HANOVER — On a 3-2 vote down party lines, the Executive Council approved a $292 million contract that allows the N.H. Health Protection Program, or Medicaid expansion, to begin Sept. 1.
The contract with the two managed-care companies — N.H. Healthy Families and Well Sense — that administer the state’s Medicaid managed care program, sets the rates the state pays to the administrators and the rates the managed care companies pay medical providers for the 50,000 or more low-income adults who qualify for government-paid health insurance under the Affordable Care Act.
The contract was not on the Executive Council’s agenda but was added as a late item, and that upset District 3 Executive Councilor Chris Sununu, R-Newfields, who said he saw the contract for the first time two hours before the meeting.
He asked to put the vote off for two weeks until he and other councilors had more time to digest the contract and talk to the managed care companies, but Health and Human Services Commissioner Nicholas Toumpas said to have the program up and running on Sept. 1, a lot of work needs to be done, including recruiting substance abuse treatment services.
“Without an approved contract, much of that work cannot really begin,” Toumpas said. “To delay to Aug. 5, puts us up against the wall.”
He said the contract was the cornerstone of the program and critical to its moving forward.
Gov. Maggie Hassan said the managed care companies are pushing for the council to act so they will know what their rates are.
“I’d be happy to take a break if you want to make some phone calls,” Hassan said to Sununu, “but to wait almost three weeks concerns me because that delay will cause thousands of New Hampshire citizens to wait for (health insurance).”
Councilors Colin Van Ostern, D-Concord, and Chris Pappas, D-Manchester, suggested waiting several hours so Sununu could read the contract, but both said they believe it should be acted on today.
“There is not a lot of new information,” Pappas said. “This is too important not to act today.”
Van Ostern noted those who oppose Medicaid expansion have done what they could to significantly delay it. He said the state’s working poor could have had health insurance a year and a half ago without the opposition.
“Don’t tie my shoes together and then tell me I’m shuffling,” Van Ostern said. “There are legitimate policy disagreements, but this has been decided. This has been through the legislative process.”
Sununu said his hesitation has nothing to do with Medicaid expansion, noting that train has already left the station, and said to imply that is disingenuous.
He said he did not want to waste everyone’s time and said he would vote against the contract anyway.
“Our primary purpose in this state is to be a check and balance, and we rubber stamped this contract without reading it,” Sununu said after the meeting. “I don’t understand why (all the councilors were not) saying give us a couple of days.”
Medicaid expansion failed to win Senate approval last year, and a commission worked last summer and fall to develop another plan, which the Senate killed in a special session.
A bipartisan group of senators, including Senate President Chuck Morse, R-Salem, devised the N.H. Health Protection Program that was approved this spring to use private commercial insurance available on the state’s electronic marketplace to provide coverage to the newly eligible.
For the next two-and-a-half years, the federal government pays 100 percent of the cost of the program.
The state initially estimated 50,000 poor adults would qualify, but Toumpas said Wednesday he now expects the newly eligible population to exceed that figure.