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Committee approves Medicaid expansion plan

State House Bureau

May 22. 2014 8:05PM

CONCORD — The Joint Legislative Fiscal Committee Thursday approved key elements of the state’s Medicaid expansion plan or NH Health Protection Act that need to be in place before the program can begin.

“Today’s approval of the state plan amendment is an important step forward for the implementation of our bipartisan health care expansion plan,” Gov. Maggie Hassan said. “We are now looking to our federal partners to approve our amendment as quickly as possible so that we can finalize an enrollment timeline.”

The committee approved four amendments to the state’s Medicaid plan that will allow about 50,000 poor adults to have health insurance through the Medicaid program under the Affordable Care Act.

The amendments will now be presented to the Center for Medicaid Services for approval with the hope of having at least part of the program running by July 1.

One amendment outlines the “alternative benefit plan,” which will transition the newly eligible to private insurance through the state health insurance exchange by Jan. 1, 2016, paid for by federal Medicaid money.

The 2½-year pilot program would be 100 percent funded by the federal government.

The alternative plan mirrors the essential benefits required of carriers who offer policies on the state’s health exchange along with several other services such as non-emergency transportation and substance abuse treatment.

Members of the committee and health and human services officials reached agreement to approve the agency’s proposal but the agency has to present another amendment in 60 days that would eliminate non-essential use of emergency rooms from the plan.

Some of the newly eligible will go onto the state’s current Medicaid managed care program because federal law requires the “medically frail” who have difficulty with daily activities such as bathing or dressing have access to benefits not in the transition plan, officials said.

Also, the state will need to provide additional benefits to some who qualify for the Health Insurance Premium Payment program because some insurance policies offered by their employers do not include the essential benefits required of plans available on the state exchange.

The plan also requires co-pays for prescription drugs of $1 for generics and $4 for brand drugs if the recipient’s income is above the federal poverty level, but eliminates co-pays for those currently on the state managed-care Medicaid program.

The Joint Legislative Fiscal Committee meets Wednesday to approve a waiver request that would provide additional federal money to help cover existing Medicaid services.

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