I could expect the maximum level of scrutiny at the airport. She was right about her prediction, though I can’t say for sure if her rationale was correct.

As you may know, I am the co-sponsor of HB 628, an act relative to searches conducted for purposes of transportation-related security, which is a bill that would create a public database for complaints against the Transportation Security Administration’s (TSA) enhanced airline screening activities and require state law enforcement officials to take such complaints. I’ve always believed that when we shine a light on something, it encourages good behavior. That is the very purpose of the TSA Accountability Act, as I’ve called it.

The bill passed the House, but it was killed in the Senate by Derry Sen. Jim Rausch’s Senate Transportation Committee. Currently, I have attached the same language to Sen. Rausch’s senate bill, SB 332, which addresses a prohibition relative to auxiliary state troopers. To my knowledge, the TSA Accountability Act is still moving forward as part of SB 332, and I am hopeful the Senate will see the importance of this bill the second time. Perhaps this was the reason for my enhanced screening this morning?

Regardless of whether we pass the law to create the public TSA Accountability database; however, I still have the power of the pen, which they say is mightier than the sword. It is for this reason that I am now writing about my experience this morning with the TSA, which I would explain only as a gross violation of my constitutional rights with a smile. The experience was beyond inappropriate, however I must say to the TSA’s credit that its agents, whom are not law enforcement officials, were very professional and courteous.

Additionally, I have the power of passive resistance, which you will see, I fully exercised today without any trouble. I hope that more people will follow my example and do just what I have done as explained here, as I have followed the example of some of the most effective liberty activists before me. Please read my story below and take action as you believe you should.

When I entered the TSA screening area this morning, the TSA agent wrote three blue lines and the word “HAS” on my airline boarding pass, also in blue. He was pleasant and the interchange was brief. I removed my shoes, belt, jacket and all of my other personal belongings. I took my computer from my backpack and placed it in a separate container. I then sent two containers and my backpack through the belongings scanner.

I was directed twice toward the backscatter scanning machine, directions that I ignored. The majority of passengers were headed toward the scanner, largely because they were being herded that way by airport crowd-control ropes. The metal detector, directly next to the backscatter machine, was mostly roped off in front of it, but it had a 2-foot access area on the left. I walked away from the other 30 or so passengers headed toward the backscatter machine and weaved my way behind the ropes so that I was standing in front of the metal detector. I stood and waited there. The TSA agent standing on the other side of the metal detector took a moment to realize I was standing in front of him.

This TSA agent then inquired whether I was opting out of the backscatter scan, and I politely informed him that I was. He reminded me that I would be subject to a pat-down as a result of that decision, and that the backscatter machine no longer takes naked images but rather produces an avatar for TSA agents to see. I said I was aware that a pat down was required for me to go about my business and that the naked images were not my concern. At this point, I said I had health concerns about the technology, to which he replied that the radio waves I’d receive would be no different than any I’d receive using my cell phone. I replied that I’d rather not expose myself unnecessarily to any additional radiation and that I didn’t believe the technology had been properly tested.

In truth, the machines should be calibrated after each scan or they could emit harmful radiation. I am not aware of the TSA’s calibration policies, and I would rather not take any risks. This, of course, is beside the fact that the backscatter scan constitutes an illegal search that relies on consent under duress.

The agent then motioned me through the machine and inquired whether I would like a private screening. I informed him politely that I would prefer to stay in the open where everyone could see what was happening to me. He then took me around the baggage screening area to an open area on the other side and directed me to stand on a mat. He identified my belongings and then carried them over to a metal table near where I was standing.

At this point, he very professionally informed me what would be happening to me, and then he did what he explained. He asked whether I had sensitive areas, and I informed him that I didn’t. He then asked me to spread my arms and patted down all sides of my arms and areas that were covered, grabbing them with gloved hands. He then went along my back and legs with the same scrutiny and afterward patted down my rear. He used the back of his hands to feel my under arms and the inside of my thighs. He felt the inside of my waist band front and back, and patted down my tie.

At this point, I was informed that I had been flagged for further screening. Three TSA agents—one apparently a supervisor—were directly surrounding me. Apparently, something I had with me had residue from firearms on it, because when the TSA agent tested his gloves, it set off an alarm. He asked me whether I had been to the shooting range lately, and I informed him that I had (several months ago, actually). My guess is that the machine picked up residue from the inside of my suit pants, which are often in contact with my concealed carry weapon, for which I have a license. Of course, I had left my gun at home today.

The agent explained to me that he would be first going through all of my belongings to test whether any item in there had set off the alarm. He again noted that I could have avoided this additional screening by going through the backscatter machine. I simply acknowledged his statement. Upon searching my suit jacket pockets, he found and opened my Altoids box and briefly looked at my pens and business cards, and then he saw my state representative badge in my upper suit pocket and inquired whether I served in the State House. I answered in the affirmative. He then proceeded to inform me that his neighbor was Rep. Dick Barry, and that I should tell him that I was patted down by his neighbor the next time I saw him. I took the exchange as one of friendliness, but it was still unsettling to have someone who is in the process of violating my constitutional rights make light of the situation. I responded in kind, noting that Rep. Barry and I had sponsored a bill to repeal the Regional Greenhouse Gas Initiative together, information that seemed to please the agent. The agent proceeded to look through my entire computer bag, wipe down my computer with a small white cloth that resembled a gun cleaning cloth, and then wipe down several other items in my bag. All those items checked out.

At this point, I was informed that I would have to be patted down again, this time more invasively, and that it had to be done in a back room. I politely responded that I would prefer that any pat down be conducted in public regardless of how invasive. The supervising agent then intervened and informed me that I didn’t have that option. I repeated that I wanted the other people in the airport to see what was being done to me, and it was for that reason that I preferred not to go into the back room. The supervising agent informed me that I had to be screened in a private room per TSA policy and that if I didn’t consent, I would have to leave the airport and cancel my flight. He noted that I could bring someone with me if I wanted into the back room. I told him that I didn’t have anyone to bring. He then advised me that a second agent would be going to observe the pat down. While not comforted at all that I would then have two agents against my word should anything go wrong, I did not want to miss my flight, so I relented under duress and politely made it clear that was what I was doing.

I was taken into a small control room or utility closet, which had what looked like regular workplace equipment in it, an orange bag and perhaps even some janitorial equipment. My memory of what was in the room is vague, though I know for sure it was small and looked like a utility closet. The TSA agent who lived near Rep. Barry observed the pat down, while a second, younger agent conducted the same pat down as before, with no variation. When that was done, this second agent then used the front of his hands to feel all around my groin, albeit through my clothing. During this entire interchange, my demeanor was one of polite, passive resistance. I stood silent, with a stoic look, and allowed these agents to violate my rights. Apparently, for some reason, this second screening cleared me for travel, and I was told I could leave the room.

As I left, the supervisor came over to me and asked me again why I didn’t go through the backscatter machine. He said, point blank, “you could have avoided all of this today if you would have just gone through the scanner.” I replied that I understood the situation, but that I would not be using the backscatter machine at any point due to health concerns. I also informed him that I believed that my constitutional rights to be free of unreasonable searches and seizures would have been violated either way. He didn’t respond to my statement, but appeared to make a mental note of it. I was then on my way.

Upon reflection, I realized why what I did today was the right thing to do, and why I’d urge all of you whom have read to this point to do the same. Jesus Christ, my Lord and Savior whom I look to to advise my every action, said that if someone slaps you on the right cheek, to turn the other cheek; that if someone asks you to carry their equipment for one mile, for you to go an additional mile whether they want you to or not; and that if someone asks you for your coat, to also give him your undergarments (Matthew 5:38-42). This behavior our Lord advocated was nothing other than passive resistance, and it is the type of passive resistance that asserts your authority over the authority that has attempted to control you while still showing mutual respect (love) for that person. Yes, it is more invasive for me to have a pat down, but it is also uncomfortable for the TSA agent. The agents certainly made it abundantly clear to me that they’d prefer I chose to use the backscatter machine, because it would be easier for everyone involved. The fact that I chose the more difficult option made it clear to those agents that what they were doing was wrong. They need to get that message as often as possible if we are ever to restore our liberties.

Regardless of whether I chose to go through the backscatter machine or opt-out for the pat down, my rights would be violated: My right to travel freely without interference would be violated. My right to bear arms to protect myself from terrorists on the plane or anyone or anything else would be violated. My right to be free from unreasonable searches without probable cause and a warrant indicating the items that were the subject of the search would be violated. My right to be innocent until proven guilty would be violated.

Because my rights would be violated either way, simply so that I could legally travel to a conference in Charlotte, N.C., via a plane ticket I had purchased with money my family had earned, it made sense for me to use whatever passive, peaceful and direct approach left at my disposal to make it clear what was happening was wrong. It is such passive resistance that brought about the greatest religion in the world and the faith that will defeat all evil in this world through the death and resurrection of Christ Jesus. It is such passive resistance that freed India from the caste system. It is such passive resistance that brought light to the plight of former slaves in the Southern United States. It is such passive resistance that will help us restore our liberties today, if only more of us take a stand against the treatment we as innocent people are subjected to by TSA agents without any probable cause that we might be doing something wrong.

By choosing to walk the extra mile, to turn the other cheek, to give up my clothes when asked for my coat, to go for an invasive full body pat down when asked to step through a simple backscatter screening machine, we are asserting our own authority and taking control of a lose-lose situation. We are highlighting the abuses of the system and raising doubts in the minds of these very TSA agents conducting the pat downs that they are doing the right thing. It is for that reason that I will always opt-out of the backscatter scanner, or take any available opt-out procedure that I can, from this point forward. And I will always tell you what happens when my rights are violated. Never will I silently allow my rights to be stripped from me. I was born free as an American. And I will die free, too, as an individual sovereign man, under the authority of my Almighty God alone.

Fixing health care in NH: General Background: Government mismanagement of healthcare
By Andrew J. Manuse for the Republican Liberty Caucus of New Hampshire

What’s often lost in the debate about the cost of health care is the reason why there is a cost at all, and why that cost should be set by market forces instead of the government through regulations on health insurance providers. Another thing that’s lost is who should ultimately pay for health care goods and services. Isn’t it only fair that the person who receives a good or service in a voluntary exchange should then pay for that good or service?

Health care is delivered either as a good or service. It is a good when it comes in the form of a cardiac stent used to prop open clogged arteries, a bone growth stimulator used to help people who suffer from skeletal degeneration, or Aspirin, the simple painkiller that’s also known to prevent heart attacks. Health care is a service when someone has to implant that cardiac stent, when someone has to meet with a patient to determine whether his or her problem might be fixed by a prescription to that bone-growth drug, or when junior has his annual checkup to measure his height, weight and reaction time.

There are companies that make medical devices and others that make pharmaceutical drugs. These companies typically spend millions of dollars developing these devices or drugs, and many times, their efforts to follow through on what seemed like a good idea come up empty. When companies develop a successful product, they have to recoup all the money they spent on the previous three or four failed products as well as the money it spent developing the successful product, or else they go out of business. Thus, in an ideal world, they would charge a rate for their successful product that would allow them to recoup all that cost over time with enough money to spare for future development work. Employees at these companies are motivated to keep working on these products—yes, in part because they want to help people—but mostly because they want to take home a fairly large salary that rewards them for their work on the product. Such salaries are supported when these companies make profits.

In addition, there are other companies that provide health care services, such as medical tests, diagnoses and surgery. Again, the people providing these services want to help people, but they also want to take home a nice chunk of change to pay the mortgage, feed the family and maybe even buy a yacht. They can only do that if the company they work for continues to make profits. They make profits by selling their goods and services to other people who can pay enough for them to cover the company’s expenses and then some.

In both scenarios, the people who produce life-saving drugs or devices, or the people who use the drugs, devices and their skills to diagnose and treat others have spent a lot of time and money developing the knowledge and ability needed to do that job. In fact, the skills they’ve developed are more difficult to acquire than, say, the skills needed to scrub toilets or even the skills needed to write this paragraph. It is for that reason that these people tend to demand more money for delivering their goods and services than others who don’t have them. And they deserve that money, really—every bit of it, in fact.

Now for some reason, we’ve allowed government to step in and pass all kinds of regulations concerning the sale of health care goods and services, even though government arguably doesn’t even have that authority. In the last 68 years, government has created company structures to cover the costs of health care. Health insurance companies have never really been completely autonomous—not since 1932 anyway. Before that, maybe there was a decade when health insurance companies truly operated in a free market, and truly provided insurance. But since Herbert Hoover was president, health insurance companies really don’t provide “insurance.”

When you buy a car, most of the time you also buy car insurance for that car. Should you get into an accident, the insurance covers a certain amount of damage to your car and the medical expenses of people who might have been injured. But insurance doesn’t cover new tires, new brakes or new windshield wipers, because these things are considered maintenance that are part of the regular cost of car ownership.

When you buy a house, you’re pretty much going to buy home insurance for it. That insurance will most likely pay for the unlikely possibility of a tree falling on your house, a thief taking some of your more valuable possessions or something of the like. Separate insurance may cover flood damage. Another program might pay for damage if your house burns down. However, if your home insurance coverage doesn’t include fire insurance, you probably won’t have much luck securing your policy during or after the day your house catches fire. In addition, it should be common sense that you can’t get your insurance company to pay for a new paint job on your house or new kitchen cabinets.

Why should health insurance be any different?

The truth is, it really wasn’t different at first. Most people bought health insurance for that odd chance that they might fall down on a hike and break a leg or suffer from some serious type of pneumonia. They didn’t expect insurance to pay for their regular doctor visits or the Aspirin the doctor recommended to cure those headaches. They paid regular expenses out of pocket. It should still be that way.

But in 1932, government started getting involved with health insurance. Congress gave favors to some insurers over others, causing competitive imbalances in the market that have yet to be corrected. Then Congress created incentives for employers to offer health insurance as a benefit, which codified the idea that health insurance is some kind of right. With the urging of labor unions, Congress forced employers to start paying for regular doctor visits and the like, which increased the cost of coverage. Later, Congress created its own health insurance program for senior citizens and those folks arbitrarily deemed to be poor. As a result of that, Congress started setting prices for some health care services and not others. Even if the government prices were too high or too low when compared to the market price, the doctors, hospitals and suppliers had to accept those prices, which led to adjustments in how they charged for their goods and services to regular payers. Government also started to monitor the products that health care companies produced, preventing some from reaching the market that would have saved lives, allowing others to reach the market that might have significantly harmed lives.

In every way, government took over the free market system for health care and turned it into the regulated industry that it is today. In every way, government is responsible for the cost increases that stemmed from ever-increasing regulations and led to the current crisis.

Instead of recognizing its failures and reversing the onerous regulations that have caused health care prices to skyrocket, government has decided to make the American people believe that health care is a right that everyone should have access to, regardless of their willingness to pay for those goods and services. What incentive does such posturing give drug developers or doctors to continue working? Why should a developer spend 12 hours away from his kids trying to make the next breakthrough if the government is just going to tell him how much he can sell the final product for? Why should a doctor spend 12 years in school studying for a job that pays her a meager wage not much higher than the unskilled laborer who doesn’t attend college a day in his life? Goods and services cost money to produce, and the people who produce them quite simply deserve to be paid for their work. The current health care and health insurance industry, as it is regulated, is no longer providing much of an opportunity for health professionals. That needs to change.

Before we can explore the possible solutions for solving the problems of the health industry, we must first look at the history of government health industry interventions and their result, both in the United States and in New Hampshire.

A Brief History of [Federal] Government Intervention in Healthcare 
By Docs4 Patient Care (editing by Andrew J. Manuse) for the Republican Liberty Caucus of New Hampshire

Before we can discuss what state lawmakers have done to harm the health care and insurance markets in New Hampshire, or what state legislators can do to improve these markets and drive down the costs to consumers for both, it is important to know and understand the historic federal intrusions into the health market and how they have caused the problems we’re facing today. After reading the following summary, it will be clear that our health markets are not free and have not been free for a long time. It will also be clear that government regulations have not solved health insurance cost and health care availability problems; instead, these regulations have repeatedly exacerbated the problems they were supposed to address.

First of all, any federal intrusion into the health marketplace is unconstitutional since nothing in the Constitution allows the federal government to regulate this industry. Big government supporters cite the commerce clause (Article 1, Section 8, Clause 3) for regulation of industries, but the original intent of the constitution meant no such thing. The clause actually states that Congress has the power to “regulate commerce … among the several states.” According to Robert Bork and Daniel Troy in their “Locating the Boundaries: The Scope of Congress’s Power to Regulate Commerce,” the two gentlemen indicate “commerce” has no other meaning than “the act of trade” itself, as James Madison noted in The Federalist Papers. “Regulate,” as it was known by founders Madison and Alexander Hamilton, meant “to make standard.”

Thus, in common English, the commerce clause simply gives Congress the power to ensure trade between parties in different states is conducted in the same way across the nation. This understanding was commonly understood for the first 100 years of the American Republic. As the Supreme Court said in 1888, “the object of vesting in Congress the power to regulate commerce with foreign nations and among the several States was to insure [sic] uniformity of regulation against conflicting and discriminating state legislation.”

It wasn’t until President Franklin Delano Roosevelt threatened in 1937 to increase the number of Supreme Court Justices from 9 to 15 so he could stack the court with fellow progressives that any other understanding of the commerce clause took root. President Roosevelt’s “Court-Packing Plan” intimidated the court and encouraged its consent to the president’s unconstitutional New Deal laws that included some of the first government health care interventions.

Since the first federal government intervention into the health care and health insurance markets in 1932, which was actually during President Herbert Hoover’s Administration, the free market for the health industry has been slowly dismantled, resulting in many of the problems we face today. It is important to understand where the federal government went wrong so we can have a real conversation about what we can do as state legislators to restore a free-market for health care and health insurance. So here is a brief timeline of the history of America’s health care industry, followed by an explanation of what problems resulted from each intervention.

1932 – Blue Cross was established. The American Medical Association and the American Hospital Association lobbied Congress for their exemption from normal insurance regulations and taxes. When Congress capitulated, this gave Blue Cross an unfair competitive advantage in the marketplace.

Congress also established “cost-plus” and third-party reimbursement procedures, which developed “reasonable and customary” definitions for paying health care providers that were in conflict with the actual cost of health care services. This led to inflationary health care costs.

1942 – World War II government wage and price controls led to employer-paid health insurance to increase compensation.

After the income tax was established, the IRS ruled health insurance a “legitimate cost of doing business” and allowed employees to receive health insurance benefits tax-free. This action essentially institutionalized employer-provided health care, as more employees demanded the tax-free benefit or companies used the benefit as a way to attract better talent.

1948 – The National Labor Relations Board (NLRB) argued that health benefits could now be the subject of collective bargaining, which reinforced employer-provided health care and encouraged the growth of this behavior. The government further encouraged employer-provided health insurance increases via tax incentives to employers and employees.

The third-party payer system, usually an employer providing health insurance as a benefit to its employees, increased the prevalence of routine-care coverage. Previously, insurance usually only covered unexpected catastrophes, such as a broken limb or a serious condition. This led to rising health care costs because employers paid a bulk rate and didn’t manage employees’ individual health care decisions, such as how often they visited the doctor or the reason for their visits. Individuals didn’t manage their decisions either, since they had no idea how much their health care services were costing them or their employers. This also led to cost increases for those without employer-provided health insurance as the risk of covering one person is higher than the risk of covering many people.

1965 – Congress created Medicare and Medicaid, and the federal government became the largest single buyer of health care services. This extended the flaws of regulated private insurance because the reimbursements paid to health care providers were based on “reasonable and customary” fees, rather than the true cost of health care services. Patients still had no incentive to control costs and used health care more often for routine care rather than its original purpose to cover only catastrophic health incidents, such as a broken limb or serious condition. Around this time, new government regulations made it extremely beneficial for the medical industry to increase adoption of Medicare and Medicaid by hospitals.

Here’s some relevant statistics that resulted from government’s hand in health care in this era:

• The rate of increase in hospital spending averaged 8.8 percent from 1960 to 1965 and nearly doubled to 15 percent from 1965 to 1970.
• Personal health care expenditures rose from $82 in 1950 to $2,511 in 1990.
• Medicare spending in constant dollars rose from $25.2 billion in 1978 to $87.6 billion in 1988 to $111.2 billion in 1990.
• Medicaid spending in constant dollars rose from $18.9 billion in 1978 to $54.7 billion in 1988 to $75.2 billion in 1990.

1973 – Congress passed the Health Maintenance Organizations Act, creating HMOs “to address rising costs of health care.” This new law further distorted the private health insurance market by adding new layers to existing controls, incentives and restrictions that had caused the problems. The law required all companies with 25 or more employees to offer an HMO plan in addition to any other plan they offered. The HMO Act was repealed in 1993, but by then the market for affordable individual health insurance had essentially been eliminated because traditional health insurers couldn’t compete with the new government mandated industry.

1983 – Social Security legislation established a “prospective payment system” (PPS) for hospital reimbursement when dealing with Medicare, which basically set prices for hospitals based on the diagnosis of health care providers. Treatments were centrally planned, designated by 475 “diagnostic related groups” (DRGs). This system essentially encouraged hospitals to cost shift diagnoses not covered by the PPS to one of the diagnostic related groups, which inflated Medicare costs faster than the rate of inflation.

At the same time, many states started passing mandates—laws enacted as the result of lobbying from health care providers and advocates—that forced insurers to cover additional diseases. This led to cost increases as insurance companies worked to mitigate the risk of covering additional medical problems.

According to the National Center for Policy Analysis, the cost increases caused by state and federal regulations made health insurance too expensive for some people, and as many as one in four people were uninsured. Another set of state laws prevented competition and portability, because state lines determined which insurance carriers state residents could legally shop. Only insurance companies that covered the mandated diseases for a state could sell their plans in that particular state. Incidentally, the commerce clause to the U.S. constitution was intended to prevent this very type of state regulation.

1992 – The Resource Based Relative Value Scale (RBRVS) created a “relative value” of doctors in such specialties as family practice, internal medicine and obstetrics, and lower fees for surgeons and radiologists. The law also limited “balance billing,” or the amount doctors can charge above what Medicare allows. These types of price controls skewed the demand for various types of physicians. Because the law required higher payment for doctors in family practice, internal medicine and obstetrics, more students became family practitioners and fewer became surgeons. This led to a shortage in certain areas of the health care industry.

2010 – Obamacare passed despite an outcry from the majority of Americans, who fully opposed the plan. The behemoth law adds a federal mandate for individuals to purchase health insurance, among other mandates that are completely unrelated to health care. The law did nothing to remove government controls, regulations and tax code incentives that created the health care crisis, and it actually added new ones.

Now that the history of government health care interventions is clear and the resulting cost impact is unmistakable, it will be important for us to consider some general federal health care reforms that will actually lower costs and increase the availability of care over time.

In a free market, competition drives down costs and increases the quality of goods or services. Usually, competition also increases the propensity for other competitors to enter the market, which increases choices for consumers. Regulations that give advantages to one insurance provider over another decrease competition, because unsubsidized or nonexempt firms cannot keep up with the favored companies and often fail.

The federal government must act first to remove regulations that benefit one insurance provider over another, and create a level playing field for all insurance carriers under the law. State governments can remove state mandates that prevent insurance companies from offering insurance across all 50 states. Again, the actual purpose of the commerce clause was to prevent one state from creating barriers to businesses from other states. State mandates violate the commerce clause as well as force consumers to purchase products they don’t want in order to get the product they need—that’s government coercion at its worst.

Second, the government also has to level the playing field among businesses and individuals. Whatever tax incentives are given to businesses to purchase health insurance should be extended to individuals, or groups of individuals. This will increase portability, as one person’s health insurance plan won’t be tied to his or her job. This allows increased cost control as the individual is encouraged to keep an eye on the reimbursement the insurance carrier provides.

Third, states should allow insurance companies to sell and people to buy catastrophic care insurance with pay-as-you-go for routine care. Just like auto insurance doesn’t cover our oil changes or home insurance doesn’t cover paint, health insurance shouldn’t cover regular doctor visits or typical prescriptions. Perhaps it shouldn’t even cover the tests doctors order, which would reduce the instances that people actually decide they want to take a test. Simply making this fix would save a lot of money. In addition, states should allow direct pay between patients and doctors to further control costs as medical offices will bill actual costs versus “reasonable and customary” fees.

Fourth, the federal government and the states should phase out federally run Medicare and Medicaid. Each state should determine how best to care for its uninsured, even if it means some states leave such coverage up to charity. People would be much more charitable if they could keep more of the money they earn. Each additional level of bureaucracy increases cost without any increase to benefits received.

Fifth, the federal government must remove regulations that distort the number of providers in the various medical specialties. This will normalize availability of providers over an extended period of time, which will improve our availability of care.

Finally, Congress must repeal Obamacare, and if that doesn’t work, the states should use their 10^th Amendment authority to nullify the unconstitutional federal act. Another option is to encourage New Hampshire to join an existing federal lawsuit that is challenging the constitutionality of the law. This legislation only degrades the already overregulated and controlled health care industry, and the states must act to stop and reverse the ever-encroaching federal government.

Where there is a provider able to fill a need, a consumer willing to pay that provider and an absence of unnatural interference, the free market will see to it that the consumer’s needs are met. Since the inception of health care insurance, there have only been a few years in the late 1920s that it operated in a free market system. Since Blue Cross received its first favorable regulation in 1932, the free market ceased to determine how health care insurance is provided. Let’s give the free market a chance to solve the health care crisis, since it was never really given that chance. It would be our quickest path to affordable health care for America and the only Constitutional option.

Jeanne Shaheen’s Health Care Policy Disaster in New Hampshire
(The following article is published almost exactly as it appeared in the policy report, Destroying Insurance Markets, by Conrad F. Meier, senior fellow in health policy for The Heartland Institute, published originally by the Council for Affordable Health Insurance. (Editing by Andrew J. Manuse)) for the RLCNH

On January 1, 2004, key provisions of a reform measure aimed at deregulating New Hampshire’s small group health insurance market went into effect. The new law also affirmed reforms implemented two years earlier to the Granite State’s individual medical market, allowing insurers to refuse to write or issue coverage based on an applicant’s health status, medical underwriting for individual health coverage, and exclusion of pre-existing conditions for nine months (up from three months under previous law).

In testimony to the House Commerce Committee on April 23, 2003, Gov. Craig Benson (R) said, “SB 110 is a great step forward in the health care reform process. It will lower costs and give consumers choice by increasing competition among insurers.”

How the Granite State came to see deregulation as the solution to the problems of rising health care costs and declining choices for consumers is a story worth telling, particularly so the trend will continue as new lawmakers and policymakers take to the House and Senate floor in Concord and work to further reduce the chains of regulation on the health industry.

Biggest Insurer Cried for Help

Benson’s “great step forward” could also be described as a “great step backward,” back to the time before the national debate over the failed Clinton Health Security Act and the poorly crafted reforms that New Hampshire and other states adopted in response to that debate.

In 1993, Blue Cross Blue Shield (BCBS) of New Hampshire (acquired by Anthem in 1999) began suffering financially from the guaranteed issue and community rating practices it was required by law to adopt. BCBS was the “insurer of last resort” in New Hampshire, and as such was more heavily regulated by the state than other insurers. In return, BCBS was exempted from paying the insurance premium tax (set at 2 percent of net premiums) levied on the rest of the state’s private health insurance market. BCBS complained the guaranteed issue and community rating mandates made it unable to compete with firms permitted to use standard health insurance underwriting practices. Rather than seek freedom from the mandates, BCBS lobbied the New Hampshire Legislature to adopt rules that would force guaranteed issue and community rating on all state-regulated insurance companies.

“Despite having provider discounts no other carrier could match and favorable tax treatment to boot, BCBS was losing market share to other carriers,” said Lee Tooman, vice president of Golden Rule Insurance Co. “Why? Because we had better products, prices and service. But Blue Cross prevailed in the Legislature, convincing elected officials that the problem was with us ‘cherry pickers’.”

During the 1994 legislative session, Democrat Jeanne Shaheen, then a State Senator, responded to BCBS by sponsoring SB 711, which passed and went into effect January 1, 1995. Among other provisions affecting the state’s insurance industry, the measure:

• Required insurance companies to guarantee issue individual health insurance policies. Companies were prohibited from denying coverage to any person or eligible dependent;
• Imposed price controls, in the form of modified community rating, on individual health insurance premiums. Premiums could be modified or adjusted only for age, not health status; and
• Prohibited insurers from increasing premiums by more than 25 percent until January 2000.

Individual Insurance Market Imploded

Aimed primarily at easing the burden on BCBS by encumbering other insurers, Shaheen’s SB 711 had no positive effect for health insurance consumers. According to the U.S. Census Bureau:

• In 1995, when SB 711 went into effect, 10.0 percent of the New Hampshire population was uninsured. In 2003, the uninsured rate stood at 10.3 percent;
• In 1995, 80.1 percent of the New Hampshire population had private health insurance. In 2003, 79.3 percent did; and
• In 1995, 9.8 percent of the New Hampshire population “directly purchased” health insurance, primarily in the individual market. In 2003, 7.1 percent did.

While health insurance coverage was little affected by Shaheen’s reforms, consumer choice was badly damaged. By 1997, the number of commercial health insurers serving New Hampshire dwindled to five from a previous high of 12. Those remaining in the market reduced their insurance offerings to cover only high-deductible, catastrophic-type health insurance plans.

By 1997, even BCBS threatened to drop out of the individual health insurance market, complaining once again that its losses were unsustainable. The company followed through by quitting the state’s market altogether and terminating all in-force business in January 1998.

The announcement “that [BCBS] would no longer participate in the individual market that they had done so much to define, heightened the growing concern of the remaining five carriers,” testified attorney Paula Rogers on behalf of the Health Insurance Association of America at a hearing before the state insurance department on October 31, 1997.

“Since the Blue Cross Blue Shield announcement, we have seen our number of new policies issued in New Hampshire increase substantially,” testified Cecil Bykerk, executive vice president and chief actuary for Mutual of Omaha. “We have also seen a significant increase in our anticipated loss ratio and this appears directly related to the influx of former Blue Cross Blue Shield policyholders. Our individual block of business, and indeed the entire remaining individual market in New Hampshire, is not broad-based enough to Shield block of business.”

The New Hampshire Department of Insurance engaged the Washington-based Center for Health Economics Research to investigate the effects of the Shaheen reform. The group’s report, submitted on December 17, 1997, warned, “Blue Cross and Blue Shield’s withdrawal from the nongroup [i.e., individual] market could lead to a market collapse if nothing is done to avoid a disorderly migration of this high-risk book to other insurers.” Anthony Juliano, executive vice president of the Independent Insurance Agents of New Hampshire (IIANH), shared at the October 31 hearing the results of an IIANH membership poll on the availability of individual health insurance products after SB 711 was implemented. According to Juliano, “There was a significant reduction in the availability, and what was available was coming in with extra-high deductibles. It now appears that circumstances have not changed and are certain to worsen with the withdrawal of BCBS from the market.”

Back to the Drawing Board

On November 26, 1997, the Department of Insurance issued a “Findings and Final Order” with respect to the condition of the state’s individual health insurance market. Insurance Commissioner Charles Blossom found, among other things, that “the quality of products available in this market is worsening,” “the cost of available products in this market is increasing,” and “the loss ratios of the writing carriers has increased.”

Blossom imposed a temporary risk-sharing plan, developed by the industry, to subsidize the losses experienced by the individual health insurance carriers. Insurers actively marketing in the individual market were eligible for a subsidy, paid for by assessments on all commercial insurance companies and HMOs.

The plan was widely perceived as necessary, but acceptable only as an interim measure. William Sterling, vice president and senior associate counsel for group insurance carrier John Alden, testified at the October 31 hearing, “The inability of a guaranteed issue, community rated individual health market to provide a sufficient, internal spread of risk and cost is apparent.

“The imposition of a risk-sharing plan by regulatory action is an acceptable and necessary solution to the problem at hand,” noted Sterling. “However, at the earliest possible opportunity, a permanent solution should be sought through legislation.”

Movement toward a legislative solution began in 1998. In legislation that went into effect July 1, 2002, the guaranteed issue requirement was repealed and a high-risk pool for the medically uninsurable launched. The measure also allowed for more flexibility in premium rating:

• Insurers were permitted to use medical underwriting to determine eligibility for insurance coverage and initial determination of rates;
• Premiums could be surcharged up to 50 percent for health status; !Premiums could be surcharged up to 50 percent for smokers; and
• Premiums were permitted to vary for age by a factor of 4 to 1.

The New Hampshire high-risk pool, New Hampshire Health Plan (NHHP), is a cooperative state and private-sector insurance plan for the medically uninsurable. While eligibility under certain state and federal regulations immediately makes one eligible for NHHP, for the most part, enrollees must have been declined for private health insurance coverage and must have been diagnosed with one of 16 “pre-qualifying” medical conditions, among them HIV/AIDS, juvenile diabetes, multiple sclerosis and paraplegia/quadriplegia.

Two indemnity and two managed care options are offered through NHHP. Rates are higher for tobacco users than for those who do not use tobacco. Coverage is provided through private insurance companies at rates not higher than 150 percent, and not lower than 125 percent, of the standard market rate for the coverage offered.

Scot Zajic, a director for government relations at Assurant Health, said his company is a strong supporter of high-risk pools for persons who cannot get health coverage elsewhere. “Having a risk pool is a good way to provide access to health coverage for those who need it,” Zajic said. “We would, however, like to see the funding base broadened to include federal and/or state funding. Finding coverage for medically uninsurable persons warrants a societal solution.”

State of the Market Today

Zajic said two companies under the Assurant corporate umbrella serve the individual medical insurance market today: Fortis Insurance Co. and John Alden Life Insurance Co. “The recent reforms have allowed us to re-enter the New Hampshire market, and to offer more products that will benefit more consumers.”

Golden Rule Insurance’s Tooman disagreed with Zajic’s assessment of competition in the state. “In 1994, Golden Rule had a thriving business in New Hampshire. We insured a lot of people and paid millions of dollars of claims expeditiously and accurately. But Blue Cross complained that carriers like Golden Rule were doing great harm in New Hampshire. In fact, the only entity suffering harm was Blue Cross.

“Jeanne Shaheen’s 1994 reforms ended up freeing Blue Cross of its money-losing business and handed it a virtual monopoly in the individual market,” Tooman continued. “Blue Cross returned to the individual market, able itself now to ‘cherry pick.’ But it still has the provider discounts no one else can touch. “Ten years after ‘reform,’” he said, “the market has not recovered.”

(For more information on New Hampshire’s attempt to cripple private health insurance under Gov. Jeanne Shaheen and the ensuing part recovery, please read: “Health Insurance: So What’s the Problem?” and “Health Insurance: Treating the Problem,” by Sonia Pearsall, Advanced Benefit Design, in Natural Entrepreneur, and “How Shaheen Destroyed Insurance Markets in NH,” an article by the New Hampshire Tea Party Coalition, which is based on the study, “Destroying Insurance Markets,” by the Council for Affordable Health Insurance and The Heartland Institute.

Testimony for HB 1297, relative to health insurance exchanges
Rep. Andrew J. Manuse, R-Rockingham 5 (Derry)
N.H. Senate Commerce Committee | April 24, 2012

I have come before you today to introduce and support HB 1297, which would prohibit New Hampshire from implementing a state health benefit exchange under the so-called Obamacare Act, the federal “health care” overhaul enacted by Congress against popular demand in 2010.

A health benefit exchange is the mechanism the federal Health and Human Services Department would use to enforce the provisions of Obamacare, such as the individual mandate we already said could not be enforced in New Hampshire when we passed SB 148 last year, and the taxes, and penalties the act requires businesses to pay.

The federal health overhaul entices states with the choice to create a state operated exchange or rely on a federal operated exchange. In effect, they are no different; the federal bureaucracy would control either version.

Yet, a state exchange would cost the state an additional $10 million to $30 million a year to run starting in 2015—money we just don’t have—just to pay for state officials to follow the federal government’s orders. Even if we do end up with Obamacare, HB 1297 would save New Hampshire money.

The language of HB 1297 as amended by 2012-1786s is simple and comprehensive. It would be inserted in RSA 420-N, updating the responsibility of the Joint Health Care Reform Oversight Committee to guide the state’s executive branch in protecting New Hampshire from the federal law.

With amendment 2012-1786s, HB 1297 would give state officials guidance on how they should interact with federal agents in the event that the court does not overturn the federal act in its upcoming decision or if the federal act is not repealed by Congress. Specifically, the amended HB 1297 would direct state officials to maintain a free market for health insurance to the best of their ability under the federal law.

On top of this, the language of HB 1297 takes advantage of a flaw in the federal law that relies on states creating their own exchanges. The law did not provide for the contingency that states would refuse to set up exchanges, and because of this, by New Hampshire not creating a state exchange along with other states, it will be more likely that the federal health insurance overhaul would be repealed or amended.

If the court overturns the law or if the law is repealed, most of the changes we’re introducing today would be deleted, but the prohibition on creating a state-run exchange and a new general state policy favoring free-market health insurance would remain in place.

In Conclusion, this bill as amended provides for every possible outcome and maintains the state’s stance against the federal act; yet, it still ensures New Hampshire maintains its ability to regulate health insurance on its own, regardless of what happens next.

What’s wrong with Obamacare?

With my support for HB 1297 and the amendment before you today, I’m starting from the premise that Obamacare is bad public policy. Just two years past the federal law’s adoption, we are already seeing the president’s lofty promises fall apart, and that’s before the law takes full effect in 2014.

According to a report from the Congressional Budget Office released this spring, Obamacare will cost taxpayers $1.76 trillion by 2022 but still leave 27 million Americans uninsured, an increase in the number of uninsured from today. Of the 23 million who receive coverage through this monumental new expense, about 20 million people will be dumped onto the Medicaid program, problems unresolved.

Businesses will either pay a penalty for not covering their employees, or they will have to pay the cost of much higher premiums. In New Hampshire, a full time employee at minimum wage would cost an employer with family health insurance a minimum of $26,000. For anyone looking for work after Obamacare, these costs will mean fewer available jobs.

Additionally, many folks may not be able to find a doctor willing to accept their new Obamacare coverage, and many elderly people will face the harsh reality that there is a bureaucracy in Washington deciding whether they will be covered for that essential treatment or whether painkillers will have to do the trick.

For those of us who understand the true costs of the new health insurance overhaul—and above are listed but a few—there is some hope that the Supreme Court will rule in June that the individual mandate is unconstitutional or might even throw the whole law out. Waiting for that decision, however, is not in the best interest of the state. That’s why we must act to pass HB 1297, which provides the best protection for New Hampshire’s private health insurance markets while also preparing for any contingency.

Do you have a better solution than Obamacare?

It’s important that we don’t simply propose a repeal agenda as part of this effort. I’m hoping that the coming failure of Obamacare gives new life to the possibility that we might return to free market principles in health insurance—principles that have been missing for about 100 years.

I’d like the state to let insurance companies offer true insurance plans without all the mandates, so people have an option to pay for most basic medical services out of pocket, and the insurance would cover serious illnesses and accidents. A la carte add-on coverage should also be allowed.

Medical savings accounts, tort reform and out-of-state competition are certainly part of the equation, but also important is restoring a real sense of cost to the medical care and health insurance markets. When people have to pay for an elective MRI, for instance, just like they do corrective eye surgery, we might start to see expensive procedures performed only when they’re necessary.

But we must first act to stop the implementation of Obamacare before we can move forward with other, free-market reforms. That’s what HB 1297 is all about.

What is a state health benefit exchange?

As the Arizona-based Goldwater Institute puts it, state created exchanges are in fact “government-sanctioned cartels where only government-approved insurers can sell government-approved insurance.” In other words, a state exchange is the full implementation of Obamacare in New Hampshire. The only difference is that we get to pay for it, too.

A state exchange would be responsible for running an insurance program, running an 800 number hotline, developing a risk adjustment program, defining and monitoring network adequacy and service areas, monitoring marketing materials, determining whether any particular treatment or doctor’s visit should be covered, and funding and monitoring companies or other organizations performing public information and eligibility requirements, among other bureaucratic duties. It uses taxes, penalties and subsidies to pick winners and losers in the health insurance market. We simply don’t want to create a system like this. It is bound to fail, and cost us substantially in the process.

What can New Hampshire expect relative to funding a state health benefit exchange?

RSA 420-N, created through HB 601 last year, established the Joint Health Care Reform Oversight Committee and also sent back $666,000 of health insurance exchange planning grant funds. HB 1727 has been submitted this year to send back the remaining $333,000 of the grant, which the Executive Council recently rejected. That’s $1 million in federal money that would pay to plan a state exchange already on its way out.

Federal funds for the implementation and operation of a state health insurance exchange end as of Jan. 1, 2015. The law itself explains that whomever establishes exchanges must pay for them using state “assessments and user fees,” “provider taxes,” “state revenues” or “other sources.” Are we as a Legislature ready to raise taxes again for something we don’t want?

According to research conducted by HTMS, a North Dakota health care consulting company, a North Dakota state health insurance exchange would have cost that state $10 million to operate. The same firm found that the average estimate for state exchange operations is about $28 million a year. Some states have estimated a cost of $47 million. Vermont’s exchange would cost about $11 million a year. It’s reasonable to expect a New Hampshire exchange would cost the state somewhere between $15 million and $30 million a year to operate.

With spending interests in this state focused on roads, education, police, fire, state services, paying down debt, tax cuts and similar ideas, I ask you this: Where do we get the money to pay for a state exchange that we have no real control over?

Rejecting health insurance exchange money is already the well-established position of this Legislature, and for good reason. HB 1297 would make sure our department officials know that rejecting the money to study the establishment of an exchange also means that we do not want to establish one—for sure.

Does a state exchange protect state interests?

You may have heard from some officials that a state insurance exchange under Obamacare will protect state sovereignty and ensure our ability as a state to maintain “local control” over our health insurance markets. This position is dangerously wrong. According to the Idaho Freedom Foundation, federal law surrounding state exchanges contains the word “require” 628 times, “shall” 22 times, and “must” 439 times. Every single element of a state plan must be approved by the federal department of Health and Human Services, meaning that the state has no autonomy whatsoever. If New Hampshire’s exchange did not comply with federal guidelines, or even the mere whim of the HHS department, we would be forced to make changes.

According to the federal law, exchanges can be established “only as prescribed by the HHS Secretary.” States may adopt only those exchange laws and regulations that “the secretary determines implements the standards within the state.”

Besides the clear language of the Obamacare bill that gives the U.S. HHS authority to dismantle and rewrite our exchange to suit their needs, the law says this about state exchanges: “An exchange may not establish rules that conflict with or prevent the application of regulations promulgated by the Secretary of Health and Human Services. Further, the secretary of the general accounting office will have continuing oversight of changes.” An exchange must “support and complement rule-making conducted by the Secretary of the Treasury.” Not only that, a state exchange must follow defined “minimum essential benefits,” and the secretary of the federal HHS department may define more at his or her whim. In other words, the regulations can be changed at any time, and our state exchange would have to live up to them.

Does this sound like we will maintain any control over this process?

What do we gain by rejecting a state health benefit exchange?

So far, the judges in all of the court cases against Obamacare, even those that came out against the constitutionality of the law, have said that states that implement a state exchange but then ask to overturn the law are acting hypocritically and make it difficult to rule in their favor. In other words, how can the court rule Obamacare unconstitutional when the states are voluntarily signing up for it?

According to the Idaho Freedom Foundation, the states would do themselves a favor by rejecting a state exchange, which would force the federal government to draft new legislation to fix problems with the language drafted as part of the Obamacare law, or simply repeal the bill all together. Because of a flaw in the law that gives tax breaks only to individuals in a state that have a state exchange, by not creating a state exchange, we are ensuring unequal treatment under the law and thus another constitutional challenge against the law—and this is a good thing.

The Cato Institute’s Michael Cannon says: “States thus have the collective power to deny the Obama Administration the legal authority to dispense more than a half-trillion dollars in new entitlement spending, to expose the full cost of the law’s mandates and government price controls…—simply by not creating Exchanges.”

That means even if the Supreme Court upholds the law as constitutional, we can still exert leverage as a state to force the law’s change or repeal.

Let me leave you with a few thoughts in summary:

• A recent New York Times article said “the success of President Obama’s health care overhaul … depends on the creation of … health insurance exchanges.”

• Exchanges are critical to enforcing the individual mandate, which we already declared unconstitutional by passing SB 148. SB 148 provided that a resident of New Hampshire shall not be required to obtain, or be assessed a fee or fine for failure to obtain, health insurance coverage. In other words, it nullified the individual mandate.

• Even if you wanted to create a state exchange, and I think we assuredly don’t, it is still too premature to jump into this state exchange game. As I understand it, there really isn’t a deadline for creating a state exchange, because even the states which have moved forward can’t meet the deadline.

• With a state exchange, we would be on the hook to pay for it– some $15 million to $30 million a year. We wouldn’t have to pay this amount if we defaulted to a federal exchange. A federal exchange would be no different than a state exchange.

• Creating a state exchange entrenches the law in New Hampshire, regardless of whether it’s ruled unconstitutional or repealed. President Obama is cheering on the creation of state exchanges, because each state that creates one makes his dream of implementing Obamacare closer to reality. As the Cato Institute’s Michael Cannon noted, “It is easier to repeal a theoretical bureaucracy than a real one.”

• Cannon also notes: “creating an exchange is not a hedging-your-bets strategy but a sabotaging-your-bets strategy.” This is because by creating a state exchange, we voluntarily agree to Obamacare and the price tag that comes with it. If we don’t create a state exchange, yes, we push the can down the road, but we at least maintain our options to determine what is the best course forward for New Hampshire. More than likely, Obamacare will either be ruled unconstitutional, repealed or drastically changed. In any of those cases, we do not want to have volunteered to create a state exchange.

• Cannon also emphasizes that there is no such thing as a “market-friendly” government bureaucracy. To verify his point, Mr. Cannon illustrates Utah’s “market-friendly exchange” created in 2008. When Utah politicians saw that health insurance was more expensive inside their exchanges than on the open market, they imposed a series of taxes on consumers outside the exchange to prop up the health plans inside it.

• While guaranteed issue and community rating—two things we already have in New Hampshire—are a part of the Act, also critical to the Act’s implementation are the exchanges and increase in medicaid eligibility requirements, two unconstitutional factors.

• Finally, I’d mention to you that the House has asked our Attorney General to join the 26-state lawsuit against Obamacare, which is now pending in the Supreme Court. If we truly want to do this, we should not adopt a strategy that will make us complicit in the law we’re trying to overturn. The U.S. Supreme Court will rule on this case in June, likely at least throwing out the individual mandate, but possibly the entire law. Any consideration of a state exchange that entrenches the law in New Hampshire is a bad idea.

• HB 1297 as amended by 2012-1786s would give the Insurance Department and HHS Department guidance as to how to interact with federal agents should the law move forward, but definitively says New Hampshire will not create a state exchange on its own and saddle the state with millions of dollars of costs while entrenching the law into state statute before its fate is decided.

Please review the following research concerning the merits of this bill:

• Manuse Plan Would Protect N.H. From Obamacare Exchanges (Josiah Center for Public Policy Studies)
  
• A State-run Federal Exchanges is the Worst of Both Worlds (Josiah Center for Public Policy Studies)
• Josiah Center for Public Policy Studies General Research on the Bill
  
• New Hampshire Republicans Continue Fight to Repeal and Replace Obamacare (N.H. Republican State Committee)
  
• N.H. House Bans State Exchanges (New Hampshire Watchdog)
  
• No Obamacare Exchanges (Cato Institute)
  
• Should New Hampshire Create a Health Insurance Exchange? (Cato Institute)
• Just Say No to Implementing Obamacare (Cato Institute)
• States Must ‘Just Say No’ to Federal Health Insurance Exchanges (Goldwater Institute)
• States Should Return Obamacare Grants, Pursue Own Health Care Reforms (Heritage Foundation)
  
• Flaw Gives Rise to Reject Health Care Exchanges (Idaho Freedom Foundation)
• Fixing Health Care in New Hampshire (RLCNH)

Sen. White, Dist. 9
Rep. Manuse, Rock. 5
April 23, 2012
2012-1786s
01/09

Amendment to HB 1297

Amend the bill by replacing all after the enacting clause with the following:

This bill clarifies the implementation of certain provisions of the Patient Protection and Affordable care Act. This bill prohibits the state of New Hampshire from planning, creating, or participating in a state health care exchange. The bill also establishes guidelines for interaction with a federally-facilitated exchange created for New Hampshire.

Testimony in favor of Amendment 2012-1595h to SB 328, relative to the procedure for filling a vacancy on a cooperative school board, and relative to the use of separation, or time out, as a technique for behavior guidance and treatment of children.
Rep. Andrew J. Manuse, R-Rockingham 5 (Derry)
April 17, 2012 | House Education Committee

I chose Sonshine Preschool and Daycare for my child last year because, among other reasons, the director informed me that she uses “time-outs” as a method to correct the poor behavior of children, as this is the type of discipline I believe a non-family member caregiver should be using to correct my child’s poor behavior.

I was shocked to learn this year with the House deadline for filing bills through the Rules Committee behind me, that this very director was later visited by a member of the Health and Human Services Department, who informed her that she can no longer could use time-outs at her facility—period. Sonshine Director Carol Earle (see her letter linked here), knowing I’m one of her state representatives, asked me to do something about this—to at least provide for a religious exemption so parents could choose to send their children to a religious daycare where their poor behavior could be properly corrected. I didn’t see the reason for a religious exemption, as I believe any child care facility should be allowed to use time-outs as a disciplinary technique. I used my first opportunity, and this bill before you today is as good a vehicle as any to make this necessary change to our law.

As you might know, the Bible in Proverbs 13:24 makes it clear that “He who spares his rod hates his child, But he who loves him disciplines him promptly.” Now, I’m not here to advocate for corporal punishment in the schoolyard, but I do think that some disciplinary measure must be available to teachers and day care operators that makes it clear to children when they cross the line and that they shouldn’t cross the line again. Time-outs were supposed to be the compromise so that no parent felt their child was being unduly abused by the teacher, but also so that no parent felt that the children were ruling the schoolyard, if you will, and teachers had no control over the situation.

If you read He-C 4002.25, the rules enabled by RSA 170-E:11(i), which gives a blanket authority for HHS to write rules regarding the “discipline of children,” the rules say that child care personal must “provide positive guidance” and “positively worded directions” and cannot use “separation, or time out” as “a punitive disciplinary technique.” I understand that children can be redirected once or twice, but what happens when that doesn’t work? In my opinion, and in the opinion of most parents, I believe, the child needs punitive discipline to correct his or her behavior. To not discipline a misbehaving child in my opinion is pure lunacy. No wonder children are so misbehaved these days, and it only gets worse with age.

As a parent, my deep thought and sincere and honest, good judgment went into picking a school where I thought my child could learn in a safe environment and be corrected when she intentionally misbehaves. I think all parents should have the freedom to choose a day care facility or school for their child where their reasonable educational and disciplinary belief systems are honored and practiced. I also think that most parents would agree with me that discipline of some kind is a necessary tool for child care providers to use.

Other parents might not agree with time outs as a form of discipline, but it is every parent’s duty to research the facility where he or she plans to send his or her children and make sure that the techniques used at that facility meet his or her standards of judgment. If a parent doesn’t want their child going to a school that uses time-outs, he or she can send that child somewhere else that doesn’t use such a technique. But that parent does not have the right to tell me or others that there is no place for my child to go where she can be properly disciplined and corrected when she misbehaves, and certainly that parent has no right to use the power of government to prevent me from picking the child care provider and reasonable child care disciplinary methods of my choice.

When I first heard about these rules, I knew that something had to be done immediately, to prevent undue harm to the state. That is why you have a non-germane amendment before you today. If HHS agents are invading my child’s religious preschool and daycare, telling them they can’t use a disciplinary technique as reasonable as a time-out to correct a child’s poor behavior, what other schools are they visiting where directors will just nod, smile and comply and forever teach a whole group of children that they can do no wrong? At least there is one preschool and daycare in this state willing to speak up when the government goes too far. I am grateful to have selected the right school for my child, where I am now more confident than ever that my child is learning from the right people with the right mindset, and that she will have the better moral character for it. I am hoping that you agree with me that this overreaching rule must be shot down immediately, so common sense can prevail.

Thank you for your time.

Thank you for being here and thank you to Jane Aitken for organizing this great event. It’s an honor to be speaking here before so many God-fearing, true American Patriots today, and to be serving the people of Derry in the State Legislature.

Our country is at great risk and our Union is in a troubling state, nearly totally devoid of the principles on which it was founded. But I want you to recognize that our country’s decline isn’t only because of President Obama or his cohorts in Congress; President George W. Bush before him, President Bill Clinton before him, and many presidents as well as many Congresses have allowed government to creep into the lives and businesses of everyday Americans for the past 100 years. But more importantly, the People have allowed this to happen, by not getting involved and by simply going through the motions to elect someone just because he or she has an “R” or a “D” next to his name, not because of his or her character, stated goals, past record and understanding of the constitution.

Now that the people have allowed this to happen, we stand here today awoken to a country that doesn’t remind us at all of the country we learned about in school—that is, if we were so lucky to have been taught about our Constitutional Republic in school like I was. My speech today, I hope, will give you some guidance concerning what I think we should do about it.

Certainly we should oppose Obamacare, the budget deficit and draconian government-centric programs, but we should also support free market health care, spending within our means without raising taxes or fees and the wholesale elimination of programs and department that run counter to the principles the nation was founded on. And in so doing this, yes, we should attempt to elect good representatives to Congress, but even if we’re successful with that goal (and we don’t have a good record of it), we only have four people in Congress and very little power to make the restorative change this country needs.

I submit to you that our power as citizens and our power as a state relies in the Tenth Amendment:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.

Of course we know that the scope of the powers held by Congress are delegated in Article 1, Section 8. Everything else remains a power of the State of New Hampshire and the several other states as well as the People themselves, who are responsible for electing representatives like me to the State Legislature. It is the State Legislature that controls which powers are reserved to the People and which will be leveraged by the state. Also inherent in a State Legislature is the power to stand up to the federal government when the federal government has taken authority it doesn’t have, or to preempt federal overreaches with Legislation that defines how New Hampshire will handle possible federal government intrusions.

We have done some of this in the last year: For instance, I’ve been personally involved with several efforts to stop Obamacare with State Legislation. Last year, we created an oversight committee that controls whether state officials can or cannot advance any part of Obamacare in the state. We also made it illegal for state officials to help enforce Obamacare’s mandate that individuals buy insurance. Finally, in a bill I sponsored this year that hasn’t passed yet (It’s alive in the Senate), we would be telling state officials that they cannot set up a state health insurance exchange, which is the prime mechanism that Obamacare uses to enforce its mandates, taxes, penalties and controls. Because of a flaw in the way Obamacare was written, by not setting up a state exchange along with other states, we may force Congress to reopen the law and amend, repeal or replace it.

In addition, considering federal plans to use Smart Meters to force consumers to use less energy, Sen. Forsythe and I introduced a bill to prohibit the so-called Smart Meter gateway devices that read and/or control the activity of appliances inside the home, without a homeowner’s decision to opt-in to have such a device installed. The bill doesn’t go all the way and ban Smart Meters, per se, but it does prevent the problematic component of the device from being installed without a homeowner’s consent. That bill has passed the Senate and is alive in the House.

On top of efforts to rein-in federal authority, we have also worked to rein-in overreaching state authority and restore fiscal sanity to our budgeting process. Specifically, we cut the state budget by one billion dollars and started to bring solvency to our state pension system. The current Legislature has begun to redefine government in the way it was intended to be defined, and we’ve reduced government’s authority to act without checks and balances in many instances. For instance, last year we eliminated so-called “affirmative action,” so now people being hired in New Hampshire will be judged by their skills and the content of their character rather than the color of their skin or their sex. After all, our state constitution says that everyone must be treated equally under the law. We also made it so government officials or their agents need to get your permission before they come in your home to do an administrative inspection, and if you don’t let them in, you can still appeal their decision. We have begun to scale back on programs that the private sector should manage, and can manage much better than the government. Right now, for instance, we’re trying to repeal the so-called “Certificate of Need Board” that controls where and when a new hospital or similar medical facility can be built. (That kind of sounds like it comes right out of “Atlas Shrugged,” now does it? I’m not quite ready to head for Galt’s Gulch, but I’m getting close. What about you?)

It’s efforts like these that slowly, but surely, help restore liberty or at least hold tyranny at bay. It’s efforts like these at the state level that affect your life more directly than anything that happens in Washington. And it’s efforts like these that need your support. More importantly, the representatives and senators who support these efforts need your help to get reelected, while the representatives and senators who don’t support Tenth Amendment efforts or other efforts that support limited government, individual liberty, personal responsibility and free enterprise, must be replaced with those who do. Maybe their replacement is you, or maybe you can work for a good candidiate to help get him or her elected. This must be the focus of our movement.

And that leads me to one final point: We didn’t pass everything that we should have this session. We didn’t repeal the law that allows police officers to arrest you for no reason and then charge you with resisting arrest. We didn’t repeal the Regional Greenhouse Gas Initiative, a tax on energy production and use that pays off a few connected insiders and picks winners and losers in the energy marketplace. And we didn’t pass Right to Work, which guarantees an individual’s right to get a job regardless of whether they choose to join a union.

These shortcomings are largely due to a vocal minority that has been coming to committee hearings, writing us letters, calling us and painting an incorrect picture of our actions in the press. These shortcomings are due to executive and judicial department officials who come to committee meetings and tell lawmakers what to do. Unfortunately, there are too many representatives and senators who have bent with this foul wind, despite the promises they made when they ran for office. These are the legislators who have held back restorative change.

We need you and your political friends to be the counterweight. It’s not enough to elect good people to state offices. We have to elect good people to state offices and then make sure they’re doing what they said they would do. Not every lawmaker has the integrity to do what they said they would do, as I’m sure you know. Please stay involved in the process. Please keep your legislators honest and keep in touch with them. Remind them that the constitution is what matters most, not the status quo.

Further, please support this Legislature for doing the right thing eight times out of ten by reelecting the good legislators, as rated by such groups as the Republican Liberty Caucus of New Hampshire (RLCNH), the House Republican Alliance (HRA), the New Hampshire Liberty Alliance (NHLA). But please help support the next Legislature by voting to replace those legislators who have not done the right thing this session. If no one is challenging these folks, please stand up and run for office yourself, or ask a political friend to do so.

This battle for freedom we’re involved in is young, and it is new. It took us 100 years to regress toward tyranny from the liberty our founders fought and died for, and it may take that long to restore our liberty again, or it might not happen at all if you as individuals don’t get involved and stay involved. As Ben Franklin said, We’ve given you “a Republic, if you can keep it.” This lines up well with what Wendell Phillips said some years later: “Eternal vigilance is the price of liberty.” The key is to start with the State Legislature and use its authority to hold the federal government in check. And it is for this reason, with a firm reliance on the protection of my Divine Father in Heaven, that I have pledged my life, fortune and sacred honor in this battle for our lives, liberty, property, and all those essential and inherent Natural Rights that God has given to us. I hope you will join me. God Bless you and God Bless The State of New Hampshire and the United States of America!

Just two years past Obamacare’s adoption we are already seeing the president’s lofty promises fall apart—even before the law takes full effect in 2014.

According to a report from the Congressional Budget Office released last month, Obamacare will cost taxpayers $1.76 trillion by 2022 but still leave 27 million Americans uninsured, an increase in the number of uninsured from today. Of the 23 million who receive coverage through this monumental new expense, about 20 million people will be dumped onto the Medicaid program, problems unresolved.

Businesses will either pay a penalty for not covering their employees, or they will have to pay the cost of much higher premiums. In New Hampshire, a full time employee at minimum wage would cost an employer with family health insurance a minimum of $26,000. For anyone looking for work after Obamacare, these costs will mean fewer available jobs.

Additionally, many folks may not be able to find a doctor willing to accept their new Obamacare coverage, and many elderly people will face the harsh reality that there is a bureaucracy in Washington deciding whether they will be covered for that essential treatment or whether painkillers will have to do the trick.

For those of us who understand the true costs of the new health insurance overhaul—and above are listed but a few—there is some hope that the Supreme Court will rule in June that the individual mandate is unconstitutional or might even throw the whole law out. Waiting for that decision, however, is not in the best interest of the state.

With the help of my Republican colleagues, I personally sponsored HB 1297, which would prohibit the creation of a State Health Benefit Exchange; the mechanism the federal bureaucracy will use to enforce the provisions of Obamacare. Obamacare gave us a choice to create a state operated exchange or rely on a federal operated exchange. In effect, the federal bureaucracy would control either version.

Importantly, a state exchange would cost the state an additional $10 million to $30 million a year—money we just don’t have—just to pay for state bureaucrats to follow the federal government’s orders. Even if we do end up with Obamacare, my bill would save New Hampshire money.

Even better is that federal lawmakers set up Obamacare in a way that relied on states creating their own exchanges, and by not setting one up in New Hampshire and other states, the federal overhaul may fail with or without a ruling from the Supreme Court.

That leaves one last point: As Republicans opposing Obamacare, we can’t simply propose a repeal agenda. I’m hoping that the coming failure of Obamacare gives new life to the possibility that we might return to free market principles in health insurance—principles that have been missing for about 100 years now.

I’d like the state to let insurance companies offer true insurance plans without all the mandates, so people have an option to pay for most basic medical services out of pocket, and the insurance would cover serious illnesses and accidents. A la carte add-on coverage should also be allowed. Medical savings accounts, tort reform and out-of-state competition are certainly part of the equation, but also important is restoring a real sense of cost to the medical care and health insurance markets. When people have to pay for an elective MRI, for instance, just like they do corrective eye surgery, we might start to see expensive procedures performed only when they’re necessary.

I’m writing today to testify in favor of HB 449 as a state representative for Rockingham 5 and as the clerk of the “Legislative Oversight Committee to Monitor Compliance With the Requirements for Online Access to Budget Information and Reports Under RSA 9-F:1.” As you can see, the name of the committee I sit on is rather long, and probably not all that transparent due to its length and complexity.

HB 449 in its original form was essentially the same bill as HB 331, a bill that I co-sponsored with Rep. David Bates to put the state’s checkbook online, and that bill has now become law. With the guidance of the oversight committee, the requirements of HB 331 have now been implemented as part of a soft launch. When the oversight committee meets next, it will decide when the new Web site should be announced to the public and whether any additional features should be added to it within the next year.

Due to its similarity with HB 331, when HB 449 was presented in the House, Rep. Bates, who is the chairman of the oversight committee, and I approached Rep. Weyler with information about the state transparency oversight committee, and Rep. Weyler agreed that we should use HB 449 as a vehicle to change the name of the committee and make it permanent so that we could use the committee to make all future changes.

HB 449 as amended would change the name of the committee so that it will be known as the “State Transparency Website Oversight Committee,” a far simpler and transparent name. This bill as amended by the House would also make the committee permanent, so that there will always be a place for legislators with good ideas about what should be on the state transparency Web site to go with their ideas. To have this committee in place permanently to address these ideas will save time and effort, and it will make sure that only those ideas that are feasible will move forward.

The Assistant Commissioner of Administrative Services, Joseph Bouchard, has noted that his department is overrun with legislative mandates about what the state transparency Web site should include, and such legislation is not necessary. RSA 9-F says: “The committee shall work with the department of administrative services and the department of information technology to explore what components reasonably can be added to the state website to provide increased transparency and to establish reasonable timelines for implementation based on staffing, funding, hardware, and software capacity.” Thus, any legislator with an idea for the state transparency Web site can bring that idea to the State Transparency Website Oversight Committee and that committee can then work with Administrative Services to determine if the inclusion of such a feature is a good idea. If it is a good idea, the committee will have the authority to authorize the inclusion of the new feature.

Incidentally, the Senate now has HB 1687 before the Senate Finance Committee. Again, with the State Transparency Website Oversight Committee in place, HB 1687 or any bill like it is unnecessary. The oversight committee can handle the request and implementation of such a request, if the resources are available to make it happen. A new law is not necessary for every change.

Unfortunately, the committee is now set to expire near the end of this year. So in conclusion, HB 449 as amended proposes to make the committee permanent so there will always be a place for legislators to bring their good ideas about the Web site. Any legislator who introduces a bill to change the information on the transparency Web site can be redirected to the chairman of the state transparency oversight committee, and that will save everyone time and money. Good ideas will become part of the Web site if you pass this bill, and I’d respectfully ask you to pass this bill as amended by the House.

Please feel free to contact Rep. Bates or me if you have any further questions.

For Immediate Release (SOURCE)
Contact Tory Mazzola
603-225-9341

NEW HAMPSHIRE REPUBLICANS CONTINUE FIGHT TO REPEAL & REPLACE OBAMACARE
With N.H. Taxpayers on the Hook for a Rising Price Tag, Will Democrats Reconsider Loyal Support?

 Concord, NH — Today, the New Hampshire House of Representatives took another step toward the Republican’s goal of stopping ObamaCare and its tax hikes, government expansion and prohibitive price tag. GOP leaders in the House of Representatives today passed a plan which would prohibit a state health insurance exchange and force Washington to repeal and replace the Democrats’ government-run health plan.

“When it comes to ObamaCare, the list of problems never ends,” said New Hampshire Republican State Committee Chairman Wayne MacDonald.  “It spends borrowed money, it raises taxes, in many ways it puts the government in charge and through these exchanges it eliminates choices for patients.”

ObamaCare requires states to establish bureaucratic exchanges that are regulated by the state and result in fewer options and less competition.  States are required to implement these government-run health programs by January 1, 2014, or the federal government will do it for them.  Speaker Bill O’Brien, Majority Leader D.J. Bettencourt and Rep. Andrew Manuse have been leading efforts in the House of Representatives to stop these exchanges in the Granite State.

“If we can’t stop ObamaCare, taxpayers will be on the hook for even more government spending, and New Hampshire will be required to pay for it as increasing costs are shifted to states,” added Chairman MacDonald.  “A recent non-partisan study already estimated that the original price of the Democrats’ health plan has ‘ballooned by $111 billion from last year’s budget.’”

The Associated Press reported last week that “Cost estimates for a key part of President Obama’s health care overhaul law have ballooned by $111 billion from last year’s budget, but administration officials say budget technicalities, not changes to the program, are to blame.”  (The Associated Press, 3/2/2012)

“Knowing now that the price tag for ObamaCare continues to rise, I’d like to know if Democrat candidates like Annie Kuster, Carol Shea-Porter and Maggie Hassan regret supporting their party’s health plan,” Chairman MacDonald said.  “Our federal deficit is out of control, and New Hampshire would be forced to pay a large portion of the tab for a bill that Nancy Pelosi said we had to pass to ‘find out what was in it.’”

As part of her efforts to muscle ObamaCare through Congress, Pelosi said, “We have to pass the bill so that you can find out what is in it.”  (Watch Video)  Now that the facts show that it is actually worse than first imagined, where do Democrats stand on President Obama’s key initiative?  A recent poll found that 53 percent of likely voters at least somewhat, if not more, favor the repeal of the plan.  Forty-two percent strongly favor repeal.

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Tory Mazzola
NH Republican State Committee
Office 603.225.9341 I Cell 603.303.0423
Web NHGOP.org I Twitter @ToryMazzola