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Is NH’s expanded Medicaid funding illegal?

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According to representatives of President Trump’s administration, New Hampshire’s funding for expanded Medicaid eligibility may violate federal law.

Donations are part of NH’s expanded Medicaid funding

The problem is “voluntary provider contributions” from hospitals and insurance companies.  Those payments were instituted in 2016 to cover falling federal reimbursement rates for expanded Medicaid.

Theoretically health care providers have money to donate to the expanded Medicaid program because they are spending less to treat patients without insurance.  There is not very much information on where exactly the donations come from or how they are shared among hospitals, however. 

Donations may violate federal law

According to a July letter from Briane Neale, Director of the federal Centers for Medicare and Medicaid Services, New Hampshire’s use of donations violates federal law.  In particular, there is supposed to be no relationship between a provider’s donations and Medicaid payments to that provider.  The federal government argues there is a relationship because New Hampshire’s expanded Medicaid program would stop if there were not enough donations.

In his letter, Neale said New Hampshire has until 2019 to come up with a new funding scheme, so New Hampshire’s expanded Medicaid program will continue as-is through the next year.

An attempt to sabotage expanded Medicaid?

A spokesman for Sen. Maggie Hassan said the voluntary donations were cleared under President Obama.

“This is a deliberate attempt by the Trump Administration to sabotage New Hampshire’s bipartisan Medicaid expansion plan that is providing quality, affordable health care — including coverage for substance use disorder and mental health services — to over 50,000 hard-working Granite Staters.”

- Aaron Jacobs, Communications Director for Hassan

What comes next?

When the New Hampshire Legislature convenes next year, they will have to decide whether or not to continue expanded Medicaid eligibility in 2019.  They will also need to decide how to fund the program.

Roughly 50,000 New Hampshire residents are currently enrolled in the program.

Do you have an opinion on New Hampshire’s expanded Medicaid program?  Share your thoughts in the comments below.

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