New Hampshire Officials: Anti-Mandate Law May Not Affect PPACA

New Hampshire officials look at what the Supreme Court PPACA ruling means for their state's anti-health-mandate law. (AP Photo/J. Scott Applewhite) New Hampshire officials look at what the Supreme Court PPACA ruling means for their state's anti-health-mandate law. (AP Photo/J. Scott Applewhite)

New Hampshire lawmakers may have missed the mark when they tried to keep Congress from regulating individual ownership of health insurance in their state.

Officials at the New Hampshire Insurance Department deal with that issue in one answer to a batch of ansers to frequently asked questions (FAQs) posted on the department website.

Department officials developed the document to analyze how the recent U.S. Supreme Court ruling on the constitutionality of the Patient Protection and Affordable Care Act of 2010 (PPACA) might affect New Hampshire.

Many debating PPACA were proceeding on the understanding that a section of PPACA will require many individuals to own a minimum level of health coverage starting in 2014 or else pay a penalty.

The court held that Congress has no authority to require individuals to buy a minimum level of health coverage but does have the authority to impose a tax on individuals who fail to own a minimum level of health coverage, and that the individual health insurance ownership section of PPACA will, in reality, impose a tax on some people who are uninsured, not a true individual health insurance ownership mandate."

New Hampshire lawmakers earlier passed a law stating that, "No resident of this state ... shall be required to obtain or maintain a policy of individual insurance coverage except as required by a court or the department of health and human services where an individual is named a party in a judicial or administrative proceeding."

Lawmakers also stated in the new law that "no resident of the state shall be liable under the state Insurance Code 'for any penalty, assessment, fee, or fine as a result of his or her failure to procure or obtain health insurance coverage,'" department officials say.

Becuse the Supreme Court ruled that Congress does not have the power to impose an individual health insurance ownership requirement, and it said only that Congress can impose a tax on the uninsured, "the first sentence [in the state law] does not come into play," officials say. "The federal government cannot force citizens to obtain insurance, and there is no state law that imposes such a requirement."

The Supreme Court did say Congress can impose a tax on some people who are uninsured.

"The New Hampshire law does not address the tax issue," officials say. "Rather, it prohibits the state Insurance Department from imposing any penalty for failure to obtain health insurance. The Insurance Department is not involved in collecting federal taxes. Any collection of taxes (or award of tax subsidies) under the [PPACA] will be conducted entirely by the federal government."

In the document, New Hampshire department officials also said:

  • New Hampshire state law will not permit the state to set up its own PPACA health insurance exchange, or Web-based insurance market, but will let the New Hampshire department review and approve an health insurance plans that would be offered on a federal exchange in the state.
  • The New Hampshire Health Reform Oversight Committee will develop a New Hampshire version of the essential health benefits (EHB) package that must be included in all insurance policies sold through the federal exchange system in New Hampshire. 

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