N.H. Medicaid Panels Hear Insurance Options

Concord — Subsidizing private insurance to cover poor adults eligible for Medicaid would be difficult at the outset, New Hampshire’s Insurance Department told a special commission studying Medicaid expansion on Tuesday.

The nine-member commission is charged with recommending to lawmakers by Oct. 15 whether New Hampshire should expand Medicaid to an estimated 49,000 poor adults under the federal overhaul law.

The panel has been holding a series of meetings to gather information about its options if the state decides to expand the program, including whether federal Medicaid money can be used to pay private insurers to cover the adults.

The Insurance Department said the private coverage option would have to be voluntary to avoid getting a waiver from some of the federal law’s requirements. The coverage also would have to be comparable to what Medicaid provides, which might require the state to purchase additional coverage to comply with the law.

A waiver would allow New Hampshire to encourage some adults who would qualify for Medicaid to enter an insurance marketplace and use Medicaid funding to pay for the private coverage. Under the overhaul law, new insurance marketplaces will offer individuals and families a choice of private health plans resembling what workers at large companies already get.

The Insurance Department said employer-sponsored coverage is unlikely to be affordable to the new Medicaid population. They also noted that an estimated 22,300 of the people eligible for Medicaid coverage would be left without access to health coverage if the program isn’t expanded.

State Rep. Neal Kurk, a Weare Republican, asked if expansion would stretch the New Hampshire health care system’s capacity and cause delays in currently insured patients being served.

Tyler Brannen, an insurance health policy analyst, said there would probably be some delays but not for long.

“The market will respond to a new paying population,” he said.

State Rep. Thomas Sherman, a physcian and committee member, said doctors already are treating the people without being paid for their services.

“The truth is, it’s not a new population. The people are getting care,” said Sherman, a Rye Democrat.

Insurance Department representatives said New Hampshire’s health care system would benefit overall by expanding the program because people like Sherman would be paid for their services.

New Hampshire’s current Medicaid program covers low-income children, parents with nondisabled children under 18, pregnant women, senior citizens and people with disabilities.

The expansion would add anyone under age 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,000 for a single adult.