New Hampshire Senate Bill 313 (SB313) reconfigures NH Medicaid in various ways, including:
A person receiving Medicaid expansion benefits would have to work or perform community service of 100 hours a month, or be in training or a treatment program, or be a caregiver or pregnant in order to retain eligibility.
And a person could not have assets greater than $25,000 not counting a home or an automobile.
Full story here: indepthnh.org/…
Current status, according to AFSC NH State House watch:
There isn’t much coming up in Senate committee hearings, but on Monday, Tuesday, and Wednesday, a number of committees have executive sessions. There is no listing of the bills that are due to be exec’d. We believe in transparency, and we encourage the Senate to abandon this practice.
Here’s why: SB 313 the bill “reforming” the NHHPP is going to be exec’d on Tuesday, March 6 in Finance, Room 103, State House, at 1:00 PM. There’s an expectation that it will be on the voting session calendar two days later. The intent seems to be to push this through with as little public notice as possible.
It is my understanding that the ACA does not allow asset testing for the Medicaid expansion population, so I’m guessing this bill would be looking for a waiver from the federal government — someone please fill me in if you are in the know as to how that would work.
In any case, this is something I think has been a problem from the start: trying to provide “insurance” through an entity which sees itself as providing “welfare.” New Hampshire prides itself on the expectation that “welfare” of any kind is to be paid back if and when at all possible. It looks like this bill would establish a precedent that all Medicaid expansion recipients would have to report their assets to NH Medicaid, something that has so far not been required.
If this bill passes, if you are low income (138% of FPL at this time is around $17K, I believe) and have more than 25K in assets and/or are not working 25 hours per week, you cannot have ACA insurance.
The bill also provides an unusual method of funding: a state “trust fund:”
And the program does not allow state general fund money to pay its share but establishes a trust fund much like earlier versions of Medicaid expansion. The trust fund will be the source of state’s payments and will accept “any gifts, grants, donations, or other funding from any source.”
If the money in the trust fund is not enough the program will end.
What could go wrong?
Meantime premiums for healthy folks in their 60s here are now over $1000 per month, about double what they were when we started with the ACA 3 years ago. Plainly if you are anywhere near the FPL level such premiums are not affordable without the ACA subsidy.
Some may observe that there are probably not a large number of people who would be directly affected by such provisions. I would respond that these kinds of provisions are the thin edge of the wedge, and that for those affected immediately these changes could be disastrous.