NH Public Policy
New Hampshire Center for Public Policy Studies

GraniteCare: Some Questions and Answers

Executive Summary

Date: February 1st, 2005

Medicaid is a federal program that reimburses states for part of the cost of health care services delivered to low income individuals. The percent of costs covered by federal funds varies among the states. For New Hampshire, the federal share is 50% of the total (with some exceptions for specific services). In effect, Medicaid matches each dollar the state spends with one federal dollar and two dollars of health care services can be purchased.

In the spring of 2004 the New Hampshire Department of Health and Human Services (DHHS) began to plan for major reform of our state’s Medicaid program. The department’s proposal, called "GraniteCare," evolved from the planning stages and its broad outlines were made public during the summer. More details were released at a presentation made to the legislature’s Fiscal Committee on November 10.

The Center requested yet additional details from DHHS in testimony delivered at the department’s December 7 forum on GraniteCare. Not having received the requested details, on January 3, 2005, the Center submitted a right-to-know (RSA 91-A) request to DHHS and on January 5, DHHS released "GraniteCare Financial Projections & Critical Assumptions," their most detailed presentation of the plan. Material in that document raised yet further questions

The Center submitted 68 additional questions and comments to DHHS on January 18. On February 9 the Center’s Co-Executive Directors, Doug Hall and Rick Minard, met with DHHS Commissioner John Stephen and senior managers of the department who have been involved in the development of the GraniteCare plan. We have used notes taken at that meeting by both Center staff and a DHHS intern to prepare the following summary of the answers that DHHS provided. The Center submitted a preliminary draft of this summary to DHHS on February 14.

This paper is best read in parallel with the department’s "GraniteCare Financial Projections & Critical Assumptions," which can be found by clicking on "Financial Projections" at: http://www.dhhs.state.nh.us/DHHS/OCOM/GraniteCare.htm, part of the department’s website. Our questions are listed in the order in which topics appear in that document and some are keyed to specific page numbers.

The Center is hopeful that policy-makers and Medicaid stakeholders will find this compilation of questions and answers to be helpful to as they discuss the ramifications of the various components of the GraniteCare plan.

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