COVER STORY

Fred Kocher. Courtesy photo

Legislative efforts to expand health insurance coverage are getting kudos in the policy realm, but business advocates worry any additional mandates will erode the health of their bottom lines.

The Business and Industry Association of New Hampshire is busy monitoring health care bills for proposed state-sponsored health care assistance programs, medical malpractice reform, and extended coverage for dependents to as old as 26.

At the same time, New Hampshire's state chamber of commerce is promoting ways to improve health in the workplace and advance electronic medical records and prescriptions.

As businesses face 10 percent insurance increases, the discussion in the business community is focusing on ways to ease the burden, often by adjusting the employer and employee shares of coverage. The insurance issue is hounding businesses that already pay higher labor rates than competitors around the country and around the world, said BIA President Jim Roche. He says a federal solution is necessary, not a patchwork of state laws and regulations with no end in sight for insurance cost increases.

"Health insurance is perennially one of the top issues," he said. "The burden is growing." New Hampshire already has 38 health care mandates, according to Roche.

The cost of the average family health insurance plan in New Hampshire increased from $7,525 in 2000 to $11,156 in 2004, according to a February report by the New Hampshire Center for Public Policy Studies.

The Concord-based research group analyzed the cost implications of all the New Hampshire bills to expand health coverage this year, including a proposal to expand coverage through the state's Medicaid program. It concluded the expansions in public coverage would assist about 10,000 individuals at a cost of $20.3 million. Proposals to expand private coverage would add 4,500 individuals to coverage plans, but at an estimated cost of $7.7 million in new medical costs to be insured through the private insurance system.

Some of the bills may fail or be overhauled, but political forces will likely continue the trend next year, according to the Council for Affordable Health Insurance. The Virginia-based research and advocacy association of insurance carriers in individual and small group markets found states across the country this year are reviewing legislation for mandates. In a report, the council estimated mandated benefits increase the cost of basic health coverage from about 20 percent to more than 50 percent, depending on the state. Several states are extending eligibility requirements.

In its report, the council cited Maine for extending coverage to include a person who is not yet a U.S. citizen but who is residing legally in this country.

Fred Kocher, president of the New Hampshire High Tech Council, said his group's members have reported seeing health insurance cost increases of 10 percent to 50 percent. He said some are scaling back on what they can provide.

In response, Kocher said the council helped many businesses link up with Patriot Healthcare, a provider in Manchester, to establish a basic program featuring health savings accounts and wellness initiatives. Kocher said it was a move in the right direction, though not the end-all as far as addressing the concerns.

"There are other ways to do things," Kocher said. "We felt it was our obligation to do that, and we did." Health savings accounts provide an investment account from which people can withdraw money tax-free to pay for medical care, even routine and everyday purchases. They have taken off nationally, with the number of people using the vehicle doubling every six to nine months, according to Charles M. Arlinghaus, president of the Josiah Bartlett Center for Public Policy in Concord. He said such consumer-driven health care boosts personal knowledge and experience in health care options and goods.

"It's going to put some consumer pressure for price transparency in the marketplace," Arlinghaus said.

The bad news, Arlinghaus says, is there is still limited competition in New Hampshire. The push for expanded coverage, while an admirable and common goal, is not without a burden for businesses.

"They all sound nice, but they all drive up the cost," Arlinghaus said. "It is impossible in this day and age to get basic catastrophic coverage."