Dive Brief:
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The CMS said it will end federal funding to New Hampshire’s Medicaid expansion next year unless the state stops accepting voluntary donations from hospitals to fund the program, Modern Healthcare reported.
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New Hampshire legislators approved a fund in 2015 to pay for Medicaid expansion after federal funding decreased in 2016. Part of the program allows hospitals to voluntarily donate to the fund.
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The CMS called the hospital payments “an important aspect of New Hampshire’s arrangement” to pay for Medicaid costs, which the agency said violates federal law.
Dive Insight:
The CMS said in a letter to New Hampshire Gov. Chris Sununu: “CMS believes there is a relationship between the donations and Medicaid payments because Medicaid expansion is conditioned on the receipt of donations as articulated in New Hampshire legislation.”
Unless New Hampshire changes the policy, the CMS will stop paying for Medicaid expansion to the state.
There are nearly 53,000 New Hampshire residents covered through Medicaid expansion, who could lose coverage if the funds dry up. The governor said state leaders will need to figure out another funding solution. Another governor, Maggie Hassan, was in charge when the funding program was approved. Last year, Hassan, now a U.S. senator, rejected a waiver that would have required work and higher standards for proof of U.S. citizenship and state residency to take part in the state's Medicaid program.
New Hampshire was one of 31 states, as well as the District of Columbia, that expanded its Medicaid program. Medicaid expansion led to more than 11 million insured Americans, which is more than half of the 20 million newly insured Americans after the Affordable Care Act.
Ending Medicaid expansion could mean 53,000 losing coverage and may increase uncompensated care for hospitals in the Granite State. Children make up about half of Medicaid enrollment and 45% of children with special healthcare needs are on Medicaid. Ending Medicaid expansion will wind up affecting children, especially at-risk children, so expect New Hampshire leaders to either push back on the CMS claims or figure out another way to fund the expansion.