The New Hampshire Granite Advantage Health Care Program is a state initiative established to provide health care coverage to a specific population within New Hampshire. Originating from the 2018 Statutory Amendments to RSA 404-G, this program is crucial for understanding the healthcare landscape of New Hampshire, particularly concerning Medicaid expansion and funding mechanisms.
The program mandates the Association, likely an insurance association, to collect assessments from its members. These funds are then deposited into the Granite Advantage Health Care Trust Fund. This trust fund is specifically designed to support the Granite Advantage Program, as outlined in New Hampshire RSA 126-AA. It effectively replaced the earlier Marketplace Premium Assistance Program. The funding is capped at the lesser of a “remainder amount” as legally defined or the revenue from alcohol abuse prevention funds and taxes related to premiums and medical services for the newly Medicaid-eligible population.
To accommodate these legislative changes, the Association adopted the First Amendment to its Restated Plan. This amendment received approval from both the Commissioner of the New Hampshire Department of Health and Human Services and the Insurance Commissioner. A key aspect of this amendment is the authorization for the Association to redirect funds, not immediately needed for the Marketplace Premium Assistance program, into a reserve fund. This reserve is intended to cover potential financial needs arising from supporting the Granite Advantage Program.
It’s important to note that the 2018 Statutory Amendments included a termination date for the Granite Advantage Program: December 31, 2023. Unless future legislation extends this date, the program is set to conclude. Consequently, the Association is expected to make its final distribution of assessment funds to the Granite Advantage Health Care Trust Fund by February 15, 2024. Following this, the Commissioner of the New Hampshire Department of Health and Human Services will determine the final “remainder amount” by February 15, 2025, and report it to the Association.
This “true-up” process is critical for financial reconciliation. If the Association’s assessments fall short of the final remainder amount, the Association is responsible for covering the underpayment, either from its reserves or through a special assessment on its members. Conversely, if an overpayment occurred, the excess funds will be returned to the Association within 45 days of the Commissioner’s report. Understanding these financial mechanics is key to grasping what the Granite Advantage Health Care Program entails and how it operates within New Hampshire’s healthcare system.
