New Hampshire Insurance Department Receives Federal Approval for State Innovation Waiver Renewal After Remarkable Success Lowing Health Insurance Premiums

CONCORD, NH (November 19, 2024) – The U.S. Department of Health and Human Services and the U.S. Department of the Treasury have approved New Hampshire’s application to extend its State Innovation Waiver under Section 1332 of the Affordable Care Act (ACA). The waiver, effective from January 1, 2026, through December 31, 2030, will continue supporting New Hampshire’s state-based reinsurance program, designed to lower premiums and expand coverage in the individual health insurance market.

The reinsurance program, implemented through the Section 1332 waiver, has proven instrumental in stabilizing New Hampshire’s health insurance marketplace. Actuarial projections indicate that statewide average premiums for individual health insurance coverage will be 11.4% lower in Plan Year (PY) 2026 than they would be without the waiver. This reduction in premiums is expected to attract new consumers while retaining existing enrollees, with enrollment projected to increase by 1% in PY 2026.

“This extension reinforces New Hampshire’s commitment to ensuring access to affordable, high-quality health insurance for Granite State residents,” said Insurance Commissioner DJ Bettencourt. “The reinsurance program’s proven success in lowering premiums and fostering market stability has resulted in New Hampshire having the lowest average monthly health insurance premiums in the country and demonstrates the value of innovative, state-driven solutions.”

The waiver’s extension also secures substantial federal funding for the state’s reinsurance program through pass-through savings from reduced federal premium tax credit (PTC) costs. The program is projected to generate $21.9 million in federal savings in 2026 and $134 million over the five-year waiver period. These savings will help offset state costs for operating the reinsurance program, resulting in significant financial benefits for New Hampshire.

The state’s reinsurance program operates as a traditional claims-based program, reimbursing individual market insurers for high-cost claims above a specified threshold. By mitigating financial risk for insurers, the program encourages premium reductions, which benefit all individual market consumers.

New Hampshire’s Section 1332 waiver extension was approved after a thorough review by federal agencies to ensure compliance with statutory requirements. The program will continue to provide coverage that is as comprehensive, affordable, and widely available as coverage without the waiver, while maintaining federal deficit neutrality.

For more information about the waiver extension and its benefits to New Hampshire consumers, please visit https://www.insurance.nh.gov/about-us/life-health-division.

The New Hampshire Insurance Department Can Help

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. Contact us with any questions or concerns you may have regarding your insurance coverage at 1‐800‐ 852‐3416 or (603) 271‐2261, or by email at consumerservices@ins.nh.gov. For more information, visit https://insurance.nh.gov.