Medicaid waivers are opportunities for states to make decisions associated with delivering and paying for health care services for that state’s residents. In 1981, the Omnibus Budget Reconciliation Act of 1981 put these options into place. It un-tied states’ hands in many ways and allowed each to determine its various needs associated with institutionalization, children’s healthcare, healthcare for the elderly and other important community based services.
Political Channels
A group of bipartisan senators worked out an agreement that would provide health care insurance to 50,000 New Hampshire residents via Medicaid waivers. The residents must fall below 138 percent of the federal poverty level using 100 percent federal funding for the next three years.
Senate President Chuck Morse, R-Salem made the announcement with Senate Democratic Leader Sylvia Larsen, Concord, and they explained how the Medicaid waivers would work. The plan will require three federal waivers, would sunset after three years without continued 100 percent federal contributions and would use private insurance to reach the additional low-income residents in New Hampshire. This is exactly the reason why Medicaid waivers are a good thing.
Morse called it a “prudent” approach to “take care of those people that need help and give them private health insurance.”
The details haven’t been released yet and our guess it’s simply because they’re still doing their checks and balances, but it’s expected to be wrapped up in mid-February. They will announce that as well.
Governor Maggie Hassan has shown her support, most recently during the State of the State address, though she did release a brief statement following the announcement last week, “With today’s positive step forward,” she said, “it’s clear that we can work through this together and help working people access critical health coverage.
New Hampshire Medicaid Waivers
Morse said the timeline, which had been the sticking point in long debate over Medicaid expansion, now has “firm deadlines and a firm approval process, “and a requirement that if for any reason the waiver necessary to implement private insurance is not approved, then the program will end on June, 30, 2015.” He also explained the built in safety mechanisms for taxpayers. He said the sunset clause ends the programs if the Medicaid waivers are not approved or if federal funding falls below 100 percent.
One reason this is such a win-win is the absence of the requirement of the state having to contribute half of the funding. The Medicaid waivers ensure that. “Medicaid would have hurt the state,” he said, “because someone else would have to match that 50 cents.
“If we had been debating that, I don’t think we’d be at this point right now,” Morse said. “What we did go to was a framework that brought in private health care, brought in health insurance policies that pay 150 cents on the dollar and Medicare rates that pay 85 cent on the dollar. Those are all positive things.”
The waiver process is an 1115-B and will effectively “change the way we deliver healthcare in New Hampshire”. These waivers provide program flexibility for those looking to better finance and deliver Medicaid. States use these particular waivers to test new approaches for delivering Medicaid. This is good news for thousands of seniors.
Have questions about how these Medicaid waivers can help the seniors in your family? Contact one of our elder law and estate planning lawyers today. We stand ready to explore these new options with your family.
Daniel DeBruyckere
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