Editor’s Note: Last week, New Hampshire joined Arkansas and Iowa in adopting Medicaid expansion plans that rely on premium assistance for coverage of expansion adults. Our new issue of “Manatt on Medicaid,” summarized below, provides insights into the main features of New Hampshire’s new legislation, including how it compares to other recent state expansions. To download the full “Manatt on Medicaid” brief, click here.
Last week, New Hampshire’s governor signed a law (Senate Bill 413-FN-A) that will expand Medicaid to adults with incomes up to 133 percent of the federal poverty line. The law is expected to result in some 50,000 New Hampshire residents securing coverage through private plans (both Medicaid managed care plans and Qualified Health Plans in the marketplace), with enrollment beginning as early as July 1, 2014. The new legislation:
How the New Hampshire Expansion Compares to Other Recent State Expansions
New Hampshire’s decision to rely on a Medicaid premium assistance program for coverage of its expansion adults builds on the Arkansas and Iowa waivers, which also rely on premium assistance, with an emphasis on personal responsibility. (In New Hampshire, that includes a particular focus on inappropriate emergency room use, as well as cost sharing, wellness programs and assistance in finding employment.) Like Iowa, New Hampshire is coupling its QHP premium assistance program with a mandatory HIPP program for Medicaid-eligible adults who have access to ESI.
While New Hampshire had recently initiated a Medicaid managed care program, the proposed legislation deploys Medicaid managed care plans only as an interim coverage vehicle until the QHP premium assistance program can be approved and operationalized. By amending existing managed care contracts, New Hampshire will be able to initiate the expansion relatively quickly and take maximum advantage of the three years of 100% federal funding.