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Consumers weigh in on N.H. hospital network

Russ Grazier isn’t happy that his hometown hospital won’t be an option if he buys insurance through the Affordable Care Act’s new online marketplace. But, he’s also understanding.

Anthem Blue Cross Blue Shield of New Hampshire will be the only company providing individual health insurance plans through the new marketplaces, or exchanges, required under President Obama’s health overhaul law. The company said Thursday it is creating a new provider network for individuals who purchase plans either on or off the exchange that includes 16 of the state’s 26 hospitals, plus one in Massachusetts.

Grazier, director of the Portsmouth Music and Arts Center, said he’s disappointed Portsmouth Regional Hospital isn’t on the list, but he understands Anthem’s reasoning that a narrower network will help control costs. According to Anthem, the network providers are offering rate concessions that will keep premium costs 25 percent lower than they would be if all hospitals were included.

“I think there is probably truth in the desire by most consumers to prioritize cost over accessibility, so I understand what the situation is and how it came to be,” he said.

Like Grazier, about 170,000 people are uninsured in New Hampshire, but it’s unclear how many will get coverage under the exchange since the state has not yet decided whether to expand its Medicaid program to cover more poor adults. Others, such as Laura Miller of Concord, will be switching from the state’s high risk pool to the exchange.

While Grazier has followed New Hampshire’s implementation of the law closely as a member of a state advisory board, Miller, a manager at Gibson’s bookstore and cafe, was surprised to hear about Anthem’s plans yesterday. But after taking some time to read up on the developments, she came to the same conclusion. She’s disappointed that the network will be so narrow, but is hopeful it will eventually expand.

“I’m not really panicked about it because I think it will work itself out,” said Miller, who added she will be able to keep her current doctor and hopes she won’t need hospital care anytime soon. “It’s taken how long for (the Affordable Care Act) to get implemented at all? Three years? And now it’s going to be another year or two before it’s actually in effect in a practical way because New Hampshire has taken this back-door approach to everything.”

New Hampshire opted not to run its own online markets, but Gov. Maggie Hassan’s administration has tried to have the state partner with the federal government to manage health plans and provide consumer assistance. Republicans have tried to block the second partnership, leaving a $5 million grant intended for New Hampshire-specific education and outreach in limbo, and were quick to point to Anthem’s network news as proof of the Affordable Care Act’s flaws.

But Grazier called for a more level-headed approach.

“People who want to criticize the program are going to look for every opportunity to do so,” he said. “Things have been delayed, and they’ve been delayed by our own elected officials, and now we have to wait and see how it plays out.”

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