Despite a sustained push by Gov. Kelly Ayotte in recent days, the New Hampshire House on Thursday voted down a bill that would create a new funding mechanism for intensive behavioral health services for children covered by private insurance.
But the bill’s fate remains unclear, after the New Hampshire Senate, late Thursday, tacked on a version of the mental health funding bill as an amendment to an unrelated topic, meaning the two chambers could still find a compromise to the issue by the end of the session next month.
The bill, Senate Bill 498, sought to move more of the financial burden for intensive treatment for youth onto insurers, rather than the state Medicaid program. It initially cleared the New Hampshire Senate in late March on a voice vote, but met opposition in the House, where some Republican lawmakers labeled it a tax.
Rep. John Hunt, chair of the House Commerce Committee, told his colleagues Thursday that he supported covering additional services for kids, but said the bill’s unknown price tag and ill-defined oversight mechanisms needed more work. He said he would continue to work with private insurers and advocacy groups to find a solution.
“I guarantee you we'll get it done,” said Hunt, who pledged to have a new proposal ready by the end of August.
Under the current system, children covered by private insurance in New Hampshire are unable to directly enroll in an intensive behavioral health program known as FAST Forward, which provides a range of services for families that can last as long as 18 months. The bill sought to add an assessment — what some opponents call a “tax” — on private health insurers to help pay for those services, which otherwise fall on the state to cover.
“The choice is not between paying and not paying,” said Rep. Julie Miles, a Republican from Merrimack who supported the bill. “The choice is whether private insurance finally shares responsibility for care that families have already purchased.”
The measure called for the creation of a new quasi-governmental entity that would oversee the program. Health insurers and opponents have argued this could result in ballooning costs, which will be passed on to consumers.
Over the past week, Ayotte has aggressively pushed for passage of the bill and cast Anthem, the state’s largest health insurer, as the villain in what had erupted into a pitched legislative battle.
Following a second procedural vote by the House that saw a coalition of Republicans and Democrats sink the bill on a 183-to-162 vote, Ayotte issued a press release Thursday afternoon vowing to continue fighting for the bill.
“It’s disappointing to see elected representatives choose subsidizing insurance companies over kids’ mental health care,” Ayotte said.
“Gov. Ayotte’s recent criticisms of our company (and industry) regarding coverage of behavioral healthcare for children have been inaccurate and misleading,” Anthem said in a statement following Thursday’s vote. The insurer said that over the past year, it has paid in excess of $30 million in claims for behavioral health care for children under 19 years old.
The House’s vote, which saw 146 Republicans and 37 Democrats come out against the bill, arrived despite Ayotte’s all-in approach in recent days. Her office sent a flurry of press releases on the issue, and on Thursday, as lawmakers made their way to Representatives Hall, the governor posed outside her office with advocates sporting lime green t-shirts and holding signs reading “NH’s kids can’t wait.”
Ayotte’s public advocacy is a notable move for a governor who usually stays out of legislative matters until they have reached her desk. Ayotte told NHPR on Wednesday that she was personally calling lawmakers. “Improving mental health is my priority,” she said.
With the Senate’s move late Thursday, the two chambers could now decide to continue negotiations on the bill. Any compromise would still need to win approval in both the House and Senate.
