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Health Policy Gets Reboot After Election

President Obama’s re-election didn’t exactly smooth over implementation of his signature health care law. State governments across the nation maintain a solid level of anxiety over the bill.

Concord is no different…lawmakers like Republican Jeb Bradley expect to spend a lot of time grappling with the Affordable Care Act’s key provisions.

“The biggest single issue that this legislature in the upcoming two years will face is the expansion of Medicaid.”

Bradley, who by the way prefers the term angst, over anxiety, says he wants data and research to drive the debate over expansion. Not ideology.

The Senator’s position differs from that of outgoing Speaker Bill O’Brien and House Republicans. They made it clear last session that they had no interest in expanding Medicaid.

But with Maggie Hassan’s win in the Governor’s race, and a new Democratic majority in the House, expansion is back on the table.

For her part, House Democratic Leader Terie Norelli looks forward to the debate.

“Hopefully, rather than quarreling, we will have an open and honest discussion about the benefits and disadvantages of expanding Medicaid will mean, both in short term, and long term.”

The issue of who will run New Hampshire’s health exchange is also going to come up this term.

Exchanges, remember, are the online marketplaces where individuals and small businesses will shop for health insurance starting in 2014.

Last June, lawmakers passed a bill prohibiting the state from setting up its own exchange. That means the Federal government will do it instead.

But with the recent Democratic gains, there’s now a push for the state to play a larger role in its design.

Regardless of what happens, just the fact that these issues are being debated is a win for voters, says Tom Bunnell. He’s with NH Voices for Health, an advocacy group.

“One of the things I’ve seen all over this state is that everyday folks in New Hampshire, the voting public, the folks that are responsible for putting folks in office, are really tired of ideology eclipsing pragmatism.”

There are still going to be some partisan health battles this session, such as over a proposed bill to limit abortion after a fetus’s heartbeat can be detected.

But other controversial measures may face less opposition with the new landscape in Concord.

Last summer, when the Republican-held legislature failed in its effort to de-fund Planned Parenthood, members of the Executive Council did it for them.

The Council, which has final say over contracts, voted to terminate Planned Parenthood’s $1.8 million deal to provide contraception and other health services.

This fired up Democrats like Colin Van Ostern, who saw the move as politics interfering with good policy.

“Well, it didn’t just fire me up, it fired up a lot of grassroots support.”

He says proof of that support was all over the state.

“I remember last summer, there were pink yard signs all across New Hampshire that said, ‘I stand with Planned Parenthood.’ You don’t usually see yard signs in the summer the year in between elections.”

So this election, Van Ostern decided to run for Executive Council. He won the seat, helping Democrats re-take control of the 5-member body.

Another issue is medical marijuana. Advocates see this as their best chance to move through legislation. Outgoing Democratic Governor John Lynch had vetoed several attempts at legalization.

There will also be movement on the tobacco tax. There’s bi-partisan support to undue the 10-cent cut Republicans pushed through last term.

They hoped it would increase cigarette sales at convenience stores along the border with Massachusetts. But that didn’t happen, and revenues came in $11.5 million below projections. One reason: immediately following the tax cut, cigarette manufacturers raised prices per pack by about a dime.

The cigarette tax, along with the fight over Medicaid expansion will most likely play out during the budgeting process this spring.

And voters…will be watching.

Todd started as a news correspondent with NHPR in 2009. He spent nearly a decade in the non-profit world, working with international development agencies and anti-poverty groups. He holds a master’s degree in public administration from Columbia University.
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