To The Daily Sun,
We in the legislature have been grappling with how to expand health care coverage to low income adults and families during the past year. The bipartisan committee studying the expansion of Medicaid issued its compromise plan a month ago. Governor Hassan and House members worked to make this plan better, and I will be voting to support this plan on Thursday when the House and Senate meet.
The House plan, SSHB-1, will extend health insurance to nearly 60,000 low-income, working Granite Staters without increasing any taxes. It takes full advantage of 100 percent federal funding of Medicaid expansion for three years.
SSHB-1, the House plan will implement The Health Insurance Premium Program (HIPP). Newly-eligible adults with access to employer-sponsored insurance that is cost-effective will keep that insurance. The Department of Health and Human Services will pay the employee's share of this insurance with funds allocated in the Affordable Care Act. The bill requires that this program, HIPP, apply for and obtain a waiver by January 1, 2014 or as soon as possible to ensure coverage for these folks. The Senate plan similarly utilizes HIPP. However, the Senate plan terminates December 31, 2016.
In the House plan, any adult ineligible for the above HIPP, (they have no employer or their employer does not offer adequate health insurance) will select coverage from one of the private managed care organizations (MCO) which have already been contracted to provide benefits under NH's Medicaid program. MCOs will ensure that each enrollee has access to a primary care provider and be linked to a medical home within 60 days of enrollment.
Under House bill, SSHB-1, beginning in January 2017, newly-eligible adults with incomes between 100-138 percent of the federal poverty line, will be required to enroll in the Health Care Marketplace to receive health insurance benefits. Federal funds outlined in the Affordable Care Act will provide premium assistance necessary to purchase these plans.
Lastly, if the federal assistance for the programs outlined above drops below the levels outlined in the Affordable Care Act, the House plan would terminate the program within six months.
The Senate plan for Medicaid expansion requires more complex waivers from the Center for Medicare and Medicaid Services (CMS) and creates a commission to write the waivers. These waivers are not required to be submitted by the state Department of Human Services until May of 2014. Without these waivers, N.H. will be ineligible for the first year of 100 percent federal funding. The Senate plan repeals Medicaid Expansion fully in December 2016.
When 60,000 plus New Hampshire citizens are uninsured or underinsured, we all pay the price. This is paid in the increasing cost of health care and in rising health insurance premiums paid by those of us with insurance. The Senate plan with its waivers will postpone implementation of Medicaid expansion and then be repealed in three years. It is an unworkable plan — one that I cannot support. I urge you to contact your state senator today, and ask them to compromise with the governor and House to bring together a New Hampshire solution to a challenge that affects us all.
Rep. Suzanne Smith