New Hampshire outlines 2018 health care choices

The health insurance landscape in New Hampshire continues to shift as the fifth enrollment period under President Barack Obama's health care overhaul law approaches.

While Republicans in Congress continue trying to dismantle the law, the New Hampshire Insurance Department released information Wednesday about what consumers will face when the next enrollment season starts on Nov. 1 for the online marketplace created by the Affordable Care Act. Underscoring how quickly things can change, the presentation came just days after one insurer that applied to sell plans in the marketplace announced it is closing and plans to re-open as a for-profit company.

"It's no secret to anyone that a lot has happened since last year, and there's a lot of uncertainty right now," Insurance Commissioner Roger Sevigny said. "Not knowing where the feds are going with it, the state is in the mode of having to act and react as quickly as possible."

Nothing is final yet, but three companies — Ambetter from New Hampshire Healthy Families, Anthem and Harvard Pilgrim — plan to offer 15 plans for individuals and six for small businesses, the insurance department said. For 2017, there were four companies offering 32 individual plans and 17 small-group plans. The 2018 figures don't include Minuteman Health, which announced Friday it is closing and plans to reopen as a for-profit insurer in January, selling plans both on and off the exchange.

In 2014, the first year of the online marketplaces, Anthem was the only participating insurer in New Hampshire, and it faced criticism for its narrow provider network of 16 hospitals. In 2018, Anthem plans to contract with 21 hospitals, Ambetter with 23 and Harvard Pilgrim with 18. Anthem and Ambetter have statewide networks; Harvard Pilgrim excludes Belknap and Carroll counties. Of the state's 26 acute care hospitals, all but Parkland Medical Center, in Derry, are included in at least one network.

At the insurance department's request, state lawmakers passed legislation this session that would give the department the authority to take steps to shore up the state's individual market, including seeking a federal waiver to help fund the availability of health insurance. Sevigny said the department is looking to hire a consultant to research that option, in part by examining what other states have done.

"It's the state's effort to jump out ahead of this so we can be in a position to act as quickly as possible," he said.

In Washington, the Senate has delayed its consideration of the measure until after the July Fourth holiday after failing to get the minimum number of votes needed to begin debate.