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Next Steps for the New Hampshire Health Protection Program

New Hampshire policymakers recently created the New Hampshire Health Protection Program, which will permit the Granite State to dedicate millions of dollars in federal funds, available via the Affordable Care Act, to extend affordable health insurance coverage to thousands of local residents. While the creation of the New Hampshire Health Protection Program required many months of debate and deliberation, the hard work of ensuring that low-income Granite Staters have access to affordable health insurance has only just begun.

The New Hampshire Health Protection Program consists of three separate but related elements: the Health Insurance Premium Program (HIPP), the Bridge to Marketplace Premium Assistance Program (Bridge), and the Marketplace Premium Assistance Program (Premium Assistance). The legislation establishing the Health Protection Program, SB 413, specifies and implies numerous implementation timelines. The following attempts to integrate those timelines into a single chronology. As those timelines may change as time passes, the following should be viewed as an initial guide.

 

New Hampshire Health Protection Program Implementation Timeline

 

March-April 2014

  • New Hampshire Department of Health and Human Services (DHHS) begins preparing HIPP State Plan Amendment
  • DHHS begins preparing expanded eligibility State Plan Amendment
  • DHHS begins preparation and implementation activities
 

April 2014

 

  • State-level 30-day public input process relating to the Designated State Health Plan (DSH-P) §1115 waiver application likely begins. New Hampshire must conduct two public hearings in two different locations and keep a current website to share materials with interested parties; those materials must contain a sufficient level of detail to ensure meaningful input from the public.
  • DHHS likely seeks rule making authority from Joint Health Reform Oversight Committee (Jt. Health Reform)
  • DSH-P waiver application likely submitted to Joint Legislative Fiscal Committee (Jt. Fiscal)
  • HIPP State Plan Amendment submitted to Jt. Fiscal and Centers for Medicare and Medicaid Services (CMS)
  • Expanded eligibility State Plan Amendment submitted to Jt. Fiscal and CMS
 

May 1, 2014 

  • Enrollment in HIPP begins (or as soon as practicable after May 1)
  • Enrollment in Bridge Program begins (or as soon as practicable after May 1)
  • Insurance carriers wishing to offer products in the Marketplace submit applications to the New Hampshire Department of Insurance (NHID)
 

June 1, 2014

  • State submits DSH-P §1115 waiver application to CMS
 

July 1, 2014 

  • HIPP coverage begins (or as soon as practicable after July 1)
  • Bridge coverage through managed care organizations (MCOs) or qualified health plans (QHPs) begins (or as soon as practicable after July 1)
  • Breast and Cervical Cancer Program (BCCP) suspended for new enrollees after Bridge program begins. BCCP enrollees undergoing treatment or with eligibility prior to re-determination dates will have coverage continued.
 

August 2014 

  • NHID makes recommendations on QHPs to CMS’ Center for Consumer Information & Insurance Oversight (CCIIO)
  • Earliest possible date for CMS approval of DSH-P §1115 waiver
 

October 2014 

  • State-level 30 day public input process relating to the Premium Assistance §1115 waiver application likely begins. State must conduct two public hearings in two different locations and keep a current website to share materials with interested parties. Materials must contain a sufficient level of detail to ensure meaningful input from the public.
  • Premium Assistance §1115 waiver application likely submitted to Jt. Fiscal and possibly the Joint Committee on Health Reform Oversight
 

November 15, 2014

  • Open enrollment in the Marketplace begins for 2015
 

December 1, 2014 

  • New Hampshire submits §1115 Premium Assistance waiver application to CMS
 

February 1, 2015

 

  • Earliest possible date for CMS approval of §1115 Premium Assistance waiver

February 15, 2015

  • Open enrollment in the Marketplace ends
 

March 31, 2015

 

  • Last date to receive CMS approval of Premium Assistance §1115 waiver application
 

May 1, 2015 

  • Insurance carriers wishing to offer QHPs in the Marketplace in 2016 submit plans to NHID (tentative)
 

June 30, 2015

 

  • Bridge to Marketplace Premium Assistance Program terminates if CMS approval of the program not received by March 31, 2015
 

August 2015 

  • NHID sends recommendation of QHP approvals to CCIIO (tentative)
 

October 15, 2015

 

  • Enrollment in Premium Assistance begins if waiver approved by March 31, 2015
  • Open enrollment in the Marketplace begins for 2016 (tentative)
 

December 31, 2015 

  • Bridge to Marketplace Premium Assistance Program terminates if CMS approval of §1115 waiver received by March 31, 2015
 

January 1, 2016

 

  • Coverage under Premium Assistance §1115 waiver authority begins
 

December 31, 2016

 

  • Coverage under Premium Assistance §1115 waiver authority ends
  • Coverage under HIPP program ends
  • BCCP reinstated when coverage under Premium Assistance/HIPP ends

 

 

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Elections Highlight Continuing Questions About Keno Revenue

8 Nov 2017

tree with coins

While results are still preliminary, Keno gaming appears to have been legalized in seven cities around New Hampshire as a result of Tuesday’s votes. The margin of victory in Rochester for Keno legalization was reportedly only one vote and may still be subject to change or recount, but voters appear to have legalized Keno gaming in Berlin, Claremont, Laconia, Manchester, Nashua, Rochester, and Somersworth. Voters in Concord, Dover, and Keene voted against Keno gaming legalization. Franklin had legalized Keno gaming previously, and the Portsmouth City Council decided to not put Keno on the ballot. Other municipalities, including the City of Lebanon, may make decisions regarding Keno legalization next year. These results have implications for State policy and finances.