At Wednesday’s meeting of the Commission to Study Expanded Medicaid Eligibility, Representative Tom Sherman presented a plan to extend health insurance to low-income Granite Staters under the Affordable Care Act (ACA). A majority of members of the Commission expressed support for each of the following elements of the plan.
- Adults aged 19 to 64 with incomes up to 138 percent of the federal poverty level (FPL) would be covered. For an individual, this means someone who makes just under $16,000 every year.
- If any of these adults chose to be covered by New Hampshire’s traditional Medicaid program, the benefits they would receive would be those outlined in the ACA and would be delivered by the managed care organizations hired by the state.
- New Hampshire would screen all applicants for its Health Insurance Premium Program (HIPP). HIPP allows the Department of Health and Human Services to pay the employee share of health insurance costs for those beneficiaries with access to employer-sponsored insurance, provided that coverage is deemed cost-effective. If necessary, New Hampshire would seek a waiver to make HIPP mandatory so that all Medicaid enrollees with employer-sponsored insurance are screened for suitability.
- A small number of newly eligible Medicaid beneficiaries – those with incomes between 100 and138 percent of the FPL – would be allowed to choose a Qualified Health Plan in the Marketplace if they prefer, to the extent it is permitted by the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees Medicaid.
- Any reduction in the federal matching rates for this new Medicaid population below those specified in the ACA would trigger a requirement that the legislature reauthorize the program within 6 months. Failure to reauthorize would mean that the Medicaid expansion would automatically be discontinued at the end of those 6 months.
The Commission has not voted affirmatively to extend Medicaid eligibility on January 1, 2014, when the 100 percent federal reimbursement kicks in. But they did vote down a proposal to delay the start date until the federal government approves any waiver the state might request — for example, to make the HIPP program mandatory.
Nor did the commission vote on provisions of the plan calling for data collection and evaluation going forward. They will likely revisit those items when they next meet on Tuesday, October 8 at 12:30 p.m.