Even with President-elect Donald Trump’s promise to “repeal and replace” the Affordable Care Act, New Hampshire residents getting insurance as a result of the law likely wouldn’t see immediate changes.
Since 2017 insurance policies have already been set, any change in available health insurance plans before 2018 would be difficult, said New Hampshire Insurance Department Commissioner Roger Sevigny.
“Insurance coverages are set far in advance,” Sevigny said. “Once a policy is issued, it’s good for a full year.”
Beyond that, the future is uncertain.
“It’s hard to determine what impact changes would have,” Sevigny said.
The changes proposed by Trump could affect people who are now able to buy plans on the individual marketplace as well as those on expanded Medicaid.
About 49,000 people in New Hampshire get insurance through the state’s health exchange, according to numbers from the U.S. Department of Health and Human Services.
Of those people, 63 percent receive premium subsidies from the federal government. An additional 35 percent receive cost-sharing subsidies.
The 52,000 New Hampshire residents who are enrolled in expanded Medicaid could also be affected. That program is authorized until 2018, and 95 percent of the cost is covered by the federal government.
Last week, incoming Republican governor Chris Sununu did not offer specifics on what would happen to the program under his administration. Addressing the federal government’s recent rejection of New Hampshire’s work requirements for its Medicaid recipients, Sununu said he would wait and see what happens in the Trump administration.
“A lot of things may change in the federal government in the next six months,” Sununu said. “We don’t want to be pushing an issue if the entire plan is going to change.”
People who already have private health insurance through their employers – about 57 percent of state residents – wouldn’t be affected for the most part.
There is a lot of speculation as to what an Affordable Care Act repeal could look like under the incoming Trump administration and the Republican-controlled Congress.
Throughout his campaign, Trump was adamant that the law would be repealed and replaced, but he offered few specifics on how that would happen.
A full repeal would leave about 22 million Americans uninsured.
In recent days, Trump and Republican leaders have signaled that they are open to keeping the more popular provisions of the law – including children being able to stay on their parents private insurance plans until age 26 and keeping coverage for those with pre-existing conditions.
As far as the parts of the law that could change, Trump recently released a proposal saying he would replace the Affordable Care Act with a plan that includes health savings accounts – non-taxable health care accounts for people with high-deductible plans.
Trump’s plan also calls on insurance being sold across state lines and re-establishing high-risk pools, which it calls “a proven approach to ensuring access to health insurance coverage for individuals who have significant medical expenses and who have not maintained continuous coverage.”
The role of the state’s Insurance Department to administer and enforce existing laws – not create new ones. Sevigny said his department will work with the federal government and New Hampshire legislature to implement new changes, as it did when the Affordable Care Act was passed in 2010.
(Ella Nilsen can be reached at 369-3322, enilsen@cmonitor.com or on Twitter @ella_nilsen.)