New Hampshire health insurance exchange
Website glitches and concerns about limited options cloud launch of NH marketplace
By Louise Norris
November 27, 2013
After one month of open enrollment, 7,817 people had completed applications for enrollment in the New Hampshire exchange, but only 269 had selected their health plan – many more are expected to do so before December 23 (the deadline for a January 1 effective date). The state-federal partnership exchange in New Hampshire uses Healthcare.gov as its online enrollment portal, so residents have had difficulty enrolling due to the initial technological glitches in the federal site. On November 22, New Hampshire’s Insurance Commissioner Roger Sevigny announced that the state-run high risk pool will remain in effect “until the federal marketplace is fully available (it had previously been scheduled to cease operations on December 31). Sevigny has also said that health plans in New Hampshire may comply with President Obama’s proposal that existing plans be allowed to renew until late 2014, which offers an alternative for residents who are not eligible for subsidies and would otherwise see higher premiums with new ACA-compliant plans.
Although New Hampshire has not opted to expand Medicaid under the ACA’s guidelines, the state legislature met in late November for a special session to consider the possibility of expanding Medicaid to 50,000 state residents who would otherwise be likely to remain uninsured.
The New Hampshire Health Plan, which runs the state’s high-risk insurance pool, was approved in September for a federal grant to help facilitate education and outreach for the exchange. In addition, Planned Parenthood and Bi-State Primary Care were both awarded grants to serve as navigators for NH residents who have questions or need personal assistance with the enrollment process.
The exchange creation process in New Hampshire has been a legislative battle. In February 2013, Gov. Maggie Hassan announced that New Hampshire would operate its health insurance marketplace as a partnership with the federal government. Prior to the 2012 elections, New Hampshire seemed firmly on a path to relying on the federally facilitated exchange. Former Democratic Gov. John Lynch had no effective means to push back against a Republican-dominated state Legislature that was united against a state-run exchange. The 2012 elections gave control of the state House to Democrats, put more Democrats in the Senate, and kept the governor’s office in Democratic hands. The political shift and a law that allowed the state to take on specific exchange functions enabled the state to adopt a partnership model.
New Hampshire is responsible for plan management and consumer assistance, and the federal government is managing all other marketplace functions.
Only one insurer — Anthem Blue Cross — applied to participate in the exchange in New Hampshire, and currently offers 11 health plan options. Harvard Pilgrim plans to participate in 2015, and officials hope that additional insurers, including MVP Health Care, might also join the marketplace in 2015. New Hampshire consumers can compare plan options and premiums and submit an application for coverage at www.healthcare.gov. Despite the fact that the exchange has just one carrier, premiums in New Hampshire are comparable to rates in states that have many carriers offering policies.
Anthem’s dominance of the New Hampshire individual market was not triggered by the new marketplaces: it already sells more than eight of ten individual policies. However, the company’s restrictions on its hospital and physician networks are drawing fire. Critics say the exclusion of 12 of the state’s 26 hospitals, which applies to individual policies sold on and off the marketplace, will force consumers to wait longer and drive farther to get care. Anthem countered by noting that the narrower provider network was key to keeping premiums as low as possible, since their negotiations with providers hinged on the promise of each hospital in the network getting more patients than they would with a wider network.
According to state officials, about 170,000 state residents do not have health insurance. About 65,000 people are expected to purchase coverage for 2014 through the marketplace.
New Hampshire health insurance exchange links
New Hampshire Department of Insurance: Health Benefit Partnership Exchange Advisory Board
Includes meeting agendas and documents from November 2012 until the present.
State Exchange Profile: New Hampshire
The Henry J. Kaiser Family Foundation overview of New Hampshire’s progress toward creating a state health insurance exchange.
New Hampshire Consumer Assistance Program
Assists consumers who have purchased insurance on the individual market or who have insurance through an employer who only does business in New Hampshire.
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