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Trouble for Obamacare in New Hampshire

By Sarah KliffPublished: May 29, 2013
Welcome to Health Reform Watch, Sarah Kliff’s regular look at how the Affordable Care Act is changing the American health-care system — and being changed by it. You can reach Sarah with questions, comments and suggestions here. Check back every Monday, Wednesday and Friday afternoon for the latest edition, and read previous columns here.

If a health insurance marketplace launches in the woods with exactly one insurance carrier, does it count as a marketplace at all?
This is not an odd health policy riddle (although that sounds fun as well!). It is actually the situation in New Hampshire, where its increasingly looking like just one health insurer, Anthem BlueCross BlueShield, will compete on the exchange – if that counts as competing at all.  An official from that the plan confirmed to the Associated Press that it would sell in the New Hampshire market. A spokesperson did not return a request for comment. The state insurance department, meanwhile, says its quite possible that the exchange could end up with one competitor.

“We expect the exchange to look a lot like our individual market, where there’s one carrier with about 90 percent of the business,” says Alex Feldvebel, deputy commissioner at the New Hampshire Department of Insurance. “It’s not very surprising that in New Hampshire, there might be only one carrier offering coverage through the exchange.”

New Hampshire appears to be the first and, so far, only state on the path to a one-plan marketplace. This is in stark contrast to states like California, which will have 13 states on its health insurance exchange or Colorado, where 11 plans will be offered.

Group Health Insurance in New Hampshire
  • Coverage at the same price is available to every eligible applicant in New Hampshire, despite health problems and late enrollment.
  • Some life changes may provide more opportunities for group coverage.
  • New employers may impose a wait period on new employees.
  • The medical history review period for pre-existing conditions is three months long for fully insured policies and six months for self-insured plans.
  • Group health providers can require an exclusion period for pre-existing conditions.
  • If continuous coverage is maintained without a lapse of more than 63 days, creditable coverage is available.

Small Business Health Insurance in New Hampshire

  • Small businesses with up to 50 employees may not be denied small group coverage.
  • Coverage may not be cancelled because of illness within the employee group, though costs may be increased.

Self-Employed Health Insurance in New Hampshire

  • The self-employed may purchase small group health coverage.
  • Consult the New Hampshire Insurance Department for rules concerning business associations with group health coverage availability.

New Hampshire Insurance Department 
56 Old Suncook Road 
Concord, NH 03301
(603) 271-2261

Individual Health Insurance in New Hampshire

  • Providers may deny coverage based on a health problem.
  • Those who are HIPAA eligible may be denied individual insurance.
  • For pre-existing conditions, providers may review medical history for the three months prior to coverage.
  • If there is a pre-existing condition, coverage may be excluded for up to nine months.
  • Providers may attach an exclusion rider for a pre-existing condition.
  • Providers may classify pregnancy as a pre-existing condition.
  • There are limits on the cost of individual policies and coverage cannot be cancelled due to sickness.

New Hampshire Health Care Programs

  • Assistance is provided for those who can not afford health care coverage through the New Hampshire Health Plan.
  • Those who are HIPAA eligible may use the Health Plan for coverage.
  • Medicaid, Healthy Kids, and Let No Woman Be Overlooked are available to low income individuals.
Location Status of State Exchange Decision Medicaid Expansion Decision Executive Activity
New Hampshire Planning for Partnership Exchange Supports