Starting in 2014, as part of health care reform, health insurance coverage for individuals and small businesses will become available through new state health insurance exchanges. Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. individual health premium subsidies) will only be available for coverage purchased through their state health insurance exchanges. 
Under health care reform, there will be an exchange (also called "marketplaces") in every state. All states have three options for setting up a state health insurance exchange for 2014:
-
Build a state-based exchange
-
Enter into a state-federal partnership exchange
-
Default to a federally-facilitated exchange
New Hampshire plans to offer a state-federal partnership exchange that will open October 1, 2013 (for coverage starting January 1, 2014).
New Hampshire Health Insurance Exchange - What is it?
The New Hampshire Health Insurance Exchange will be a new online marketplace designed to help New Hampshire residents shop for and enroll in health insurance coverage, and access health insurance tax subsidies and credits. The Exchange will also screen applicants for eligibility in public programs such as Medicaid. The New Hampshire Health Insurance Exchange will have two offerings:
-
Individual exchange for individuals and families
-
Small businesses "SHOP" exchange
Insurance coverage can be purchased through the New Hampshire Health Insurance Exchange beginning in October 2013, for coverage effective January 1, 2014.
According to healthcare.gov, approximately 125,600 or 11% of New Hampshire’s non-elderly residents are uninsured, of whom 110,000 (88% of these) may qualify for either health insurance tax credits or for Medicaid if New Hampshire participates in the Medicaid expansion (New Hampshire currently supports Medicaid expansion).
New Hampshire will use federally-run technology and a federally-based navigator program, and the state will manage plan (insurance carrier) oversight and consumer outreach and assistance. As of writing, exact details of this coordination are being clarified and confirmed.
New Hampshire Health Insurance Exchange - How Was it Formed?
In June 2012, former Governor John Lynch signed HB 1297 into law, which prohibited the state from participating in or enabling a state-based health insurance exchange. However, HB 1297 allowed New Hampshire to “operate specific functions of a federally-facilitated exchange." In February 2013, Governor Maggie Hassan confirmed that New Hampshire would pursue a state-federal partnership exchange. On March 7, 2013, New Hampshire received conditional approval from the U.S. Department of Health and Human Services (HHS) to establish a partnership exchange.
Click here for more information on New Hampshire's Exchange planning process.
New Hampshire Health Insurance Exchange - What Insurance Plans Will be Available?
Under the Affordable Care Act, all insurance plans sold on the New Hampshire Health Insurance Exchange will be qualified health plans (QHPs) that meet federal requirements and provide essential health benefits (EHB). The Exchange will offer uniform plans categorized in four "metal" levels of value. These metal levels are intended to allow consumers to compare plans with different levels of coverage for EHB. The levels include:
-
Bronze (60% actuarial value)
-
Silver (70% actuarial value)
-
Gold (80% actuarial value)
- Platinum (90% actuarial value)
At time of writing specific information on the types of plans, carriers and cost have not been released.
