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N.H. Senate Approves Medicaid Expansion Proposal

Daniel S. Hurd via Flickr CC

New Hampshire’s fault line for expanding its Medicaid program has always run through the GOP-controlled Senate. 

There, top lawmakers from both parties have tried and failed to reach compromise over the past year. And so now with a deal clearly in reach, Democratic co-sponsor Peggy Gilmour of Hollis reminded colleagues of all they’ve been through.

“We’ve gone through our summer vacation, we went through the holidays, we’ve gone through the recent frigid cold weather to come to today. And I think we are at a point where we are moving forward as a Senate, as a state,” says Gilmour.

Under the bill which passed 18-5, roughly 50,000 low-income residents would get coverage through the government. Starting this summer it would come through Medicaid, but then in 2016, recipients would select private insurance on the exchange.

The federal government promises to pay 100% of the costs for the newly eligible. Senate Majority Leader Jeb Bradley says that doesn’t mean it gets to direct how the state reforms its program.

“We’re telling Washington how we can solve our health care problems in New Hampshire. It is not the other way around. And we have all the tax payer protection built into it to ensure that this thing stays on the tracks,” says Bradley.

But not all Republicans see a bright future.

Andy Sanborn of Bedford was one of five lawmakers who voted against the plan. He says cost estimates have the potential to explode in coming years, potentially leaving New Hampshire residents on the hook.

“We are telling the tax payers of New Hampshire today that we are going to charge them with buying other people’s mansions while they have to live in tents,” says Sanborn.

Sanborn also questioned if lawmakers would have the courage to undue the program after it sunsets in 2017.

Voters will get to weigh in long before then.

Greg Moore with the conservative advocacy group Americans For Prosperity says Medicaid expansion under Obamacare could be the decisive issue this November.

“In Washington, ironically, they are taking steps to move away from implementing Obamacare, delaying significant portions of the law, casting votes with both New Hampshire Representatives supporting to delay the individual mandate. Here in New Hampshire, we are seeing just the opposite,” says Moore.

The proposal still needs to move through the Democratically-controlled House, which will start debate next week.

Representative Cindy Rosenwald (D-Nashua) says the Senate’s bill is close in substance to what House leaders approved in the past.

“They’ve done a good job. I think it is a strong, bi-partisan effort, and I think it will be good for New Hampshire,” says Rosenwald.

Senate passage is also good for Governor Maggie Hassan, who made Medicaid expansion a top priority. She thanked lawmakers for their cooperation, and says health coverage should be ready on July 1st for the newly eligible.

“This is a very tight timeline, but I’m very confident that if we continue to work together, we are going to be able to meet it,” says Hassan.

Some of that will depend on the federal government, which still needs to approve the plan. One key requirement is if New Hampshire's reliance on private insurance coverage won’t end up costing Washington more than government-run care.

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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