Child docs, insurers, advocates plead to save vaccine nonprofit purchaser

Yahoo

19-03-2025

Mar. 18—Concord pediatrician Thomas Albushies said eliminating the New Hampshire Vaccine Association (NHVA) would cost his small practice $26,000 more each month to buy vaccines for his young patients.
"This will be a tremendous financial strain for small businesses," Albushies told lawmakers on Tuesday.
A parade of health care providers, insurers and advocates for children urged the House Ways and Means Committee Tuesday to reject the House-passed bill (HB 524) that would turn over vaccine purchases to the free market.
Opponents pushed hard against the bill for a second public hearing since the House narrowly approved it, 187-181, earlier this month.
Sixteen House Republicans joined with all but one Democrat to oppose the bill; Rep. Dale Girard of Claremont was the only Democrat to support it.
The bill's sponsor, Rep. Michael Granger, R-Milton, and former Vaccine Association member Laura Condon of Bedford were the only speakers in favor of the bill, which would do away with the NHVA 60 days after it becomes law.
"This does no damage to vaccine availability whatsoever," Granger said.
Condon said there are 44 states without a state-created nonprofit group such as the NHVA and they can acquire and administer affordable vaccines for children.
"This bill will save money and create efficiencies," Condon maintained.
Numerous pediatricians and insurance company executives said the opposite is true and that the NHVA is uniquely positioned to get an average 30% discount on the market price for vaccines.
"There is no buying group in this country that has the buying power of our federal government purchasing of vaccines," said Dr. Alexandra Deblasio Bonesho, a pediatrician from Epping.
Ending the NHVA would greatly impact doctors who secure vaccines on their own, and on the patient side, seasonal workers who throughout the year go from being on private coverage to government health care like Medicaid or no insurance at all, she said.
Since 2004, the NHVA has purchased vaccines for providers who then administer them to child patients for free.
Without the NHVA, providers will have to pursue insurers for reimbursement of the cost of free childhood vaccines, which are required under the Affordable Care Act.
The state Insurance Department estimates that eliminating the NHVA will balloon the total cost for vaccines from an annual $24 million in 2026-27 to around $31.5 million.
The vaccine costs are then included in the insurance premium taxes charged to the state's 91 insurers and third-party payers in the commercial health market.
State oversight still required
Granger and Condon contend that getting rid of the NHVA would also eliminate the vaccine staffing in the Department of Health and Human Services that costs taxpayers nearly $1 million a year.
Colleen Smith, a bureau chief of the Bureau of Infectious Disease Control in charge of the program, said all that money comes in a federal grant.
Even without the NHVA, the state still needs to have that staff monitoring its implementation, she said.
"This will be a major step backwards," Smith said.
Patrick Miller, executive director of the NHVA, said its administrative costs of just under $159,000 represent well under 1% of the program.
"There is zero financial downside to the existing funding mechanism," Miller said. "This bill will not save the state money if it is passed; it will make health care more unaffordable for payers, employers and the government."
Leaders of small pediatric practices said they would have to send their families to county health departments to get their vaccines and some will charge a hefty administrative fee to recoup some of their losses.
"I will absolutely go out of business or not be able to provide vaccines for my patients," said Dr. Amy Watson of Breakthrough Pediatrics, who runs her one-person practice in Concord.
Rep. Cyril Aures, R-Pittsfield, said many conservative House Republicans might support this bill but only if the state stops purchasing COVID-19 vaccines that they don't consider to be safe or effective.
"Get rid of COVID-19 shots," Aures told one bill opponent. "Are you willing to do without $2.6 million to save this program?"
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What's Next: The House Ways and Means Committee must make a recommendation on this by April 3.
Prospects: Murky. The state's medical lobby opposed to this bill has more political clout in the state Senate than in the larger, more unpredictable House.
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