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Bill would have allowed an unelected board to tax private health insurance policies

CONCORD, NH (May 14, 2026) — The National Federation of Independent Business (NFIB), New Hampshire’s leading small business advocacy organization, released the following statement on the vote to refer Senate Bill 498 for Interim Study:

“Today’s vote recognizes that affordable health insurance coverage is important for small businesses, workers, and families,” said John Reynolds, NFIB New Hampshire State Director. “This bill would have allowed an unelected board to tax private health insurance policies without knowing how much it would actually cost. Families of children who are struggling deserve care, and there are better ways to address the administrative disputes at issue in SB 498 without raising costs for everyone else.”

NFIB New Hampshire has proposed alternatives to ensure that services provided through the FAST Forward program are accurately billed and reimbursed by insurance companies:

Network Adequacy: Health insurance companies are required to provide in-network access to covered services and treatments for plans sold in each county. If insurers fail to meet their legal obligation, a network adequacy complaint can be filed with the New Hampshire Insurance Department. Lawmakers could update this process to ensure the care management entities can seek redress.

Payment Resolution: The care management entities could bill insurance companies for these services using guidance provided by the New Hampshire Insurance Department in March 2024. This was the original intent of the Executive Council and DHHS when the program was expanded from Medicaid to children with private health insurance coverage in 2020. The state has an existing external claims appeal process to resolve payment disputes between consumers and insurers. This process could be emulated or amended to provide a billing dispute resolution path for the care management entities.

Existing Resources: The care management entities should bill insurers for clinical services that are reimbursable. If the care management entities offer services that are not among NHID’s list of billable services, the state should continue covering those costs within existing resources. This would avoid additional costs being shifted from a broad tax base (the general fund) onto a narrower tax base (the fully insured healthcare market).

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For over 80 years, NFIB has been advocating on behalf of America’s small and independent business owners, both in Washington, D.C., and in all 50 state capitals. NFIB is nonprofit, nonpartisan, and member-driven. Since our founding in 1943, NFIB has been exclusively dedicated to small and independent businesses, and remains so today. For more information, please visit nfib.com.