[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6650839,"mediaKeyId","2503344-0db7686d294c93f05cf8b3332a84208f","parentId",2503344,"title","Division 3 advances Medicaid budget changes in HB 2 including premiums, co‑pays and eligibility adjustments","audioSeconds",9380,"startMs",198000,"endMs",9578000,"viewUrl","/Search/View?dp=1&key=2503344-0db7686d294c93f05cf8b3332a84208f&start=198&end=9578","thumbnailUrl","https://assets.pipeline.soar.com/2503344-0db7686d294c93f05cf8b3332a84208f/thumbnail_198000.jpg","articleUrl","/articles/6650839/New-Hampshire/Division-3-advances-Medicaid-budget-changes-in-HB-2-including-premiums-copays-and-eligibility-adjustments","mediaUrl","https://secure.pipeline.soar.com/6650839-7c73306d92284aadeaa4171e3fed1fe6/orig.mp4?Expires=1773700490&Signature=Ct32Dio0FFNxPF2Jl6QK8NFIut3FTLD7XRk5amUt3-Ree6uskSziDJdpIvrdhxXcvDYJSh-n2m4DXJUFxXmdbxj4aGepNj-CUnFihWb19pwtz6jmFCQxjYze0SLJAYbd3n64mwhEuZFMDdey1KaG5gxm0Kyw0V~dmt91R-ppAKXcY7UG75y6CB9YWib1uI1XAGZBjd7mu~mLIe2nVo2u57j9yLxFnf7RGnWrhc5lSgubOz~KdNh-gQISEiwdFwdcJ-uEOuro7WjYeYu--TscSwelYo2xaUbfbyQqLmq72X9ld15xZ8ydDVB3nfAKQ6TqkwCMzd-pJyupy2avB3Gglw__&Key-Pair-Id=KUT5TJCACFTXG","author","New Hampshire Legislature","date","2025-03-05T18:27:51.817Z","article","House Finance Division 3 continued a work session on Medicaid on March 5, 2025, focusing on provisions in House Bill 2 that would change eligibility, cost sharing and other Medicaid program rules. The committee heard technical presentations from Nathan White, chief financial officer at the Department of Health and Human Services, and Henry Littman, the state Medicaid director, then posed detailed implementation questions to staff and attorneys.

Division members were presented with the governor's proposed HB 2 adjustments and a handout showing service additions and eligibility changes enacted since 2019. DHHS staff outlined the provisions that Division 3 most directly considered: a return to pre‑public‑health‑emergency income verification standards, establishment of prescription co‑payments up to $4, and a premium structure affecting higher‑income CHIP and a separate premium for Granite Advantage enrollees. DHHS officials told the committee the budget assumes the reinstituted verification and cost‑sharing changes will lower general‑fund costs in the 2026–27 biennium, and indicated estimated savings on a schedule included in their handout.

Committee members repeatedly asked for implementation detail. Representatives sought clarity on who would be subject to co‑pays and premiums, how the measures would be administered by managed‑care organizations, and whether the systems to collect payments and avoid duplicate charges could be built without eroding projected savings. Nathan White said the administration could provide further reporting showing fund splits (general, federal, other) for the cost and savings estimates and would add a third column for “other funds.” Division members asked DHHS to model the enrollment and administrative impact if the governor signed the budget late in the fiscal year.

The bill text in HB 2 that Division 3 reviewed included: section 107 (establishing Medicaid prescription co‑pays up to $4), section 108 (limits on the number of managed‑care rate filings to one per year for planning purposes), section 109 (premiums for Granite Advantage enrollees), section 110 (CHIP premiums for families above the 255% FPL threshold), and section 111 (return to pre‑PHE eligibility verification). DHHS told the committee the estimated biennial general‑fund savings tied to those items are captured in the department’s crosswalk spreadsheet but cautioned that the timing of implementation, IT changes and federal approvals could affect the first‑year numbers.

Members expressed two recurring concerns: (1) the near‑term operational burden on eligibility staff when certain PHE flexibilities expire and case redeterminations resume, and (2) the potential for modest co‑pays or premiums to deter enrollment, especially for families near the eligibility thresholds. DHHS staff described ongoing outreach work — including MCO and department calls and tailored notices — and agreed to provide a breakdown showing how many people would be affected by each HB 2 provision and the projected administrative costs tied to implementing the changes. Several public witnesses representing health‑care advocacy organizations urged caution on co‑pays and premiums, citing national studies and state experiences that associated premiums and modest cost sharing with drops in enrollment and increased administrative costs.

The work session ended with committee requests for written follow‑up from DHHS: (1) a third‑column breakdown (general/federal/other) for the department’s cost and savings spreadsheet; (2) the expected number of people (by eligibility group) who would be affected by each HB 2 provision; and (3) implementation timelines and one‑time IT/administrative costs needed to operationalize co‑pays and premiums. Division 3 scheduled further review as part of its continuing budget work.

Less critical details: Division members said they would not require immediate statutory language changes from the committee; instead many members asked DHHS to return with program‑level modeling showing the operational impacts of each provision.

","mediaType","Video","parentTitle","House Finance Division III (03/05/2025)","oneSentenceSummary","House Finance Division 3 continued a work session March 5, 2025, on Medicaid components of HB 2, asking the Department of Health and Human Services for additional detail about proposed premiums, prescription co‑payments and a return to pre‑pandemic eligibility verification.","taxTitle","Finance - Division III, House of Representatives, Committees\t, Legislative, New Hampshire","taxId",17752,"location","New Hampshire","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6650823,"House Finance Division 3 recommends Ought to Pass on HB 71 in 5–4 vote",217,14400000,14617000,"/Search/View?dp=1&key=2503344-0db7686d294c93f05cf8b3332a84208f&start=14400&end=14617","https://assets.pipeline.soar.com/2503344-0db7686d294c93f05cf8b3332a84208f/thumbnail_14400000.jpg","/articles/6650823/New-Hampshire/House-Finance-Division-3-recommends-Ought-to-Pass-on-HB-71-in-54-vote","https://secure.pipeline.soar.com/6650823-508e418e7b076d6c35a73e4bddd980f3/orig.mp4?Expires=1773700490&Signature=FY3l~Bo2xDecsvuzuRQcNqrN-getdETAkoZoYeVVIA3EEJHnokYJCCcdx6kvHQ9avUfq29onReqwwb~vEmAhYoTVDZwfMK~BfjTXTb4-3JT63n0mhj~M8IKaf1pZeWOh~8MkB67Aw-Sfv6KmPM6fCXQg9piw9gChqegmL~nDyqVRanAwv-fHN1B3VHYLNMaK6frr9iTlwPK50H71vMGWr3nKcIVOCxxInBWApWzxaYlpRmPGFGviR5ZZj3WPlTPSOmrJOeqLw6QRR~FxZ8drrlSao2juF4HtHy0sNUGsERa42tt-8dF72xIwmnezGK0tEEg11lto~5fJxeAapd6uvg__&Key-Pair-Id=KUT5TJCACFTXG","House Finance Division 3 took a final committee vote on House Bill 71 during its March 5 work session. Following a short discussion that included questions about the bill's language and a fiscal note, Representative Daniels moved Ought to Pass and the motion carried on a 5–4 recorded vote.

Committee discussion before the vote focused on whether the bill's statutory language was sufficiently precise, and whether the bill could create unintended fiscal exposure to federal funds under a worst‑case interpretation. Several members said they were concerned the bill text could be read more broadly than the sponsors intended; other members said the scope was narrow and unlikely to trigger the worst‑case fiscal exposure. The minority indicated it would prepare a written minority report to accompany the committee recommendation.

Committee staff recorded an Ought to Pass recommendation with a 5‑to‑4 tally. Division members who requested additional follow‑up said they would prepare documentation for the full finance committee as the bill moves forward.","After brief debate, Division 3 voted 5–4 to recommend HB 71 as Ought to Pass. The committee recorded requests for additional fiscal context; a minority report to accompany the committee recommendation was announced.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6650829,"DHHS outlines recent Medicaid service additions and waivers: doula care, adult dental, mobile crisis, DRF beds and reentry supports",795,5355000,6150000,"/Search/View?dp=1&key=2503344-0db7686d294c93f05cf8b3332a84208f&start=5355&end=6150","https://assets.pipeline.soar.com/2503344-0db7686d294c93f05cf8b3332a84208f/thumbnail_5355000.jpg","/articles/6650829/New-Hampshire/DHHS-outlines-recent-Medicaid-service-additions-and-waivers-doula-care-adult-dental-mobile-crisis-DRF-beds-and-reentry-supports","https://secure.pipeline.soar.com/6650829-81eace78887d797657671ad95a766d9d/orig.mp4?Expires=1773700490&Signature=TgkzwRPZBFmnHfRB1w~fEZpU2mn2DRk0cYaVWeQYRNgFc-nKlCyytYwQyjLh2J66fED33A9dCVafHmH-Vq32YTEVX2RBEA77tcpbj1o0oPB2RqE-qqrv-VYL1Ajvb5n-qUuiexxvJBYvhpWueJegy1ZQc7KkgVfyyroR3l~-qZTbs50Nj~dOZX7vYmk40PkSftrwH99-5a7bRQovlTpBhS~cKaK2If1DeN63TPvgkiwfSV8Lq~X95syd0p5E6qD6nfshNofJkKMun0s-RLSKt24776yi1Pa8jfZMTuH47qVZm-0G4-lHarqp4YwGJ3~AvO79ycitjNMmMF0F0hxZ3g__&Key-Pair-Id=KUT5TJCACFTXG","Department of Health and Human Services officials told House Finance Division 3 on March 5 that the department has implemented or requested a broad set of Medicaid service additions and waivers since 2019. The department provided a handout that enumerated nearly 39 service or eligibility changes enacted or pursued in recent years; Division members asked about costs, implementation timing and the populations served.

Highlights from the DHHS presentation included:
• Adult dental benefit: Implemented April 2023; DHHS said the benefit was intended to include denture coverage for some long‑term settings and to lower emergency‑room use for dental conditions. DHHS prepared a state‑plan amendment to expand access and detailed related cost‑sharing decisions.
• Doula and lactation services: The legislature added doula coverage and expanded lactation service settings. DHHS said rulemaking with the Office of Professional Licensure and Certification (OPLC) was required before implementation and that short‑term costs may be offset over time by improved maternal outcomes and reduced emergency‑care use.
• Mobile crisis and community behavioral health: DHS described obtaining enhanced federal match opportunities to build mobile crisis teams so communities get an 85% federal match for qualifying services; the program is part of a broader effort to expand community‑based mental‑health supports and reduce inpatient backups.
• Designated receiving facilities (DRFs) and transitional housing: The department described targeted rate increases to expand DRF beds and transitional/supportive housing intended to reduce emergency‑room backups and improve discharge options from hospitals and state facilities.
• Reentry and discharge supports: DHHS talked about a waiver to provide certain transitional services and discharge prescriptions for people leaving correctional settings. The state intends those targeted, budget‑neutral services to reduce recidivism and emergency‑room use by ensuring timely medications and community provider connections at release.
• Home and community‑based presumptive eligibility and other waiver work: DHHS has filed waivers (including an 11‑15 waiver renewal) to expand institutional alternatives and to allow presumptive eligibility for home and community‑based care while formal eligibility paperwork is processed.

Committee members asked about the populations reached, the number of beds and locations for DRFs, and the ability to staff expanded services. DHHS said some capacity is constrained by workforce shortages — particularly behavioral‑health clinicians and home‑care workers — and that sustaining services statewide requires continued investments. DHHS committed to returning with additional data on program counts (beds, targeted populations) and the estimated annualized costs for the notable service additions.

Public commenters and advocates who spoke during the meeting asked the committee to consider the fiscal and access tradeoffs of co‑pays and premiums while preserving gains on mental‑health, maternal and dental coverage.","In a detailed handout, DHHS reviewed service additions and state plan/waiver changes enacted since 2019 — including adult dental, doula coverage, mobile crisis teams, designated receiving facility (DRF) rate increases and a waiver for transitional reentry supports for people leaving correctional facilities.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6650834,"Division 3 reviews Granite Advantage trigger law, enrollment trends and funding options",368,744000,1112000,"/Search/View?dp=1&key=2503344-0db7686d294c93f05cf8b3332a84208f&start=744&end=1112","https://assets.pipeline.soar.com/2503344-0db7686d294c93f05cf8b3332a84208f/thumbnail_744000.jpg","/articles/6650834/New-Hampshire/Division-3-reviews-Granite-Advantage-trigger-law-enrollment-trends-and-funding-options","https://secure.pipeline.soar.com/6650834-1eafc918231df11dc1096f5be6666e36/orig.mp4?Expires=1773700490&Signature=BElvZiEY~OjLOsnJuc2HcG4xjatyB7WJPaNLLDXw9Nwy8UwMy5suRwdw3rV35LMTne26yNdASknsBAhG~tQq~VKoWCzvpJ0pdmkZyQEYYYwRUU0~BcMn~ynEU1~20nfb1iSNw8oppGr4XNFmJpfiTNQwFHqjBTMvk0mBcW6-OAqjYUvx3Xs7IOgHn9iG3NojXXcpskaJ3XSJ177jt~VVioZ5r1~GalgeoxTvfOElWdXdN8ZMT8G7o209W-7TX27uPA7HFGFFUa-hJfKJjb05FR5a-NbLfb9NrnRPGe-Nnb6tqcErXRMwZFDCF8PUSNHoE1HEk8khSezMrsz3eRlE8g__&Key-Pair-Id=KUT5TJCACFTXG","House Finance Division 3 spent part of its March 5 work session examining the Granite Advantage healthcare program, the state 'trigger' law that could end expansion if the federal match dropped below statutory thresholds, and the funding sources that back the program.

Henry Littman, Medicaid director, told the committee that as of March 3 the Granite Advantage (Medicaid expansion) caseload was just under 59,000 active enrollees; over the course of the previous 12 months roughly 87,000 individuals had participated in the program, and over the life of the program more than a quarter‑million residents had had some period of enrollment. Littman said the average tenure in the expansion group was less than one year, and that some of the caseload fluctuation reflected transitional coverage for people awaiting disability determinations or taking advantage of 12‑month postpartum coverage.

Representative concerns focused on the state’s statutory “trigger” mechanism, enacted as chapter law, which currently says that if the federal match for the expansion falls below 90% the program requires notice to legislative leaders and a sunset after a fixed wind‑down period (Laws of 2018, chapter cited to Division). Committee members asked whether DHHS had modeled sensitivity scenarios for reduced federal match levels such as 88% or 85%. Littman said the department had looked at high‑level scenarios and that Granite Advantage funding is structured under current law to rely primarily on federal match — with a remaining state share funded by a mix of premium taxes on insurance policies, liquor commission transfers, and a contribution from the New Hampshire Health Plan (the state’s historic high‑risk pool). He noted that under current statutes some sources (liquor proceeds and premium tax revenues) are limited in size and that legislative action could be required to change the law or identify alternative state funding if the federal match declined.

DHHS provided a program cost example for FY25 showing total program costs of roughly $620 million with $582 million financed by the federal match; the remainder would have to come from the premium tax, liquor funds and other non‑general‑fund sources under existing statutes. Committee members requested further sensitivity analyses and timeline clarifications, and sought the precise statutory citations for the chapter law (DHHS referenced chapter law “section 342:12, laws of 2018” during the session).

The department also explained the administrative steps that would follow a trigger event: statutorily, the commissioner must notify executive and legislative leaders within a short period (DHHS cited 48 hours for gubernatorial/legislative notice and 10 business days for notice to program participants), and the program repeal would follow the statute’s wind‑down period (DHHS cited 180 days in the chapter law language the committee examined).

Members asked for written follow‑up with sensitivity scenarios showing fiscal impacts under different federal match percentages and for a clear list of the statutory citations and the expected timeline required by the trigger law.","Members pressed DHHS about the state's 'trigger' law for Medicaid expansion, current enrollment counts and the mix of funding sources that would cover Granite Advantage if the federal match changed.","actionData","errors"]

Article not found

Division 3 advances Medicaid budget changes in HB 2 including premiums, co‑pays and eligibility adjustments

House Finance Division 3 recommends Ought to Pass on HB 71 in 5–4 vote

DHHS outlines recent Medicaid service additions and waivers: doula care, adult dental, mobile crisis, DRF beds and reentry supports

Division 3 reviews Granite Advantage trigger law, enrollment trends and funding options