HB 565-FN-A - AS AMENDED BY THE HOUSE

22Feb2023... 0304h

2023 SESSION

23-0711

05/04

HOUSE BILL 565-FN-A

AN ACT relative to expanding Medicaid to include certain postpartum health care services.

SPONSORS: Rep. M. Murray, Hills. 37

COMMITTEE: Health, Human Services and Elderly Affairs

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ANALYSIS

This bill expands Medicaid to include certain postpartum health care services and makes an appropriation to the department of health and human services for this purpose.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

22Feb2023... 0304h 23-0711

05/04

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty Three

AN ACT relative to expanding Medicaid to include certain postpartum health care services.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1  Title.  This act shall be known and may be cited as the "Healthy Moms, Healthy Babies Act of 2023".

2  New Paragraph; Medicaid Enhancement for Children and Pregnant Women.  Amend RSA 167:68 by inserting after paragraph III the following new paragraph:

IV.(a)  Pursuant to the state option under the section 5113 of the Consolidated Appropriations Act of 2023 to expand maternity care under Medicaid and section 1902(e)(16) of the Social Security Act (42 U.S.C. 1396a(e)), the commissioner of the department of health and human services shall submit, no later than August 15, 2023, a Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services to establish and implement 12 months of continuous coverage for the entire postpartum period.  This benefit shall be available to anyone who received medical assistance under the state plan for all pregnancy-related and postpartum medical assistance available under the state plan through the last day of the month in which the 60-day period (beginning on the last day of her pregnancy) ends, remain eligible under the state plan for medical assistance for the period beginning on the first day occurring after the end of such 60-day period and ending on the last day of the month in which the 12-month period (beginning on the last day of her pregnancy) ends.

(b)  The medical assistance provided for a pregnant or postpartum woman under this section shall, consistent with Section 1902(e)(16) include all items and services covered under the state plan that are not less in amount, duration, or scope, or are determined by the Secretary to be substantially equivalent, to the medical assistance available for an individual described in subsection (a)(10)(A)(i); and be provided for the individual while pregnant and during the 12-month period that begins on the last day of the individual’s pregnancy and ends on the last day of the month in which such 12-month period ends.

(c)  The purpose of the program shall be, through ensuring continuous coverage for a 12-month postpartum period, to increase identification and mitigation of preventable pregnancy related and pregnancy associated morbidity and mortality, including those related to substance use disorder and mental illness.

(d)  On January 1, 2024, the commissioner shall begin submitting quarterly reports to the oversight committee on health and human services, the legislative committees with jurisdiction over health and human services, and the governor regarding the department's progress in obtaining and implementing the state plan amendment.  The quarterly reports shall include the department's plans for reducing administrative burdens for enrollees and the department’s efforts to expand access and participation to voluntary, evidence-based maternal home visiting programs, pursuant to subparagraph (a).  Reports submitted under this subparagraph shall also be posted on the department's website.

3  Appropriation.  The sum of $200,000 for the fiscal year ending June 30, 2024 is hereby appropriated to the department of health and human services for the purpose of expanding postpartum health care services under the state Medicaid plan as provided in section 2 of this act.  The governor shall determine if any discretionary funds appropriated in the American Rescue Plan Act of 2021, Public Law 117-2, or any other federal funds, can be used for this purpose, and the commissioner shall expend such federal funds for this purpose.  Any remainder shall be appropriated from the general fund.  The governor is authorized to draw a warrant for the general fund portion of such sum from any money in the treasury not otherwise appropriated.  

4  Effective Date.  This act shall take effect July 1, 2023.

LBA

23-0711

Amended 3/6/23

HB 565-FN-A- FISCAL NOTE

AS AMENDED BY THE HOUSE (AMENDMENT #2023-0304h)

AN ACT relative to expanding Medicaid to include certain postpartum health care services.

FISCAL IMPACT:      [ X ] State              [    ] County               [    ] Local              [    ] None

METHODOLOGY:

This bill requires the Department of Health and Human Services to submit a state plan amendment expanding postpartum coverage under Medicaid. The Department notes that currently, the state provides Medicaid coverage to pregnant women with incomes up to 196 percent of the federal poverty level (FPL) for 60 days postpartum, which would be extended to 12 months under the bill.  In addition, the Granite Advantage Program currently covers individuals with incomes up to 138 percent of the FPL.  Accordingly, the Department states the bill will effectively provide 10 months' worth of postpartum coverage for those between 138 percent and 196 percent of the FPL.  Based on an actuarial review, the Department estimates an annual increase in state general fund expenditures of $300,000 to $1,000,000 per year. (This range is slightly higher than the $200,000 to $1,000,000 estimate provided for a similar bill in 2022.  The Department attributes the increase to the enhanced rates for birthing centers required by HB 1661 and SB 408 from 2022).  The Department did not provide information on whether an enhanced federal matching rate would be available for the postpartum benefit.

The bill contains an appropriation of $200,000 in FY 2024.  If federal funds are available under the American Rescue Plan Act of 2021 (ARPA), those shall be used first, with state general funds used for the remainder.

AGENCIES CONTACTED:

Department of Health and Human Services