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Medicaid expansion plan draws crowd to public hearing


State House Bureau

February 21. 2018 6:05AM
Manchester Mayor Joyce Craig urges lawmakers to continue Medicaid expansion in New Hampshire for another five years at a public hearing Tuesday in the State House. (Dave Solomon/Union Leader)

CONCORD — Edward Shanshala, CEO of Ammonoosuc Community Health Services in Littleton, came to the State House well-prepared to make the case for expanded Medicaid in New Hampshire.

Like many others at Tuesday’s public hearing in Representatives Hall, Shanshala was there to voice his support for a bipartisan proposal just unveiled last Friday to extend the program for at least another five years.

In addition to a petition signed by more than 1,600 Ammonoosuc patients, he presented the Senate Finance Committee with a bound volume of Medicaid expansion success stories, including a young woman addicted to heroin for several years who is now thriving and learning the skills needed to enter the workforce and to parent again.

“These are some individual case studies you can read at your convenience that demonstrate the reality of how this affects people’s personal lives in a very positive way,” said Shanshala.

New Hampshire is one of 33 states that opted to expand eligibility for Medicaid to embrace a larger portion of the population through the Affordable Care Act (Obamacare); the current authorization expires at the end of 2018.

By increasing the eligibility for Medicaid to 138 percent of the federal poverty limit, New Hampshire added about 50,000 individuals to the program, which prior to expansion was serving about 130,000.

The proposal unveiled on Friday, with bipartisan support, includes work or community service requirements for certain participants and conversion of the program to an HMO-style managed care approach.

Funding for the state share of the expansion, which rises to 10 percent by 2020, would come in part from the state’s Alcohol and Drug Abuse Prevention and Treatment Fund. Current law requires that 3.4 percent of the profits from state liquor sales go into the fund; that would rise to 5 percent under the new law.

Manchester Mayor Joyce Craig was among those urging lawmakers to support the proposal. She said terminating the expanded Medicaid program, as some have proposed, would be “devastating and catastrophic” for Manchester.

“In our city, the hospitals and the Greater Manchester Chamber of Commerce have all voiced support, as have our leaders on the front lines ... our police chief, fire chief and director of public health,” she said. “They have seen how Medicaid expansion provides for better options, helps keep our drug courts open and keeps Safe Stations operational. Our residents rely on this critical funding.”

State Rep. Cindy Rosenwald, D-Nashua, voiced the concern of many Democrats when she said some changes should be made in the work requirement and how it is administered. As proposed, the bill would allow an exemption from the work requirement for a parent or caretaker of a dependent child under 6.

“This age needs to be raised,” she said. “The idea that a 7-year-old can be left unsupervised all summer or in the evenings and on weekends when the parent is working is not where we want to be as a state.”

Greg Moore, state director with the conservative policy group Americans for Prosperity, argued that the exceptions to the work requirement are too generous, allowing community service, care-giving and volunteering as alternatives.

“I think volunteering and babysitting are great and have a lot of value,” he said. “But they do not move people to independence and self-sufficiency. We’ve even added bad weather and family problems. These are things people are dealing with now ... People who are working and have to get to work.”

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