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For 2018, the company was seeking to increase premiums by about 30 percent but is working to organize as a new insurance provider, Minuteman Insurance. It would remain in the ACA exchange but would not be subject to the co-op rules.

“Offering our members a quality, more affordable coverage option has been Minuteman’s mission from day one,” said Minuteman Health CEO Tom Policelli. “We want to continue that mission in 2018 and beyond through the new company we are currently working to organize. Forming Minuteman Insurance Company will allow us to address numerous federal restrictions and work to make our coverage available to more people.”

Nationally, insurers are pulling out of some markets or are seeking to charge higher premiums. Republicans are hoping to repeal President Barack Obama’s health care law, and the Senate is pushing a bill that would leave 22 million more Americans uninsured over the next decade, according to a Monday analysis from the Congressional Budget Office. It would also cut the federal deficit by $321 billion, driven by reductions in Medicaid and smaller subsidies to help people buy insurance.

Minuteman Health is the second co-op to drop out of the New Hampshire market. Community Health Options pulled out for 2017 to focus on Maine, and recently announced it made a surplus after two years of losses. With Minuteman Health exiting, individual and small group customers in New Hampshire will have three options in next year’s exchange: Anthem, Harvard Pilgrim, and Ambetter.

The American Health Care Act (AHCA) was pulled Friday minutes before a vote was to take place on the bill in the U.S. House of Representatives, which essentially means Obamacare is here to stay.

House Republicans were shy of the votes needed to get the legislation passed, and defections from the conservative House Freedom Caucus, whose members didn’t think the “repeal and replace” bill went far enough, put it out of reach for President Donald Trump and House Speaker Paul Ryan.

After pulling the vote, Trump said that the “best thing we can do, politically speaking, is let Obamacare explode. It’s exploding right now. Almost all states have big problems.”

With no new health care plan in the foreseeable future, there are a couple of bills that New Hampshire lawmakers are expected to revisit that would make changes to Granite Staters’ health care.

Under AHCA, the Congressional Budget Office estimated that 14 million fewer people would be insured in the first year if it passed. Although it was unknown how many New Hampshire residents could have lost coverage under the plan, about 91,000 people had individual plans on the health exchanges as of February, according to state estimates. Also, 52,000 low-income people in New Hampshire who have insurance through Medicaid expansion were at risk.

It didn’t take long for the Granite State’s all-Democratic congressional delegation to praise the withdrawal of the AHCA, citing how much harm it would do to the state’s residents.

“It’s time for them to admit that while the Affordable Care Act is not perfect, it has made New Hampshire and the country healthier and is worth improving, rather than repealing,” U.S. Sen. Jeanne Shaheen said to WMUR.

U.S. Sen. Maggie Hassan also applauded the defeat of the bill.

“The failure of Trumpcare is good news for people across New Hampshire and America who would have faced higher costs for less care,” she said.

They also all said that Republicans and Democrats should work together to make improvements to former President Barack Obama’s Affordable Care Act (ACA).

“It’s time to have a serious discussion about improvements that can help our health care system work better for everyone,” U.S. Rep. Carol Shea-Porter said. “There’s so much more work to do if we can put partisanship aside and work for the good of our constituents. Let’s get to work.”

Since it appears Congress isn’t going to change health care, it’s now up to the states to make changes within the scope of the ACA, and that’s what the New Hampshire Legislature will do. Leaders of each state party also seem ready to tackle Medicaid expansion with bipartisanship, yet there appears to be some disagreement over when it should get done.

Gov. Chris Sununu said he had issues with the AHCA and he wanted flexibility under the law to allow states the power to implement the policy in ways that made sense to each state. He previously supported a block grant system for Medicaid, which would have capped the federal share, letting the states decide how to spend the dollars on care.

“The bill that’s been proposed in Congress gives us concerns on a lot of different levels,” Sununu said last week. “Expanded Medicaid is part of that discussion. There’s no doubt expanded Medicaid has provided [drug] recovery, treatment options for a lot of folks that otherwise may not have had that option available.”

New Hampshire was one of 31 states that expanded Medicaid under Obamacare. Former Democratic Gov. Maggie Hassan signed the plan into law in 2014 after working with Republican legislators to approve it in two-year increments. She signed the latest expansion bill in 2016. New Hampshire has more than 187,000 individuals enrolled in either traditional or expanded Medicaid, according to state health officials.

Now that block grants aren’t on the table anymore, New Hampshire lawmakers will figure out if they want to extend the program past 2018. The Senate tabled a bill last week, without debate, that would make Medicaid expansion permanent. Senate leadership said they wanted to see what happened with the AHCA before they debated Medicaid expansion in the state.

Senate Minority Leader Jeff Woodburn told NH1 News that “what we designed in a bipartisan fashion clearly has worked. Democrats are ready to move immediately.”

Senate Majority Leader Jeb Bradley said lawmakers shouldn’t rush into anything, especially since the New Hampshire Protection Health Program doesn’t expire until the end of next year.

“Even though the legislation in Washington was pulled and there’s no changes right now to federal guidelines for Medicaid Expansion, I think before we think about reauthorizing the current program, we need to make sure that’s exactly what’s going to happen in Washington that three or four or five months from now, they’re not coming back with a new health care bill,” Bradley told NH1 News. “If December comes and there are no changes to the ACA, that will guide us in what we’re going to do in terms of Medicaid Expansion next year. To me that’s the prudent way to do it. It’s what we did in 2016. We waited for the implementation to go forward in [2015]…So I continue to think doing it now is premature.”

Sununu has also previously indicated that he doesn’t want to continue kicking the can down the road with Medicaid expansion by renewing it every two years. He said he wants to find a long-term solution.

The right-leaning public policy group, Federalism in Action, released a 2016 study discussing the issue of long term care in New Hampshire and the challenges it will face in the future.

“New Hampshire is an apt harbinger of the country’s long-term care challenges. The state’s age 85 plus population will nearly quadruple in the next three and a half decades,” the report stated. “If its Medicaid long-term care expenditures for the elderly keep pace they’ll increase from $282 million per year to $1,047 million, more than one billion dollars every year. Sustainability at that level is highly dubious.”

It’s not immediately clear if New Hampshire lawmakers plan on taking the Medicaid expansion bill off the table in 2017 or will debate in 2018.

The N.H. Senate also tabled Senate Bill 149 last week that would allow out-of-state health insurance companies to operate in the Granite State without providing the benefits required under state law. It was tabled most likely to see what the federal government was going to do.

Significant questions still remain over what Obamacare would have in store for people with health insurance on the exchanges. Health experts are also curious about how the insurance industry will react in 2018. Will they stay or leave? What will rates be like? Minuteman Health in New Hampshire said it plans to be on the exchange in 2018, but no other health insurer has yet to say it would remain in the state.

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After President Donald Trump issued his immigration executive order on Friday, which put a four-month hold on allowing refugees into the United States and temporarily barred travelers from Syria and six other countries, New Hampshire’s congressional delegation was quick to respond.

But for some of the Democratic lawmakers, their statements are at odds with their previous rhetoric and voting records.

Before getting into their statements, it’s important to reiterate what Trump’s executive order entails. You can read guides from USA Today and Reuters. But here’s the quick highlights:

1. His executive order suspends all refugee entry for 120 days.
2. It indefinitely suspends entry by Syrian refugees.
3. The order blocks for 90 days all immigration of citizens of Iraq, Iran, Syria, Somalia, Sudan, Libya, and Yemen, which are Muslim-majority countries.

Since he announced his executive order, Green Card holders and permanent residents of the United States have been detained at airports, the American Civil Liberties Union filed a lawsuit against the order, and protests have erupted at airports across the country. Trump’s administration has made it clear that the immigration ban would not apply to Green Card holders.

Sen. Maggie Hassan probably has one of the most unclear records when it comes to immigration and Syrian refugees. Following the November 2015 terrorist attacks in Paris, Hassan became the first Democratic governor in the country to call for a pause in Syrian refugee resettlement.

“The governor has always made clear that we must ensure robust refugee screening to protect American citizens, and the governor believes that the federal government should halt acceptance of refugees from Syria until intelligence and defense officials can assure that the process for vetting all refugees, including those from Syria, is as strong as possible to ensure the safety of the American people,” said Hassan’s spokesman at the time.

And she never wavered from that position throughout the extremely close campaign against Republican Sen. Kelly Ayotte. Ayotte was known for being a foreign policy and immigration hawk.

But now, it seems Hassan is singing a different tune. She called Trump’s executive order “un-American” and her office said that she never supported an indefinite ban on Syrian refugees.

“Senator Hassan believes we can strengthen the vetting process for all entryways into the country while staying true to the values that make America the greatest country on earth. She never has and never will support a policy like what the President has put into place with this executive order, which is a backdoor Muslim ban and religious test that goes against American values. Senator Hassan will work with colleagues on both sides of the aisle to reverse this un-American executive order that will make America less safe,” her office said in a statement to WMUR.

“Senator Hassan strongly opposes this un-American and dangerous executive order which includes an indefinite ban on Syrian refugees, something that the Senator has never supported,” her office added. “The Senator believes that we can strengthen the process for all entryways into the country while remaining true to our values and engaged in addressing this humanitarian crisis.”

So while that statement is technically correct, since she only supported a “temporary halt” in Syrian refugees, not an indefinite ban, some people are wondering where she really stands on the issue. Was she reacting to the Paris attacks with what she thought was the best decision or was she pandering to voters on her right? It’s still unclear.

@SenatorHassan yes or no? Do you support a ban on Syrian Refugees as you previously said you did? #MuslimBan #nhpolitics #NHpolitics

— Winston Smith (@RumpoleinUSA) January 30, 2017

Rep. Annie Kuster also has an interesting position on Syrian refugees and immigration policies.

Kuster called for a broad expansion of former President Barack Obama’s administration’s program to bring Syrian refugees to the United States before the Paris attacks. She joined other House Democrats in signing a letter to Obama, calling on him to increase the number of refugees to be allowed in the United States to 200,000 by the end of 2016.

But after the terrorist attacks, Kuster didn’t mention anything about bringing in more Syrian refugees. She actually voted with Republicans for a stronger vetting process.

“I am fiercely protective of our national security and believe we must be tough and smart in pursuing policies that protect Americans both at home and abroad,” she said in a statement. “As we work with our allies to defeat ISIS without endangering American lives in another civil war, we must maintain and expand rigorous screening and security checks for any Syrian refugee fleeing terrorism by seeking to enter our country.”

She joined 46 other Democrats and all of the House Republicans to pass the American Security Against Foreign Enemies Act. The bill expanded the screening process for refugees attempting to enter the United States from Iraq or Syria by requiring the Federal Bureau of Investigation to conduct its own background checks in addition to those conducted by the Department of Homeland Security.

In defense of her vote, Kuster told New Hampshire Public Radio that, “it doesn’t pause the program. It doesn’t apply a religious test. It’s a certification that the person does not pose a threat to the security of the United States.”

But Kuster is now the only member of New Hampshire’s congressional delegation that did not release a statement after Trump’s executive order was announced. Instead, she took to Twitter for a very brief statement that didn’t really say if she was for or against the ban.

America can & should be a beacon of hope around the world. Urge @realDonaldTrump to honor the values of inclusion that make us truly great.

— Ann McLane Kuster (@RepAnnieKuster) January 29, 2017

She followed that tweet up later with another one that said, “Not as Republicans or Democrats, but as Americans, we can balance security & compassion. USA founded on freedom from religious persecution.”

Both Kuster and Hassan have brought up religion in their statements, saying they believe his executive order is a religion test as a way to ban Muslims from coming to the United States. That point is still debateable and up for interpretation. There are many media reports that have former New York Mayor Rudy Giuliani saying it is a “Muslim ban” as Trump put it.

But other articles say religion already plays a role in federal asylum and refugee law. David French from the National Review has an extensive piece on it and Politifact rated former Republican presidential candidate Jeb Bush’s claim that religion plays a role in refugee screenings as “Mostly True.” Obviously, the law leaves much room for interpretation, so expect several legal experts to weigh in on the subject in the coming weeks.

As for Sen. Jeanne Shaheen and Rep. Carol Shea-Porter, they both have been the most consistent in their language when discussing Syrian refugee resettlement and immigration.

Shaheen was supportive of allowing more Syrian refugees to come to America during Obama’s presidency and she hasn’t changed her mind after Trump’s executive order.

“We’re among those members of Congress who think that the United States can and should do more, both to try and take in more of the refugees who have been vetted, but also to support — in every way we can — the humanitarian crisis that has been created,” she said in 2015.

After Trump’s announcement, she said in a statement, “This executive order is un-American and grossly inhumane. We are a nation of immigrants and should remain welcoming to all nations and faiths, particularly those who are fleeing violence and oppression. Refugees, from Syria in particular, are fleeing unspeakable terror and hunger, and it’s unconscionable that the United States will no longer provide any of these refugees a safe haven.”

Shea-Porter said the United States should welcome Syrian refugees, but should also ensure they are properly vetted. She voted with House Democrats against a 2013 Republican amendment that would defund Obama’s executive orders on immigration.

“I think we’re very capable of absorbing a certain number of refugees who are fleeing their country for the same reasons that we would,” she said in 2015. “I think we all need to know exactly what kind of vetting is being done.”

She released a very straightforward statement on Saturday rejecting Trump’s actions.

“Our nation’s founders built this nation on dreams of a better, more tolerant society, and now we must stand together and defend and preserve those ideals,” she said. “I call on President Trump to immediately reverse his actions, and I invite all Granite Staters to join me in letting our refugee and immigrant neighbors know that we stand shoulder-to-shoulder with them as one community.”

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