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Editorial: Healthy Trends for Insurance in New Hampshire

Health care experts have said all along that it will take years to accurately assess whether the Affordable Care Act is succeeding . Given that patience is not now an American virtue, and wait-and-see does not a compelling political (or journalistic) narrative make, their counsel has been largely ignored.

Recent developments in New Hampshire, though, demonstrate the wisdom of not rushing to judgment. It now appears that individuals seeking to buy coverage through the state’s federally operated health insurance exchange in 2015 will have far more options than they did in the first year it was open for business, and that all of the state’s hospitals will be included in provider networks.

Some 38,000 New Hampshire residents purchased insurance through the exchange this year, even though their options were restricted to plans offered by a single company, Anthem Blue Cross Blue Shield. Anthem also excluded 10 of New Hampshire’s 26 hospitals — including three in the Upper Valley — from its network of providers, a decision driven by the ability to extract lower prices from hospitals in return for guaranteeing increased patient volume. This predictably created an uproar.

As staff writer Rick Jurgens reported earlier this week, things look markedly different heading into the next open enrollment period, which begins Nov. 15. The state Insurance Department is reviewing proposals from five providers to offer coverage next year through a total of 50 different policies. Moreover, the hospitals left out in the cold this year, including Alice Peck Day in Lebanon, Valley Regional in Claremont and Cottage in Woodsville, all appear on track to be included in multiple provider networks. Assuming that these proposals pass state and federal muster, consumers stand to be better served in 2015.

There are several possible explanations for why more insurers are seeking to enter the New Hampshire market, including that they were waiting to see how the exchange’s first year went before taking the plunge. With the relatively successful launch, perhaps some of the unknowns were answered and the risk of participating appeared more manageable. It’s also possible that the state’s decision to expand its Medicaid program by having eligible participants buy private insurance through the exchange held out the prospect of increasing the number of enrollees. Perhaps the simplest explanation is the one offered to USA Today by Larry Levitt of the non-profit Kaiser Family Foundation, who commented on national trends: “Insurers are seeing this as a growth opportunity and a profitable market.”

Lest we forget the expert advice, however, let’s remember that the Affordable Care Act was intended not only to provide health insurance for the uninsured, but also to make coverage affordable. It remains to be seen whether increased competition in the New Hampshire market will result in less costly policies for consumers. Nationally, the early returns suggest that the ACA is neither resulting in the cost savings its proponents hoped for, nor the sharp increases its critics feared, according to USA Today. On the other had, insurance companies had relatively little data from 2014 on which to base their 2015 offerings, so over time the ACA could still have the desired effect on prices. But it’s too soon to tell.