You asked for a summary of a recently passed New Hampshire law that requires the state’s Medicaid agency to get legislative approval before it can ask the federal government to allow the state to provide Medicaid through block grants instead of the more traditional, entitlement structure.

Last week, New Hampshire’s governor Craig Benson allowed an act to become law without his signature that requires his Medicaid agency to get legislative approval before it can make wholesale changes in how Medicaid is financed. Specifically, SB 376 prohibits the Department of Health and Human Services (DHHS) from amending or seeking to amend the Medicaid state plan, or getting waivers to the plan, that would consolidate federal grants or allotments, cap the federal portion of Medicaid spending, or in any way change the state-federal proportional share of Medicaid spending without getting prior approval from the legislature’s Fiscal Committee.

Although he was concerned about the legislature “micro managing and meddling in the affairs of the executive branch,” Benson ultimately decided not to veto or sign the law, which meant it went into effect. In part, he did this because the same bill contains fiscal relief for the state’s struggling hospitals and nursing homes. Greg Moore, DHHS’ director of Public and Government Relations, indicated that the state continues to work on Medicaid restructuring or “modernization” but that the result will most likely be something other than block grants.

RC: ts