Latest news with #NHVA
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
27-02-2025
- Health
- Yahoo
HB 524 would repeal the New Hampshire Vaccine Association. But what does the NHVA actually do?
The NHVA is a nonprofit established by the Legislature in 2002 and is a universal vaccine purchasing program. (Photo courtesy of Executive Office of the Maryland Governor) Next week, House Bill 524 will be heard by the New Hampshire House of Representatives. This bill would repeal and eliminate the New Hampshire Vaccine Association (NHVA), but it is important for our legislators and their constituents to know exactly what this might mean for the children and families of our state. The NHVA is a nonprofit established by the Legislature in 2002 and is a universal vaccine purchasing program. This NHVA does not set vaccine policies or recommendations. Rather, this program allows the state to use a federal, contracted price list when purchasing vaccines. While 'how' and 'for what price' vaccines are purchased by the state may seem like an unimportant detail, the NHVA allows the state to purchase vaccines at the lowest possible cost. This in turn allows Granite State families to get their children vaccinated for free, regardless of insurance coverage or income. Furthermore, the NHVA also saves New Hampshire millions of dollars each year by contributing $24 million annually to the state Department of Health and Human Services for vaccine purchases. When we consider the rising costs of health care, it is no surprise that cost may factor heavily into which elements of care families feel that they can engage with. As a physician, I have encountered many patients who have felt compelled to delay or decline medical care, ration medications, or be otherwise unable to prioritize their health — all due to how much this care may cost. The NHVA, though, has ensured that families in New Hampshire have not needed to choose between purchasing necessities like groceries and the health and future of their children. In projecting what our state might look like without the NHVA, it is important to have this context and this information about what the NHVA is — and what it is not. Eliminating the NHVA would not eliminate vaccines. Instead, it would increase the cost of vaccines for all Granite Staters. This cost would be passed on to physicians and clinics, insurance providers, and most importantly to families who wish to vaccinate their children. The unintended consequences of eliminating the NHVA could be devastating. New Hampshire has been among the top states in terms of percentage of children who have been vaccinated, and the free availability of vaccines due to the NHVA has been an important contributor to this. Without the universal purchasing program of the NHVA, vaccines would no longer be able to be purchased at the lowest possible price. In this scenario, Granite Staters with the lowest incomes would be disproportionately impacted. This would be unconscionable, because all children should be able to be protected against deadly preventable diseases, not just children raised in higher-income households. In the best-case scenario, childhood vaccinations become a privilege for wealthier families. Unfortunately, we are already seeing the worst-case scenario unfold in Texas, where an outbreak of measles, a disease that had once been eliminated in the U.S., has materialized. The Granite State has been a great example of the benefits of removing barriers to care, and the NHVA has been a large part of this success. 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. With so many barriers already making health care hard enough to access, it would be unacceptable to add more barriers in an area where our state has seen success. Thus, it is important to know what the NHVA actually does, and that without them, our children would suffer the most.
