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The Affordable Care Act’s vision for a reformed individual market was wobbling under the weight of increased costs and financial losses that made the market unsustainable for both consumers and insurers.
Consequently, it was estimated that 10,000 citizens, 40% of those who paid full premium, would justifiably determine this to be financially untenable and forgo having coverage.
■ New Hampshire’s approach to expanding Medicaid by putting eligible members on the individual market increased premiums due to inaccurate assumptions of patient utilization and because individuals could enroll in expanded Medicaid on a rolling basis outside of the open enrollment period.
In 2018, New Hampshire reformed its Medicaid expansion program to transition eligible citizens off the individual exchange and into managed care.
Over the course of the following year, the state launched the process of creating a reinsurance program that would further lower premiums. Reinsurance is a reimbursement mechanism that protects insurers from high medical claims for beneficiaries with complex and costly medical needs.
Further, the federal government listened to states, like New Hampshire, that requested additional funding to account for federal savings generated as more individuals entered the market during the COVID-19 pandemic.
Those actions also resulted in a highly successful special enrollment period in New Hampshire that ran from February to August of this year.