The Centers for Medicare & Medicaid Services recently agreed to allow the New Hampshire Health Protection Program to continue unchanged through 2018, but said the state will need to change how it finances the non-federal share of the program in the future. One of 31 expansion states, New Hampshire created the New Hampshire Health Protection Program in 2014 under the Affordable Care Act, enrolling 53,000 low-income uninsured residents in private health coverage through the Health Insurance Marketplace. When extending the program last year, the state legislature incorporated voluntary donations from hospitals and insurance carriers to cover a portion of the state’s costs, which CMS said may not comply with federal requirements. “To date, the program has successfully reduced the number of uninsured patients seeking care in emergency rooms; reduced the amount of uncompensated care provided by hospitals to those without insurance; and reduced the cost shift to those with insurance,” the New Hampshire Hospital Association said. “CMS’s recent letter to the State of New Hampshire creates a number of challenges that we look forward to discussing with Governor Sununu, Commissioner Meyers and House and Senate leadership as we approach the 2018 legislative session.”