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NH Senate committee recommends making Medicaid expansion permanent

A state Senate committee recommended permanently reauthorizing New Hampshire’s Medicaid expansion program Wednesday, after a broad coalition of businesses, health care providers and patients testified in support.

“The question for us today is: has Medicaid expansion worked?” Republican Senate President Jeb Bradley said at the start of a hearing Wednesday. “And I think you're going to hear a lot of testimony today that the answer clearly and unequivocally is yes.”

Medicaid expansion — known as Granite Advantage — provides health coverage for tens of thousands of low-income adults. It was last reauthorized in 2018, and will expire at the end of this year if lawmakers don’t renew it.

Bradley is leading a bipartisan group of 17 state senators sponsoring a bill to make the program permanent. Two Democratic state representatives have also signed on.

The 2010 Affordable Care Act allowed states to expand Medicaid coverage, with the federal government paying most of the costs. New Hampshire lawmakers first adopted the program in 2014 and have reauthorized it, with changes, twice since.

A recent report from the New Hampshire Fiscal Policy Institutefound that Medicaid expansion significantly cut the rate of uninsured people in the state and expanded access to health care, including mental health care and addiction treatment.

It has also meant fewer uninsured patients show up in emergency departments seeking care, Steve Ahnen, the president of the New Hampshire Hospital Association, told lawmakers Wednesday. He said the costs to New Hampshire hospitals of providing uncompensated care has dropped from $173 million in fiscal year 2014 to $69 million in fiscal year 2021.

Business groups also testified in support. Mike Skelton of the Business and Industry Association called reauthorization an “economic and workforce imperative.”

“Having a healthy population is important to having a healthy workforce,” he said.

Henry Lipman, the state’s Medicaid director, said about 95,000 people are currently enrolled in the expanded Medicaid program. He expects that to drop to around 64,000 by the end of the year, astemporary pandemic-era rules expire.

Medicaid disproportionately covers rural residents and Black, Latino and Indigenous Granite Staters, according to the Fiscal Policy Institute. Many people spend short times enrolled in Medicaid as they lose and gain employment, or work seasonal jobs.

Lawmakers heard from several individuals who said Medicaid coverage was a lifeline for them. Michelle Lawrence of Manchester was diagnosed with cancer more than a decade ago. After losing a job last year, she said Medicaid was her only option.

“With treatment and access to care. I have regained strength and even started a small part time job,” she said. “I'm not waking up in the middle of the night thinking about having to decide whether to pay rent or delay treatment.”

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at pcuno-booth@nhpr.org.
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