NH committee hears bill to repeal planned Medicaid premiums and copays, citing access and federal conflict
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Summary
Representatives, providers and advocates told the House Health Committee that planned Medicaid premiums and pharmacy copays would erect financial barriers to care and risk provider viability; the Medicaid director warned implementation and federal interactions create budget uncertainty.
Representative Laura Telerski introduced House Bill 17‑60 FNA, the "Protecting Access to Affordable Health Care for Working Families Act," telling the House Committee on Health, Human Services and Elderly Affairs that the measure would repeal a recent budget directive directing the Department of Health and Human Services to seek a waiver establishing pharmacy copays and Medicaid premiums for certain enrollees.
"Medicaid recipients are, by definition, our lowest income and most medically vulnerable neighbors," Telerski said, adding that even modest pharmacy copays "can become a real barrier, leading people to delay or skip medications." The bill would also strike copays and premiums from Granite Advantage and the Children’s Health Insurance Program and direct an appropriation to offset expected revenue shortfalls.
Witnesses from federally qualified health centers and provider organizations told the committee that premiums and copays will create direct financial barriers for patients and increase uncompensated care for safety‑net providers. Gregory White, co‑CEO of Lamprey Healthcare, said FQHCs treat large shares of low‑income patients and that requiring premiums "will create financial barriers for our patients and their families" and could force program cuts or service reductions.
Advocates cited historical evidence that premiums can sharply reduce enrollment. Sam Burgess of New Futures cited a case often referenced in testimony—Oregon in 2003—where the affected population’s enrollment dropped dramatically after sliding‑scale premiums were imposed and lockouts used for nonpayment.
State Medicaid Director Henry Lippman provided the administration’s perspective: he described the federal law cited in testimony as changing the Medicaid cost‑sharing landscape and noted that federal rules will exempt primary care, prenatal care, pediatric care and FQHC or Community Behavioral Health Clinic services from cost sharing. Lippman said the department is still working with the Centers for Medicare & Medicaid Services (CMS) on details and estimated initial implementation costs for administrative build‑out at under $1,000,000 but warned that foregoing premium revenue would create a larger gap in the Medicaid budget. "If in large sum total think about this way it'll create a $23,000,000 hole in terms of what Medicaid has to contend with," he said.
Committee members pressed for missing fiscal notes and implementation timelines; several said they remain concerned about the short window between state decisions and forthcoming federal requirements, and about the net effect of premiums on coverage and hospital finances in rural areas.
The public hearing closed without a committee vote. The committee later addressed multiple related bills and amendments during executive session.