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NH Senate OK's Medicaid expansion

State House Bureau

March 31. 2016 8:56PM

CONCORD — Low-income adults will be eligible for publicly funded health insurance for two more years under the state’s Medicaid expansion program, thanks to a 16-8 Senate vote on Thursday.

Gov. Maggie Hassan has said she will sign House Bill 1696.

During two hours of debate, a majority of senators rejected proposals to change the bill. Six Republicans joined all 10 Democrats to approve the program, begun nearly two years ago under the Affordable Care Act.

Under the plan, hospitals and insurance companies will pay the state’s approximately $40 million share of the costs over the next two years when the federal government no longer pays 100 percent.

Supporters said the program provides health insurance to more than 48,000 low-income adults while protecting taxpayers, putting a lid on health care and insurance costs and making treatment and recovery benefits available to 6,000 substance abuse sufferers.

But opponents said $1 billion of taxpayer money will be spent on free health insurance to able-bodied adults without assurance that health care costs or insurance premiums will stabilize, or that it will improve anyone’s health.

Conservative Republicans complained they were left out of the process as Democrats and more moderate Republicans crafted the program extension.

That money will be spent without accountability, said Sen. Andy Sanborn, R-Bedford.

“That is hardly a frugal amount of money for 48,000 people,” he said. “Who’s in charge here? Every piece of legislation we want, do we have to get down on our knees and bow to the federal government?”

He and several other opponents focused on the bill’s 30-hour-a week work requirement. They said the provision was meaningless because federal regulators have denied all similar requests.

Sen. Lou D’Allesandro, D-Manchester, noted that more than 40 percent of people qualifying for the program are working.

“Let’s not demean our population,” D’Allesandro said. “They are good, hard-working people. They need help.”

Senate Majority Leader Jeb Bradley, R-Wolfeboro, said Sanborn’s proposed amendment to remove a provision that would allow the program to continue if federal regulators denied the work requirement was intended to kill the program.

Bradley said without it, uncompensated care costs for hospitals and medical clinics will increase and drive up insurance premiums and health care costs.

And he said Medicaid expansion is paying about 40 percent of the cost for treatment and recovery programs to fight the state’s heroin and opioid epidemic.

“Are you going to turn down 40 percent of funding in the midst of a heroin crisis,” Bradley asked. “I’m not. Some of you may, but I’m not.”

Sanborn’s amendment was defeated 17-7.

Sen. Russell Prescott, R-Kingston, unsuccessfully proposed continuing the program for one year if the work requirement is turned down by the feds. He also suggested creating a commission to study the program and continuing the program — but only for those below 100 percent of the federal poverty level, not the current 138 percent limit.

After the vote, Hassan praised the groups and lawmakers who worked to pass the bill.

“Thanks to our bipartisan health care expansion plan, nearly 50,000 hard-working Granite Staters have access to quality, affordable health insurance, reducing health care cost-shifting onto all of our people and businesses,” Hassan said.

Under the program, the state will receive more than $800 million from the federal government. Participants purchase private insurance policies through the state’s health insurance exchange using federal Medicaid money.

If the program was not reauthorized, it would have ended Jan. 1, 2017.

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