Recently, the New Hampshire insurance commissioner and his deputy took to these pages (“The reality of paid family medical leave in NH, Monitor, July 20) as salesmen for Gov. Chris Sununu’s recently passed paid leave proposal.
In their reality, all that seems to matter is how the “plan” has been embraced by the insurance industry and how tax credits will flow to business interests. Throughout their sales pitch, there is not even a mention of the role that paid leave should play in strengthening our economy or retaining employees, nor any commitment expressed to relieving the financial and caregiving stress facing New Hampshire families. The most glaring omission: no actual commitment to ensure that working people have paid leave when they need it.
As an advocate for working families, I’ve been working side by side with dedicated, committed leaders and policy experts to enact a paid leave program in New Hampshire that meets the needs of our workforce. Based on our years of work I can say without hesitation that Gov. Sununu and his political appointees at the Department of Insurance have failed to fix the underlying problem that paid leave policy is intended to address.
Two thirds of working people in this state don’t have access to paid time off when they need to care for themselves or a family member. The people least likely to have paid leave are working people with the lowest incomes and the most significant caregiving responsibilities. The reality is that the governor’s paid leave “plan” will only perpetuate this status quo.
After vetoing bipartisan paid leave bills that would have ensured all working people have paid leave when they need it two years in a row, the alternative pushed by Gov. Sununu into law is a series of enticements to try to artificially prop up a private insurance market that has failed to function on it’s own.
Sununu’s commissioners repeatedly remind us that “industry experts” influenced their proposal but there were no public hearings in which the insurance industry commented on the proposal and no disclosure regarding which private insurers they have been crafting this proposal with or the details of those private conversations. So it shouldn’t come as a surprise that Sununu gives insurance companies control of the cost of premiums and rate setting that can lead to higher costs for employers with a higher percentage of women or people with disabilities.
His plan also doesn’t set up any guard rails to protect workers against the incentive the private insurer will have to deny claims to save on cost of the benefits they have to pay out. There is no process outlined for appeals of denied claims or even jurisdiction indicating who those appeals would be made to. Private insurers too often control our health care decisions already. Why should we trust them to decide when and whether we can provide care to our loved ones?
Private insurers are for-profit companies. New Hampshire already saw how insurance companies responded to the governor’s proposal two years ago: they included profit margins of several percentage points in their cost estimates. People have long seen how health insurers drive up prices. The same would be true with respect to paid leave, especially with the government picking a single winner and giving one insurer essentially a monopoly within the state.
Sununu’s program entirely leaves out any path for employees at companies with less than 50 employees to access this benefit if their employer doesn’t choose to offer it.Our state’s economy is fueled by small businesses and more than 40% of New Hampshire workers are employed in these settings.
There is no consideration in the policy about the many obstacles that workers will have in navigating such a benefit outside the employee-employer relationship. It is silent on essential operational questions, such as, where will employees go to purchase individual coverage if not through their employer? What if the employee purchases independent coverage for medical leave but the employer fails to grant the employee time off? What if the employer recognizes the need for time off but the independent insurer denies coverage? How is this type of dispute resolved? Due to the lack of worker focus in Sununu’s approach there are no answers to these basic questions about program operations.
What is strikingly clear from the commissioner’s own words is that Sununu’s plan was tailored to satisfy the desires of the insurance industry, with little or no focus on increasing access for working people.
The COVID-19 pandemic has underscored the value of paid family and medical leave programs to workers, businesses and the economy. The health risks to essential workers, the shifts to and from remote work and school have increased caregiving struggles and enhanced the long-standing need for our state to adopt an effective paid leave program.
As our state strives to recover and rebuild an economy that supports working families, we must modernize and evolve our support structures to ensure a workforce with better options to balance work and family health needs. Tragically, Gov. Sununu’s approach not only fails to put us on a path to that future, it wastes time and resources building a program that is flawed from the start.
(Amanda Sears is the director of Campaign for a Family Friendly Economy.)