The October 1 enrollment date for states to put the Affordable Care Act into play is rapidly approaching. There are still many questions, however, about how this is all going to work. Each state has taken a different path to rolling out the plan, and one stark contrast is between neighbors Vermont and New Hampshire.
"Many saw this, primarily Republicans, as a federal initiative," says Fleisher
Chris Fleisher reported on this divide for Valley News and says that in New Hampshire, some lawmakers didn’t think the state should be responsible, but ultimately decided to go with an exchange designed in partnership between the state and the federal government.
“Many saw this, primarily Republicans, as a federal initiative. In being so, it was incumbent on the federal government to take responsibility for designing it, for educating consumers, rather than leave that to the states,” says Fleisher.
Another key issue for New Hampshire is which providers will be available to consumers on the exchange. Anthem, the only insurer on the exchange market right now, doesn’t cover all of New Hampshire’s hospital facilities.
In the Upper Valley, that means that while Dartmouth-Hitchcock is covered as an in-network provider, three other Upper Valley hospitals –Valley Regional, Cottage, and Alice Peck Day- are not.
Fleisher says that he spoke to a Dartmouth official who said she was concerned about the potential influx of patients.
“A couple of months is just not enough time to build up the capacity if in fact they are flooded with new patients,” says Fleisher.
Of course, New Hampshire residents also have the option of buying insurance off-exchange, while Vermont residents do not. And as Fleisher reports, only time will tell which option will be more effective.
"We just don’t know, and we probably won’t know for many months or even years which was the wiser path,” he says.
