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Medicaid expansion: So much for market-based plans

November 14. 2017 7:47PM

The premise of the bipartisan compromise to expand Medicaid to able-bodied, low-income New Hampshire adults was that the state would use federal funds to help these folks buy private health insurance.

That compromise would go out the window if a legislative commission has its way. The panel wants to extend the program for five more years, even as New Hampshire’s share of the price tag escalates.

But the group would also abandon the basic structure of what Senate Republicans labeled a New Hampshire solution.

The state would no longer leverage federal money to provide subsidies for health insurance plans through the Affordable Care Act exchange. It would instead put the newly-eligible population into the same managed care framework that is already sending Medicaid toward fiscal insolvency.

Senate Majority Leader Jeb Bradley is behind the commission’s recommendation, even though it undercuts the deal he sold to his fellow Republicans four years ago.

Putting able-bodied, childless adults on Medicaid was always a bad idea. Following the commission’s recommendations would drop the pretense that this program was ever anything other than an expansion of big government into the private health care marketplace.

Bradley gave up too much in convincing a handful of Republicans to go along with Medicaid expansion. Now, he wants to abandon the small sliver of market-based reforms that they got for doing so.

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