- Associated Press - Friday, April 10, 2015

CONCORD, N.H. (AP) - Even if lawmakers reauthorize New Hampshire’s expanded Medicaid program, implementing the next phase will be hugely complicated, state officials said Friday.

Since July, more than 38,000 adults making up to 138 percent of the federal poverty limit - about $15,900 a year - have signed up for coverage either through the state’s managed care program for Medicaid or through a program that subsidizes existing employer coverage. If the Legislature allows the program to continue, the state would use federal money to move those who initially sign up for managed care onto private plans through the Affordable Care Act marketplace starting in January.

Coverage will end at the end of 2016 if the Legislature doesn’t reauthorize it. Gov. Maggie Hassan included $12 million to continue the plan in her proposed budget, but the budget passed by the House doesn’t include funding to continue the expansion plan, and its fate remains uncertain in the Senate. Health and Human Services Commissioner Nick Toumpas said Friday he has been meeting with senators and is hopeful they will reauthorize the program once they hear how it has succeeded in both personal and financial terms.

“They’re looking for all the different data in order to support the reauthorization of the program and I’m fairly confident that the Senate will do so,” he told the Health Exchange Advisory Board. “The challenge that we face is that the Senate has pretty directly said they do not want this as part of the budget.”

In the meantime, insurance companies will be submitting their plans and rates next week without knowing how the Legislature will proceed. Assuming the program is reauthorized, insurance department officials say significant challenges remain in bringing together two very complicated systems. The plans will have to meet federal Medicaid requirements while also being designed for other populations, said insurance department attorney Jennifer Patterson. The longer the Legislature takes to act, the more difficult it will be for insurance companies to develop their plans, she said, and that affects more than just those who are covered under the health care overhaul law.

“The decisions that (insurance companies) make and any uncertainties that result from what’s going on in the legislative process, all of that gets played out in the rate development, and that is reflected across the entire private market,” she said.

Removing that uncertainty doesn’t just make things easier for insurers, said Lisa Guertin, president of Anthem Blue Cross and Blue Shield of New Hampshire.

“It has huge implications on the prices people pay,” she said.

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