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Supreme Court Gives Decision on ACA Medicaid Expansion to NH

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This is a closer look at the Supreme Court’s Ruling as it relates to Medicaid in the Granite State. Under the upheld law, an additional 17 million people nationwide are set to become eligible for Medicaid in 2014. That’s a 27 percent increase. The new threshold is $29,000 dollars a year for a family of four.

In their ruling the judges say that the federal government can’t punish states that don’t want to come up to that higher threshold, but it can reward the ones that do. In other words, it’s now up to New Hampshire to decide if it wants to expand Medicaid, and take the federal dollars that go with that decision.

But exactly who in New Hampshire decides?

Buckley: Well ultimately, the Legislature has the last word on any of this.

Ray Buckley is the chair of the New Hampshire Democratic Party.

He says if Granite Staters want more low-income people to get health insurance, they’ll have to get some Democrats into office.

Buckley: This is an important argument on why Bill O’Brien needs to be replaced as speaker of the House. We need to have responsible leaders in positions of influence.

If the GOP is still in power after the next election, it’s pretty clear what the decision on Medicaid will be.

O’Brien: The increasing expansion of Medicaid is something the state of New Hampshire ultimately will not be able to afford.

New Hampshire House Speaker Bill O’Brien says he’s up to the challenge of defending the GOP position on the Affordable Care Act.

O’Brien: Well I think we’ve laid the groundwork here that will play itself out at the ballot box.

And O’Brien’s not the only one.

Republicans around the state were extremely quick to react to the Supreme Court ruling.

They may not have been happy to read what the majority opinion says, but they certainly don’t mind having what they call “Obamacare” to campaign against.

O’Brien: We’re gonna make sure that Mitt Romney gets a great vote in New Hampshire. We’re gonna make sure that Charlie Bass gets a great vote in New Hampshire. We're gonna make sure that Frank Guinta gets a great vote in New Hampshire.

So only hours after the ruling came down, parties in New Hampshire are already marshaling their forces for a showdown over the Affordable Care Act come November.

And what’s at stake in this political dust-up is healthcare for a lot of people.

The Kaiser Foundation estimates that expanded Medicaid would increase enrollment of New Hampshire residents by almost 39 percent by 2019.

The same Kaiser study estimates that state Medicaid spending would increase by only 1 percent in the same period, with the feds paying most of the bill.

But like the Supreme Court says, it’s up to New Hampshire to decide.

Sam Evans-Brown has been working for New Hampshire Public Radio since 2010, when he began as a freelancer. He shifted gears in 2016 and began producing Outside/In, a podcast and radio show about “the natural world and how we use it.” His work has won him several awards, including two regional Edward R. Murrow awards, one national Murrow, and the Overseas Press Club of America's award for best environmental reporting in any medium. He studied Politics and Spanish at Bates College, and before reporting was variously employed as a Spanish teacher, farmer, bicycle mechanic, ski coach, research assistant, a wilderness trip leader and a technical supporter.

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