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As the Affordable Care Act (ACA) faces ongoing scrutiny and challenges nationwide, Latest Hampshire stands out as a state that proactively built a stable and affordable health insurance marketplace. A deliberate strategy focused on market-based solutions, rather than short-term fixes, has resulted in New Hampshire consistently offering some of the lowest premiums in the country, a position solidified by the entry of new market participants. This success story offers valuable lessons for other states grappling with healthcare affordability and access.
The story of New Hampshire’s insurance stability isn’t accidental. It’s a result of conscious choices made during a period when the ACA’s individual market was widely perceived as fragile. Between 2017 and 2018, as Insurance Commissioner, officials faced a critical decision: pursue temporary measures or address the underlying structural issues impacting affordability. The path chosen prioritized long-term stability, a decision that appears to be yielding significant benefits for Granite Staters.
A Focus on Affordability and Competition
According to a recent analysis by the Kaiser Family Foundation (KFF), New Hampshire’s average benchmark premium for 2025 is the lowest in the United States, at $325. This affordability is further enhanced by increased competition within the marketplace. The addition of WellSense Health Plan to the state’s ACA Individual Marketplace for 2025 expands consumer choice and drives down costs.
This success is rooted in New Hampshire’s commitment to a free-market approach to healthcare. Rather than relying on extensive regulation or subsidies, the state focused on creating an environment where insurers could compete effectively. This strategy has been validated by independent assessments, including a WalletHub study that ranked New Hampshire fifth among states with the best overall healthcare systems, based on 44 measures of cost, accessibility, and quality of outcomes.
The Role of State Innovation Waivers
New Hampshire’s approach to healthcare stability has likewise been supported by innovative policy measures, including the use of State Innovation Waivers under Section 1332 of the Affordable Care Act. In August 2020, the Department of Health and Human Services and the Department of the Treasury approved New Hampshire’s waiver, which allowed the state to implement a reinsurance program. This program helps to mitigate the risk for insurers, leading to lower premiums for consumers.
The state’s reinsurance program, specifically, works by covering a portion of high-cost claims, reducing the financial burden on insurance companies and ultimately keeping premiums more manageable. This approach differs from strategies employed in other states, highlighting New Hampshire’s willingness to explore tailored solutions to address its unique healthcare challenges.
Open Enrollment and Access to Coverage
The 2025 Open Enrollment Period for the ACA Individual Marketplace in New Hampshire ran from November 1, 2024, through January 15, 2025, providing residents with ample opportunity to secure health coverage for the year. For those who missed the open enrollment window, options may still be available through Special Enrollment Periods triggered by qualifying life events, such as losing existing coverage, moving, or experiencing changes in household income. Medicaid and the Children’s Health Insurance Program (CHIP) remain available year-round for eligible individuals and families.
Resources like Covering New Hampshire (800-318-2596) offer free, unbiased assistance to residents navigating the health insurance landscape. The New Hampshire Insurance Department also provides consumer support at 1-800-852-3416 or (603) 271-2261, and via email at [email protected].
Looking Ahead
New Hampshire’s success in stabilizing its health insurance market demonstrates the potential of a strategic, market-oriented approach. As the healthcare landscape continues to evolve, the state’s experience will likely be closely watched by other states seeking to improve affordability and access to coverage. The upcoming Open Enrollment period in the fall of 2026 will be a key indicator of whether New Hampshire can maintain its position as a leader in healthcare innovation and affordability.
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Disclaimer: This article provides informational content only and is not intended to be a substitute for professional medical or financial advice.