The New Hampshire Granite Advantage Health Care Program, established under RSA 126-AA, replaced the Marketplace Premium Assistance Program (RSA 126-A:5(:XXV)). This program is funded through assessments collected by the New Hampshire Health Care Association. This article outlines the program’s funding mechanism, its projected lifespan, and the process for reconciliation of funds.
Funding the Granite Advantage Health Care Program
The 2018 statutory amendments to RSA 404-G mandate the Health Care Association to collect funds from its members for the Granite Advantage Program. These funds are deposited into the Granite Advantage Health Care Trust Fund. The collected amount is capped at the lesser of the “remainder amount” (RSA 126-AA:1(V)) or the revenue transferred from specific sources. These sources include the alcohol abuse prevention and treatment fund (RSA 176-A:1(IV)) and taxes linked to premiums and medical services for newly eligible Medicaid recipients.
To comply with these changes, the Association adopted the First Amendment to its Restated Plan. This amendment, approved by the Commissioners of the New Hampshire Department of Health and Human Services and the New Hampshire Insurance Department, allows the Association to transfer unused funds from the former Marketplace Premium Assistance program, along with related expenses, into a reserve fund for contingencies arising from the Granite Advantage Program.
Program Sunset and Reconciliation Process
The Granite Advantage Health Care Program is currently scheduled to terminate on December 31, 2023, unless extended by future legislation. In the absence of an extension, the Association is required to make a final distribution of assessed 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 calculate the final “remainder amount” and report it to the Association by February 15, 2025. This “true-up” process will determine if the collected assessments accurately reflect the program’s final financial needs.
If the assessments result in an underpayment, the Association will cover the shortfall using its reserve funds. If reserves are insufficient, a special assessment will be levied on the Association’s members. Conversely, any overpayment will be returned to the Association within 45 days of the Commissioner’s report. This ensures a balanced and accountable funding mechanism for the Granite Advantage Health Care Program.
