Deadline Looming, Granite Staters Urge Lawmakers to Renew Medicaid Expansion

Feb 20, 2018

People traveled from all corners of the state Tuesday afternoon to urge New Hampshire lawmakers to renew Medicaid expansion, which is set to expire at the end of this year.

Many of them, like Carrie Duran of Wolfeboro, shared personal stories of how the health care coverage they got through the program has connected them with important medical coverage that would otherwise be unaffordable.

Duran is a single mom of three daughters under age 13, one of whom has special medical needs that require extra attention. She also works part time, goes to school and has a father recently diagnosed with Alzheimer’s – all of which, she said, would likely be out of reach if not for expanded Medicaid.

“I am on my own taking care of my kids and taking care of my dad,” Duran said. “And I have to stay healthy and I have to do that preventative care. I don’t know what I would do without it.”

If the program doesn’t get renewed this year, Duran and more than 50,000 other New Hampshire residents could lose their health coverage.

While most of those who testified at Wednesday’s hearing agreed expansion should continue – the group of supporters ranging from municipal officials to the heads of community health centers to mental health advocates – there were disagreements over there were disagreements over whether the current proposal put forward by Senate Republicans was the best way to do so.

That proposal, as written, would make significant changes to program eligibility standards, what kind of insurance plans are offered and how New Hampshire subsidizes that coverage.

As written, the plan would also tap into New Hampshire’s alcohol fund to finance some of the costs of continuing expansion.

Michael Apfelberg, president of the United Way of Greater Nashua, was one of several advocates who sought assurances from state officials that using these liquor profits for Medicaid wouldn’t come at a cost to other local treatment programs that are already seeing steep funding cuts and struggling to stay afloat.

“We have of course a long history of raiding that fund of it not being used for the purposes that it’s for and in the amount that it’s intended to be for,” Apfelberg said.

Notably, the bill would also add what lawmakers are referring to as “work and community engagement requirements” as a condition of coverage. Sen. Jeb Bradley, the prime sponsor of the bill and one of the loudest voices in his party in favor of the expansion since its inception, said the measure isn’t meant to be “punitive” and is meant to encompass a broad range of possible activities: volunteer work, continuing education, caregiving, substance misuse treatment and more.

The current version of the bill would exempt parents caring for children under age 6 from those requirements, but some Democratic lawmakers argued that threshold is too young and could create child welfare risks – putting parents of, for example, 7-year-olds in the position of having to leave their children at home while fulfilling program requirements.

Department of Health and Human Services Commissioner Jeff Meyers, who worked with lawmakers to draft the proposal and said he was “fully supportive” of the plan to reauthorize expanded Medicaid, agreed that the work requirement age for parental exemption should be raised.

Meyers said New Hampshire officials have been in “active negotiation” with the federal government over the terms of the state’s work requirement waiver but expects to get approval before the end of April.