Medicaid Expansion Part 2: Understanding the Health Insurance Premium Payment Program

Two weeks ago I wrote about the work that I am doing on the Medicaid Expansion Study Commission and mentioned the Health Insurance Premium Payment Program, or HIPP Program. Since I received a number of emails from you asking for more information about the program and what role it may play in Medicaid expansion, I am writing about it today.

The Medicaid expansion population includes adults with or without children who make 0-138% of the federal poverty level (FPL), meaning individuals who earn less than $15,500 annually. Many people in the expansion population work in low-paying jobs, often doing seasonal work or in the hospitality industry. Currently, only parents who make less than 54% of FPL (earning less than $6,300 annually) are eligible for Medicaid. So, childless adults and parents making more than 54% of FPL define the expansion population.

Violence as a Public Health Issue

The violent events of the past year and my writing about them here have provoked strong feelings among our members and raised, I think, good questions like: What can I do as a physician to impact this problem? Do I even have a role?  The problem seems so big that it is very difficult for us to get our hands around.  Are there only policy solutions? Are there clinical solutions?  Are there community solutions? Or, is this just the way things are and we should accept them? 

Moving Towards Medicaid Expansion

Because of our hard work on expanding coverage to the uninsured in New Hampshire, I was asked to serve on the Medicaid Expansion Study Commission and I wanted to share some updates from this.  The Commission was set up to give the State more time to study expansion so that the Legislature can possibly come back for a special session this fall so that we can take full advantage of federal funds.  So far we have met three times and have been given background information on the Medicaid program, what it costs and who it serves, and options for expansion.  In NH, Medicaid is a 50-50 partnership between the federal and state governments.  Under expansion, the newly covered population would be 100% financed by the federal government for 3 years and then would titrate down to 90% by 2021 and the state would be responsible for 10% into the future. 

Have I got your attention?

We choose to go to the moon in this decade and do the other things, not because they are easy, but because they are hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win, and the others, too. - President John F. Kennedy, Sept. 12, 1962

The right to bear arms.....

"A 7-year-old boy was killed Thursday at a Fourth of July celebration in Virginia after someone evidently fired a gun in the air." July 4, 2013

Will Therapeutic Cannabis Be Part of Your Practice?

The New Hampshire House and Senate have crafted and passed a therapeutic cannabis bill that Gov. Maggie Hassan is poised to sign soon, and now we, the physicians of New Hampshire, must decide how to incorporate or not incorporate this into our practices.  New Hampshire's bill is unique, and, with input from NHMS, we helped make this the tightest therapeutic cannabis bill in the country by limiting its scope, eliminating the home-grow provision, establishing that there must be at least a three-month ongoing relationship with a physician or nurse practitioner and limiting patient possession to no more than 2 ounces.  

It's Playoff Time for Hockey, Basketball & the NH Legislature

This week, legislators have been meeting in committees of conference (C of C) to resolve House and Senate differences on many bills including four bills being followed closely by NHMS.

Last week, pathologists contacted NHMS after identifying a potential problem in the genetic counseling bill, SB135. Via emails, phone calls and live testimony, NHMS was able to explain the problem to key legislators and offer amended language. At Monday’s C of C, House and Senate conferees unanimously adopted the amendment.

NHMS Physician Opinion Survey

Last week you received an email from me announcing the NHMS physician opinion survey and yesterday, we launched it.

For NHMS to better represent its members and carry-out its mission -- to bring together physicians to advocate for the well being of our patients, for our profession and for the betterment of the public health – we need your input.

Use Your Skills to Enrich the Debate

Science is facts; just as houses are made of stone, so is science made of facts; but a pile of stones is not a house, and a collection of facts is not necessarily science. Jules Henri Poincaré (1854-1912), French mathematician

Recently I was reminded that we often take our basic science skills for granted and how extremely valuable they truly are. Last week, on New Hampshire Public Radio's The Exchange, Tom Sherman, MD, a gastroenterologist and state representative from Rye, NH, spoke with clarity and reason to bring a scientific lens to the Medicaid expansion debate. (Listen to broadcast.)

There is a Seasonality to our Work

For me as a family physician, my seasonal work  includes, school and sports physicals in the summer, flu shots in the fall and winter and attention to problems associated with allergy in the spring. Similarly NHMS has seasonal priorities and now is our time to be active legislatively. We don't do this often but over the past few weeks we have asked you to speak out on an issue of importance to all of us. Thank you for taking time from your busy schedules to contact your legislators asking them to support the tobacco tax increase. Your calls will make a difference as the Senate and House negotiate the final budget.

Pages