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Medicaid Expansion Left Out Of Next State Budget

Todd Bookman


The heavy lifting on the state’s next two year budget wrapped up a little past 3 a.m. Thursday. So when the two sides gathered less than twelve hours later to make it official, House budget leader Mary Jane Wallner was happy to call it a day.

“That’s it. I think we’re done. We’re adjourned!”

But despite that celebratory flourish, lawmakers are far from done when it comes to Medicaid.

After a series of back and forth proposals, in which the House had sought an automatic expansion and the Senate insisted the matter be brought to the full legislature, the two sides agreed to instead create a commission to study the options.

Governor Maggie Hassan says it’s important for New Hampshire to act fast and join the 24 others states that are moving forward with expansion.

“Medicaid expansion is something we should try to get done as quickly as possible, and if possible, in a special session, because for every day after January 1st that we don’t have it, we’re losing $1 million a day.”

Hassan is pointing to the estimated $2.5 billion in Federal money expansion could bring the state’s economy. Under the terms of the Affordable Care Act, Washington picks up 100% of the tab through 2016, eventually phasing down to 90% in 2020.

But Republicans remain skeptical of those promises and anything to do with so-called ‘Obamacare.’ They say the state could be left holding the bag if the federal government can’t pay its bills.

The GOP also wants to look at options for using private insurance to expand coverage, as other states including Arkansas and Iowa are pursuing.  Chuck Morse from Salem, the Senate’ top budget writer, argues that with so much at stake, it's prudent to spend time researching every angle.

“There will be an effective process, and we’ll do what’s right for the people of the state of New Hampshire.”

Morse says both Republicans and Democrats want to craft a plan that takes care of residents. The state’s current Medicaid program already covers low income children, pregnant women, seniors and disabled people. The expansion group are individuals earning less than about $15,000 a year who don’t fit in any other category.

That’s an estimated 58,000 people who Steve Ahnen with the New Hampshire Hospital Association says already get care, but through a patchwork system.

“You know, right now, our hospitals see those patients. They’re in the system, but they’re getting care at the wrong time, at the wrong place. We want to make sure they get the right care at the right time, every time, and this is the right first step.”

The next step will be in early July, when the 10-member bi-partisan study commission first meets.

The group has until October 15th to report out its recommendations. Any plan would then be put to a vote by lawmakers.

Tom Bunnell with the advocacy group N.H. Voices for Health says that makes a January 1st implementation date, as Democrats had hoped for, an unlikely outcome.

“I think the timetable that was ultimately agreed to may make that challenging, so I think it is a subject of ongoing inquiry.”  

And potentially ongoing disagreement about the course New Hampshire should take.

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