New Hampshire Governor Hassan signed bipartisan Medicaid expansion legislation into law yesterday, and my home state becomes the twenty-sixth (plus D.C.) to expand health coverage to the state’s lowest income adults. Although New Hampshire is moving toward an Arkansas-like private option, rather than delay implementation, in May the state will begin providing premium assistance to adults at or below 138%FPL who have access to employer-sponsored (ESI) coverage. In July, low-income adults without ESI will be able to enroll in one of three Medicaid managed care plans, as a temporary bridge while the state’s 1115 waiver is being developed and negotiated.
In a statement at the bill’s signing, Governor Hassan said “By expanding access to health insurance, we will help reduce uncompensated care and cost-shifting on New Hampshire businesses, encourage cost-saving primary and preventive care, and provide substance abuse and mental health treatment to thousands while injecting $2.5 billion in federal funds into our state’s economy.”
New Hampshire is expected to quickly begin developing its waiver proposal seeking federal approval to use Medicaid expansion dollars to purchase qualified health plans (QHP) in the state’s partnership marketplace for the expansion group. Currently, only one issuer offers QHPs in New Hampshire, so it will be important for the state to attract additional insurers. It would be helpful if the three private managed care plans available in Medicaid were to opt to participate in the marketplace, providing a smooth transition path for those who enroll.
Personally, I haven’t been able to figure out what’s more private about a QHP offered by a private insurance company than a Medicaid managed care plan offered by a private insurance company. In Arkansas, there was a difference because the state operated its Medicaid on a fee-for-service basis. But whatever the distinction is, it seems to merit a greater level of support for expanding coverage. So be it! I can’t claim any credit for New Hampshire’s victory this week, but at least now my D.C. friends can stop asking me what I’m going to do about New Hampshire. I spent 15 years working to expand coverage for Granite State children and I know what this means to their families, so kudos to so many friends who have worked diligently to get to this moment in history.
