Latest news with #HB524
Yahoo
19-03-2025
- Health
- Yahoo
Child docs, insurers, advocates plead to save vaccine nonprofit purchaser
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?" . 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. klandrigan@
Yahoo
13-03-2025
- Health
- Yahoo
The New Hampshire Vaccine Association is under siege. The ‘why' is troubling.
The New Hampshire House, shown here during convening day in January, earlier this month voted in favor of repealing the New Hampshire Vaccine Association. (Photo by Ethan DeWitt/New Hampshire Bulletin) Up until a couple of weeks ago, I had never heard of the nonprofit New Hampshire Vaccine Association, which was created by statute in 2002. But late last month, a commentary written by Dr. Patrick Ho, president of the New Hampshire Medical Society, landed in my inbox. On Feb. 27, the Bulletin published his piece: 'HB 524 would repeal the New Hampshire Vaccine Association. But what does the NHVA actually do?' Dr. Ho wrote what I think is the best kind of commentary: clear, thoughtful, and illuminating. In just over 600 words, he shares the background of this entity that maybe voters or even lawmakers don't know much about — the NHVA — and explains what it does. The argument for or against its existence doesn't matter nearly as much as clarifying the purpose it serves (the purchase of vaccines at the lowest possible cost) and how it fits into our existing public health system (affordable preventative health care for children). Importantly, Dr. Ho underscores what it does not do: 'This NHVA does not set vaccine policies or recommendations.' If we're going to get rid of something, we should at the very least understand its purpose. Better still is knowing what we're going to do instead of the thing we're getting rid of, but that is absolutely not the forte of the party currently in power in Concord and Washington. 'Smaller government' is their mantra, and 'private sector' is their answer — to nearly everything. But in practice, in the absence of a plan or even 'the concept of a plan,' 'private sector' sure feels like another way of saying 'dunno don't care.' Toward the end Dr. Ho's piece, the certain result of repeal — the 'dunno' vote — is rendered in the clearest possible terms: 'Eliminating the NHVA would not eliminate vaccines, or even change policies relating to vaccines. This would, however, take the option out of the hands of lower-income families who would otherwise be able to vaccinate their children for free.' So, to summarize: If you hate vaccines and very much want them to go away, this is not the bill for you. If, however, you merely hate the idea of families having access to vaccines regardless of their income, then, yes, House Bill 524 is right up your alley. As the Bulletin reported last week, House Republicans did indeed decide that the NHVA is providing entirely too much important health care access to Granite Staters — and at no cost in state dollars, according to the bill's fiscal note. But it's really not fair to say 'House Republicans' voted to eliminate the association, because while 188 of them backed repeal, 16 of them voted with Democrats. Among them was Rep. David Nagel, who is also a doctor. Here's what Nagel said when asked why he voted against the bill: 'I gotta live with myself.' It's demolition time in New Hampshire, and as any home-flipper will tell you demolition is a necessary stage of revitalization. But if you don't have a renovation plan, then all you're doing is wildly swinging away and breaking stuff you should have preserved. And that's what it feels like the House is doing. I began this piece with an admission — that until very recently I was unfamiliar with the New Hampshire Vaccine Association. But I think there's a reason why I didn't know much about it: For more than two decades, it has served the families of the state quietly and well. Health care providers and insurers agree. And Dr. Nagel believes in the importance of the NHVA so deeply that he defied his own party and as a result lost his spot on the House Health, Human Services, and Elderly Affairs Committee. Past Republicans must have believed in it, too, because it's survived a lot of Republican legislative majorities over 23 years – including the slash-and-dash reign of House Speaker Bill O'Brien in the early 2010s. What it may not be able to survive is this modern nonsense era, where a large chunk of the American political right is under the impression that having an opinion is the same thing as possessing experience, knowledge, and expertise. Deputy Speaker Steven Smith admitted as much, albeit backwardly, in defending Republican leadership's decision to remove Nagel from his committee. 'Our hope is that people think more and recognize that our opinion isn't always necessarily correct,' Smith said. 'Rep. Nagel was unwilling to embrace that idea.' First, aren't the nondoctors who make up Republican House leadership the ones who don't understand that their low opinion of the NHVA — shaped by what exactly? — may not be 'correct'? Second, I don't think we're in a great place, democracy-wise, if opinions co-opted from fringe right-wing crusades carry the same weight as perspectives underpinned by a medical degree and decades of practice. But maybe that's just me. Within the confines of internal party politics, I do get where Smith is coming from. If you want to wield the power the election provided, you've got to keep the caucus in line. But it also speaks to the enormous, willful, and dangerous disconnect between politics and governing that is being inflicted on the nation right now. Eliminating the NHVA is not good governing; it is misguided retribution. The right has spent years creating new American boogeymen — migrants, 'wokeness,' science, education, public health, etc. — and what we're seeing nationally and in New Hampshire is the slipshod elimination of conjured enemies, damn the cost in dollars, degradation, and death. It is destruction for destruction's sake, and the crushing price of that undertaking will be paid by all, in one way or another, now and for decades to come.
Yahoo
06-03-2025
- Health
- Yahoo
House narrowly passes GOP-backed bill to eliminate New Hampshire Vaccine Association
Dover Democratic Rep. Seth Miller, right, consults with a colleague during a voting day for the New Hampshire House of Representatives on Thursday, March 6, 2025. Earlier in the day, the House voted to eliminate the New Hampshire Vaccine Association. (Photo by William Skipworth/New Hampshire Bulletin) A Republican-backed proposal to eliminate New Hampshire's mechanism for purchasing vaccines was approved by the state House of Representatives Thursday. The House voted, 189-181, in favor of House Bill 524, which seeks to terminate the New Hampshire Vaccine Association. The New Hampshire Vaccine Association is a nonprofit established by the Legislature in 2002 that serves as a universal purchasing program with the goal of providing universal access to vaccines for children. It does not set or recommend policies, but rather it buys vaccines in bulk and distributes them to doctors and providers, combining money from all insurers in the state to get a 30% discount on vaccines. The Republicans backing this bill argued the private sector could better fill this function. HB 524 would repeal the New Hampshire Vaccine Association. But what does the NHVA actually do? Rep. Michael Granger, a Milton Republican and the bill's sponsor, said while introducing the bill that its goal is 'to save a large amount of money.' He argued the association wasn't actually saving anyone any money, but still costing the state money to operate. Granger brought Laura Condon, a volunteer with the controversial nonprofit National Vaccine Information Center and a vocal vaccine conspiracy theorist, to make the case for the bill. 'It is best to remove government from involvement in the purchase of medical products when private business does quite well and cost-effectively for vaccines for adults,' said Condon, who recently publicly questioned whether vaccines might cause cancer and falsely asserted online that vaccines cause autism. She described the assertion that the government is able to do these duties cheaper than private industry as 'a false premise.' Opponents say the bill wouldn't save any money, as the funds that pass through it come from insurers, not the state itself. Without the New Hampshire Vaccine Association, medical offices would have to purchase vaccines themselves, would incur the administrative costs to do so, wouldn't get the discount, and would bill insurers at full price. This, opponents said, would threaten vaccine access and make it more difficult for parents to find vaccination clinics for their children. The bill would actually increase costs for the state, they argued, as it would have to assume the costs of managing a vaccine inventory to be prepared for disease outbreaks, a role the association currently fills in New Hampshire. 'For 20 years this is an arrangement that has worked beautifully for everybody,' Rep. Lucy Weber, a Walpole Democrat who serves on the Health, Human Services, and Elderly Affairs Committee, said. 'It's a win-win-win-win. It's good for kids. It's good for parents. It's good for the practices. And it's good for costs.' Weber said the bill would result in fewer vaccinations. Still, she argued the New Hampshire Vaccine Association 'is not pro-vaccine or pushing vaccines.' 'It is making them available to parents who want their children to be vaccinated,' she continued. 'And in that respect, it is a parental rights, parental decision organization. And parents can do what parents want to do. There is nothing in the vaccine organization as it stands that's requiring parents to get vaccines.' Deputy House Democratic Leader Laura Telerski, who represents Nashua, added that this will disproportionately impact rural communities where there are fewer providers and parents have to travel farther for pediatrician visits. 'Opponents of this bill believe that government has a role in public health and providing that access,' Telerski said. 'And the people who are supporting the bill believe that small government is taking precedence over public health.' The bill has been widely panned by doctors, nurses, and medical organizations. 'We already have a very, very good system in place,' said Dr. Patrick Ho, president of the New Hampshire Medical Association and a psychiatrist in Lebanon. Ho disagrees with proponents of the bill who say the private sector would be able to complete this function at the same cost. 'I think what that argument really disregards is the power of the program overall to leverage essentially the lower costs of purchasing the vaccines and negotiating for significantly lower priced vaccines for everybody across the state, insured or not,' he said. 'It also disregards the very significant administrative resources that would need to be deployed for each practice, each health system to procure these vaccines themselves.' Ho pointed out the bill is opposed by providers and insurers alike. 'Everyone involved in obtaining vaccines for our state and for the children of our state is aligned in thinking this is a really good program,' he said. 'There's no reason to do away with it.' Ho said the New Hampshire Vaccine Association is 'really just a big win for the children of the state' and that it 'reduces burdens to vaccines.' 'When the state is able to purchase vaccines at the lowest possible price, this ensures that the children of the state can get free vaccines,' he said. 'Because the health care provider offices, the clinics, and the insurance carriers don't have as much administrative burden.' The opposition to the bill, while ultimately unsuccessful, was bipartisan. In addition to Democrats, some Republicans voted against it Thursday. Rep. David Nagel, a Gilmanton Republican, called it 'a horrible bill.' 'I gotta live with myself,' he said, explaining why he voted against it. Outside of his work in the State House, Nagel is a doctor, known nationally for his work on pain management. He served on the House Health, Human Services, and Elderly Affairs Committee until he was removed last month ahead of the committee vote on whether to recommend this bill for approval, as reported by WMUR. The bill will now be considered by the Ways and Means Committee.
