State insurance exchanges -New Hampshire

Summary of differences between federal and state regulations

The U.S. Department of Health and Human Services (HHS) must make a determination on or before January 1, 2013, that a state will in fact have an exchange in operation by 2014 and that the exchange meets the requirements of the Affordable Care Act (ACA) and HHS guidance. In a letter dated November 15, 2012, Secretary Sebelius indicated that a state may submit both a letter of intent and an application to operate its own exchange by December 14. If a state elects not to operate an exchange, or if the HHS determines that the state will not be able to have an exchange operational by 2014 that meets the law’s requirements, the ACA gives the HHS the authority to establish and operate such exchange within the state.

Governor Lynch signed HB 1297 into law on June 18, 2012, prohibiting New Hampshire from participating in or enabling a state-based health insurance exchange. HB 1297 does, however, allow for state agencies or departments to “interact with the federal government with respect to the creation of a federally-facilitated exchange for New Hampshire.”

The state received a $1 million federal Exchange Planning grant, but spent little of the money. With the passage of HB 601, $666,000 in unused funds was required to be returned effective July 2011 and the Insurance Commissioner was directed to decline certain exchange planning funds in the future.

With the passage of HB 1297, the federal government will assume responsibility for running a health insurance exchange in New Hampshire.

State

Contacts

New Hampshire Insurance Department

New Hampshire Department of Health and Human Services

Regulations

HB 1297

HB 601

Chapter 420-M: Purchasing Alliances

Chapter 420-N: Federal Health Care Reform 2010

Federal

Contacts Center for Consumer Information and Insurance Oversight (CCIIO)

U.S. Department of Health and Human Services (HHS)

Regulations

45 CFR Parts 155, 156, and 157