PHE; STATE NEWS (NH)- Fiscal Committee Votes to Accept $51.5M in Federal Medicaid Money

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[MM Curator Summary]: This is what the details of planning for the dwindling extra PHE FMAP looks like in one state.



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Health and Human Services Medicaid Director Harry Lipman, left, and chief financial officer, Nathan White, discuss accepting $51.5 million in federal money to cover the cost of about 100,000 Medicaid recipients who may no longer qualify after the federal health emergency declaration ends March 31.


CONCORD — The state will have $51.5 million in additional federal funds to support Medicaid recipients who qualified under relaxed guidelines due to the COVID-19 pandemic.

The Joint Legislative Fiscal Committee Friday approved accepting the federal enhancement money as the state begins the process of determining if about 100,000 people who were added to the Medicaid rolls due to the pandemic qualify for the program under normal eligibility requirements.

After the federal COVID-19 Emergency Declaration ends March 31, the state will begin the process and have up to a year to complete it.

Under the emergency declaration, those on Medicaid, the state-federal health insurance program, were automatically re-enrolled.

During the pandemic the federal Medicaid match was increased by 6.2 percent, which ends March 31, and then is 5 percent through June, 2.5 percent through October and 1 percent until the end of the year.

The $51.5 million is what the state expects to receive from the federal enhancement through this calendar year.

At the fiscal meeting, Harry Lipman, state Medicaid Director, said his agency anticipates it will need almost all of the federal money to cover the additional people added to the Medicaid rolls during the pandemic.

“We are carrying 102,000 people who would not be on the program under normal circumstances,” he said, “and this allows us to cover this extra (enrollees).”

He noted the state has one of the lowest bases in the country.

Both Lipman and Nathan White, the Health and Human Services Chief Financial Officer told the committee the agency has never attempted an “unwinding” like this before and they are unsure how it will go.

Lipman noted the federal poverty level changed recently and that added 1,700 people who will now qualify under normal eligibility for Medicaid.

White noted the agency will work in phases to disenroll thousands of people.

“You don’t know how many will appeal,” he said, “and if they do, they stay on Medicaid until it’s resolved. It’s a big unknown.”

The agency has been contacting people who are on Medicaid under the emergency declaration to set up appointments to see if they qualify under the normal requirements.

According to information given to the committee, “the department is diligently developing an unwind plan with the goal of ensuring that there are no gaps in medical coverage, whether that coverage is continued Medicaid or other sources of private or Marketplace coverage, and which is consistent with the budget in managing coverage transfer or disenrollment within a three-to-four-month timeframe.”

Committee member state Sen. Cindy Rosenwald, D-Nashua, noted the department lapsed federal Medicaid funds last year and wanted to know if they would be doing the same thing with this money.

Lapse is money appropriated, but not spent by the end of the fiscal year.

Lipman said last year the agency thought the federal government might end the declaration in October, and carrying the money forward has allowed the department to cover the additional Medicaid costs through March 3 of this year through the continuous enrollment provision.

He said if everything goes perfectly as they unwind the additional recipients, there could be a small lapse, “but if there is some bumpiness, we’ll need the money to cover people.”
The pandemic emergency resulted in an increase of income- based eligibility that was highest in Rockingham County at 29.3 percent and lowest in Belknap County at 20.3 percent.

Increase in Medicaid covering the disabled, elderly and foster care was highest in Rockingham County at 18.8 percent and lowest in Coos County at 10.4 percent according to information distributed to the fiscal committee.

Winter Maintenance

The committee also approved the transfer of $3.6 million from the Highway Fund Surplus Account to cover winter maintenance of the highway system.

The biggest increases department officials told the committee are the price of salt and overtime and leased and contracted services to plow and treat the roads, due to a workforce shortage.

The money will cover the remaining winter season for the department.

Garry Rayno may be reached at