By Rosemary Ford and Melanie Plenda

NH PBS and Granite State News Collaborative

Whether or not to renew recent efforts to expand Medicaid insurance coverage for Granite Staters is back before the state legislature. At one point this was a tough sell in the legislature. Fiscal conservatives were concerned it would create increased dependence on the government, while advocates said it improves insurance coverage, health outcomes, and saves lives. Lawmakers have voted twice to continue the program which was vital during the pandemic, and must decide whether to do so again this year. If they don't, benefits are set to end for tens of thousands of people according to officials. 

On this week’s episode of The State We’re In, Paul Cuno-Booth, who covers Health for New Hampshire Public Radio, insurance expert and president of Market Health Connect Keith Ballingall, and Amber Macquarie, one of the thousands of Granite Staters affected by the expansion will discuss what Granite Staters can expect.

This interview has been lightly edited for length and clarity.

Melanie Plenda:

Who does this affect and what sort of impact does Medicaid expansion have on the state? 

Paul Cuno-Booth:

Medicaid expansion typically covers 50,000-60,000 Granite Staters. It's actually gone up during the pandemic because of some temporary rules, but a recent analysis by the New Hampshire Fiscal Policy Institute found Medicaid expansion really expanded healthcare access for thousands of people in the state. It particularly had that impact for people of color in New Hampshire and people in rural areas. It's important to note this includes mental healthcare and substance use treatment to ongoing areas of concern for New Hampshire. More than 8,000 people used Medicaid to access substance use treatment in the last fiscal year. More than 29,000 people used it to access mental healthcare. It's also worth noting that Medicaid expansion enrollees is not a static population, so as people lose a job or have other changes in their lives, they may come on and off the program as sort of that temporary safety net. 

Melanie Plenda:

What happens on April 1st?

Paul Cuno-Booth:

This is a separate issue than whether to reauthorize Medicaid expansion, but these special pandemic related rules I mentioned will end. These have essentially allowed people who enroll in Medicaid to stay on Medicaid regardless of changes in income. It also means that if they don't file certain paperwork they can stay on the program - the idea is you don't want people losing health coverage right in the middle of the pandemic. So those rules are ending. That means, um, anyone who wants to keep their coverage and is still eligible needs to actually submit certain information, take certain steps to do so. So over the coming months, the state health department will be sending everyone information on specific cards, I think they're either yellow or green, but cards that should stick out in the mail to remind people of the steps you need to take and to give us this information if you want to keep receiving these benefits. 

Melanie Plenda:

What can people do if they're worried about their coverage and looking for information? Do you have any advice about what steps they can take?

Paul Cuno-Booth:

The most immediate thing that the State Health Department wants people to be aware of is that these rules are ending related to continuous enrollment during the pandemic. So again, it's really important to pay attention to your mail. Look for these cards the Health Department is sending out. As many as 70,000 or more people may need to go through redeterminations in the coming months, and if that process doesn't go through people could lose coverage, even if they're entitled to it. So I think that's the most immediate thing for many people, is just making sure that those steps are taken care of to maintain their coverage.

Keith Ballingall:

It can be tricky to understand how to get coverage. Is it Marketplace? Is it Medicaid? Is it Granite Aadvantage? Health Market Connect is a federally funded program. We are here to help the residents in the state of New Hampshire. Our navigators sit in different parts of the state to make sure that we understand the regions. We have navigators that speak eight different languages that are here in New Hampshire, and we will assist people in person, over the phone, Zoom, however they need to be helped. Understand that our team is here to make sure wherever that solution is, we'll make sure somebody gets covered with health insurance.

Melanie Plenda:

Do you have any other advice for people who might be new to the marketplace and looking for coverage? 

Keith Ballingall:

A lot of times people will start with Medicaid and they may or may not get it, or they'll start with calling the Department of Health and Human Services in the state, which has done an amazing job through all these processes and things going on but they're super busy.  Reach out to us instead. We are an organization that exists to assist people. We are fortunate that we are in a very small state, a very interconnected state or hospitals, health centers, etc. We all really try to work together to make sure people get the coverage they need.

Melanie Plenda:

How can people access your service? Can you walk us through how it works?

Keith Ballingall:

Let's start with how to find us: hmcnh.com, Health Market Connect New Hampshire. There's a book and a meeting tool where somebody can book a meeting, pick a day and time you want to be called, pick the language you want to be called back in - even American Sign Language. You can also call (603) 309-2021 - we will ask simple questions relative to the family and help guide through income, household size, who's on the tax return, etc. Back to Amber's example, we have a lot of people in the state of New Hampshire who are self-employed, and I think sometimes that gets tricky. What counts as income? And we will help them understand whether it's on the Medicaid side or the Marketplace side, how that plays out, and make sure they have the proper coverage.

These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.