New Hampshire’s Health Insurance Success: A Model for National Stability?
New Hampshire’s health insurance marketplace has demonstrated remarkable resilience in the face of shifting federal policies, offering a potential blueprint for other states grappling with affordability and access. While many states scrambled to replace expiring federal premium tax credits with state funding, New Hampshire maintained stability without resorting to such measures.
The Reinsurance Strategy: A Foundation for Affordability
The groundwork for this success was laid years ago, with the implementation of a state-based reinsurance program. This program, initially approved in 2019 and taking effect in 2020, aimed to lower premiums by addressing high-cost claims and stabilizing the risk pool. The collaborative effort between administrations, including current Insurance Commissioner D.J. Bettencourt and former Commissioner Roger Sevigny, was crucial to its development.
The results were immediate and significant. Premiums fell, insurer participation stabilized, and enrollment steadily increased. New Hampshire became known for having some of the most affordable individual market premiums in the nation.
Navigating the Post-Subsidy Landscape
2026 proved to be a critical test as enhanced federal premium tax credits expired. Nationally, concerns arose about potential enrollment losses and market disruption. New Hampshire, however, bucked the trend. Final enrollment data showed marketplace participation remaining stable, even exceeding 2024 levels, despite the policy changes.
This stability wasn’t accidental. New Hampshire distinguished itself by maintaining enrollment without new taxpayer-funded assistance. While other states implemented emergency interventions, New Hampshire relied on its existing, low-cost structure.
Key Indicators of a Healthy Market
Beyond enrollment numbers, several factors point to the health of New Hampshire’s insurance market. The state continues to boast the lowest average marketplace premiums nationwide. Approximately 95.5% of Granite Staters currently have health coverage – one of the highest rates in the country. In a state with already high coverage, maintaining stability is a key indicator of success.
The entry of a new health insurance carrier into the New Hampshire market in 2024 further validates its stability. Insurers are unlikely to expand into markets they perceive as unstable or unsustainable.
The Value of Restraint and Long-Term Vision
Commissioner Bettencourt’s decision to maintain the existing system, rather than implement reactive changes, is being credited with preserving market stability. This approach underscores the importance of long-term vision and resisting the urge for short-term fixes that can lead to higher costs down the line.
What Does This Mean for the Future of Health Insurance?
New Hampshire’s experience suggests that a focus on structural affordability, through mechanisms like reinsurance, can create a more resilient health insurance market. This approach prioritizes long-term stability over temporary subsidies and mandates.
Pro Tip:
States considering similar strategies should prioritize collaboration between administrations and focus on building a sustainable, low-cost structure. Avoid relying solely on federal funding, as policy changes can create instability.
FAQ
Q: What is reinsurance?
A: Reinsurance is a system where the state helps insurers cover the costs of very expensive claims, which helps to lower premiums for everyone.
Q: Why did New Hampshire succeed when other states struggled?
A: New Hampshire had already implemented a reinsurance program, creating a stable foundation before federal subsidies expired.
Q: Is New Hampshire’s model applicable to all states?
A: While the specifics may vary, the core principle of focusing on structural affordability is relevant to states across the country.
Q: What percentage of New Hampshire residents have health insurance?
A: Approximately 95.5% of Granite Staters have health coverage.
Did you grasp? New Hampshire entered 2026 with one of the smallest uninsured populations in the country.
Explore further: Learn more about the Affordable Care Act and state-based reinsurance programs here.
What are your thoughts on New Hampshire’s approach to health insurance? Share your comments below!
