Brendan Williams is president and CEO of the New Hampshire Medical Association.
It’s a story that’s often told: A bipartisan Senate bill in New Hampshire (co-sponsored by more than half of the senators) passes the Senate but dies in the House.
This particular story is about Senate Bill 407, which would regulate the rates that insurance companies pay for ambulance services. If passed by the Senate, it would require insurance companies to pay a fair rate as part of good faith negotiations between the insurance company and the ambulance company. If no agreement can be reached between the insurance company and the service provider, the Senate would require insurance companies to pay the lowest of the rates set by the local government or contracting entity pursuant to a public process, the rates paid by Medicare, or the rates charged.
Seems reasonable? This would certainly be great for Granite State residents, who often have difficulty accessing ambulance services, especially in rural areas, due to inflationary costs, including wages.
A New Hampshire Ambulance Association report last year surveyed 150 emergency medical service leaders and found that 98% said the health system urgently needed improvements. One ambulance company alone was unable to fill 50 job openings because salaries were not high enough to compete in the job market. Others are on the verge of bankruptcy.
In contrast, health insurers seem to be doing just fine. For example, even after a cyberattack on one of its many claims-handling subsidiaries that could have been avoided with simple cybersecurity measures nearly crippled the U.S. health care system, UnitedHealth Group’s market cap is $455.93 billion as of this writing, 30 times the size of New Hampshire’s current biennium budget.
As a former state insurance commissioner, I can attest to the fact that tight control of health care providers and patients by health insurance companies is as American as apple pie. I paid $9,100 out of pocket last year, even though I was “insured.” It’s an experience many can relate to. Health insurance companies are buying up medical facilities to steer policyholders to their companies, circumventing the already generous restrictions of Obamacare. A large insurance company in New Hampshire was reimbursing ambulance services less than it did a decade ago. Why? Because they could get away with it.
If passed by the Senate, SB 407 would level this uneven playing field ever so slightly, benefiting all Granite Staters who need emergency response or transportation to a healthcare provider. For example, the current crisis is straining hospitals because ambulances are not available to transport patients who are ready to be discharged to long-term care facilities. However, the House now has this excellent bill up for consideration.
This is a classic legislative move. When you don’t want to do something, you just study it. I can’t tell you how many times I’ve been on a study committee that never achieved anything substantial, and then a while later another study committee studies the same thing.
The Senate has refused to go along with the House’s policy and a bicameral committee is now in place. The House should follow the Senate’s position. The well-being of Granite Staters, including our most vulnerable citizens, especially in a rural state like ours, depends on the survival of our ambulance department.
