230.09 NHHPP/NHHPP-M: Marketplace Premium Assistance Program (PAP) and the Bridge Program SR 14-28, 08/14 (MAM-A)

Individuals who do not have access to employer sponsored insurance (ESI) or if the NH Health Insurance Premium Payment (HIPP) program determines ESI is not cost-effective, must enroll in the Bridge program with coverage provided under NH Medicaid Care Management (MCM). Under the Bridge Program, the household chooses one of the Health Plans offered under NH MCM. The Health Plan covers the 10 essential health benefits required under the ACA, and the Bridge Program provides additional “wrap” benefits, such as coverage for non-emergency medical transportation and early periodic screening diagnostic and treatment (EPSDT) for ages birth to 21.

The Premium Assistance Program (PAP) becomes available in 2016 following the sunset of the Bridge Program on December 31, 2015. Under PAP, individuals still receive NHHPP/NHHPP-M, and DHHS will continue to cover the costs of NHHPP/NHHPP-M coverage, but NHHPP/NHHPP-M coverage will be provided by the health insurance plans that qualify to be on the Health Insurance Marketplace (formally known as the Federally Facilitated Marketplace or FFM). See DFA SR 14-04 or visit www.healthcare.gov for more information about the Health Insurance Marketplace.

Per RSA 126-A:5,XXIV(c)(3), the Bridge to Marketplace program is subject to cancellation upon notice.

References: He-W 511-512, He-W 841.01, He-W 841.08, RSA 126-A:5,XXIII-XXVI, RSA 126-A:5-b, RSA 126-A:67, 42 CFR 435.119, Section 1902(a)(10)(A)(i)(VIII) of the Social Security Act (SSA) [42 USC 1396a(a)(10)(A)(i)(VIII)], Section 1906 of the SSA [42 USC 1396e], Section 1937 of the SSA [42 USC 1396u-7]