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Notice of Amendment to Demonstration Authority

Notice is hereby given that the New Hampshire Department of Health and Human Services (DHHS) seeks to amend its Section 1115(a) Research and Demonstration Waiver, #11-W-100298/1 entitled, the New Hampshire Health Protection Program (NHHPP) Premium Assistance, with such amendment to be effective January 1, 2017.

Summary of Demonstration
Under the NHHPP Premium Assistance demonstration, New Hampshire uses premium assistance to support the purchase of health insurance coverage for beneficiaries eligible under the new adult group provided via certain qualified health plans (QHPs) doing business in the individual market through the Marketplace. The demonstration affects individuals in the new adult group covered under Title XIX of the Social Security Act who are adults from age 19 up to and including age 64 with incomes up to and including 133 percent of the federal poverty level (FPL) who are neither enrolled in (nor eligible for) Medicare or enrolled in the state’s Health Insurance Premium Payment (HIPP) program.

Proposed Amendment
The proposed amendment seeks to effect the following modifications:

  • Modify eligibility to be inclusive and consistent with the federal Temporary Assistance for Needy Families (TANF) Program, 42 U.S.C. section 607 (d), as well as require that newly eligible adults who are unemployed be eligible to receive benefits if the Department of Health and Human Services finds that the individual is engaging in at least 30 hours per week of one or a combination of other clearly outlined activities.
  • Modify eligibility such that a participant cannot be eligible for coverage unless such person verifies his or her United States citizenship by 2 forms of identification and proof of New Hampshire residency by either a New Hampshire driver’s license or a non-driver’s picture identification card.
  • Modify cost-sharing requirements such that newly eligible adults who participate in the demonstration who visit the emergency room for non-emergency purposes shall be required to make a co-payment of $8 for the first visit and $25 for each and every non-emergency visit thereafter.
  • Provide that all veterans who are current New Hampshire residents shall receive medical and medical-related services from any hospital in the state providing services to the newly eligible Medicaid population.
  • Waive comparability in cost-sharing requirements for the medically frail NHHPP participants under managed care and NHHPP participants who are in the Premium Assistance Program demonstration.

Existing waiver and expenditure authorities will be not modified. However, the following will be added:

  • Section 1902(a)(17) comparability of cost sharing in order to allow for different co-payments between NHHPP medically frail and the NHHPP PAP demonstration participants.
  • Section 1902(a)(10)(A)(i)(VIII) requirements related to eligibility to add as a condition of eligibility individuals who are veterans may be eligible and those who are unemployed must engage in at least 30 hours per week in one or a combination of the activities defined in 42 U.S.C. Section 607 (d).
  • Sections 1137, 1902(a)(46)(B), 1902(ee), and 1903(x) of the Act which governs verification of citizenship and immigration status.

Opportunity for Public Input

The complete version of the current draft of the Demonstration application is available for public review at Public comments may be submitted until midnight on August 1, 2016. Comments may be submitted by email to or by regular mail to Department of Health and Human Services, 129 Pleasant Street, Concord, NH 03301-3857. Comments should be addressed to Deborah Fournier, Deputy Medicaid Director.

Draft Waiver Amendment for Premium Assistance Demonstration Adobe Acrobat Reader Symbol

This notice, waiver documents, and information about the New Hampshire Health Protection Program (NHHPP) Premium Assistance Demonstration are available at: To reach all stakeholders, non-electronic copies of all the aforementioned documents are available by contacting the Department of Health and Human Services, Deborah Fournier, Deputy Medicaid Director at 603-271-9434.

The State will host one public hearing during the public comment period.

Tuesday, July 12 , 2016
1:00PM-3:00 PM
New Hampshire Department of Health and Human Services
Brown Auditorium
129 Pleasant St,
Concord, NH 03301

NH Premium Assistance Waiver Amendment Request

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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852

copyright 2016. State of New Hampshire