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Spending for health exchange nixed

Councilors vote against program

The Executive Council yesterday declined to authorize spending the final portion of a $1 million federal grant to plan an insurance marketplace under the new health care law.

The state Insurance Department would have used the $333,000 rejected yesterday to examine the technology needed to set up a health insurance exchange and the number of people who might seek policies through one.

The health care law signed last year requires states by 2014 to participate in an exchange where individuals and small businesses can buy health insurance. If a state does not have an exchange, which it can form with other states, the law requires the federal government to establish one. Insurance Commissioner Roger Sevigny said after the vote he expects that will happen for New Hampshire.

'The feds are going to set up a health insurance exchange for the state of New Hampshire,' Sevigny said.

Yesterday, the all-Republican council voted 3-2 against allowing the department to spend the $333,000 portion of the grant. In April, the council authorized spending $666,000 to examine how New Hampshire could implement an exchange. But lawmakers then passed legislation barring the department from spending the money. Before a council meeting in late November, House Speaker William O'Brien provided councilors with literature from conservative think tanks opposing the exchanges.

Councilor Dan. St. Hilaire of Concord, who voted both times to authorize spending the money, moved at a meeting last month to table the decision on the $333,000 grant. St. Hilaire said he had been concerned new federal rules would prevent New Hampshire from opting out of certain requirements. But he said he learned the state would be allowed to craft a system tailored to its own needs.

'The alternative is the federal government would basically impose their system upon New Hampshire,' St. Hilaire said.

The spending was opposed both times by Councilor Chris Sununu of Newfields, who said yesterday the federal health care law has so many requirements that state policy makers cannot retain control.

'The idea that by controlling the process ourselves, we're going to get a good exchange - that's an illusion,' Sununu said.

If the state makes no steps toward establishing an exchange, he said, it could make the case that it should not be responsible for the costs.

Councilor Ray Wieczorek of Manchester voted to authorize spending the initial sum, but yesterday voted against spending the rest.

(Karen Langley can be reached at 369-3316 or klangley@cmonitor.com.)