The last weeks of the year, usually a fairly quiet time at the State House, have been anything but. That trend is likely to continue right up to Dec. 21, when the place shuts down for the holiday.
The news that federal officials have approved a work requirement for some Medicaid recipients in the state has triggered a flurry of activity that is expected to come to a head on Dec. 20, when the legislative committee that has to approve administrative rules for the new program is expected to take testimony.
Democratic Sen. Dan Feltes, new majority leader in the state Senate, has promised a fight over the way the state’s proposal was changed by the feds to make the requirement more onerous.
Officials at the Department of Health and Human Services estimate that as many as 15,000 of the 52,000 individuals benefiting from expanded Medicaid could be subject to the new work requirement, aimed at able-bodied adults not involved in the care of a child or elderly relative.
New Hampshire now joins three other states, Arkansas, Indiana and Kentucky, with approved waivers to implement a work requirement in their Medicaid programs.
The Kaiser Foundation has crunched the numbers on Medicaid recipients nationwide, and claims that on average, only 6 percent of Medicaid recipients are not already working or eligible for an exception.
That would put the number in New Hampshire subject to the new requirement at somewhere between the high estimate of 15,000 and a low of 3,120.
New Hampshire already had an aggressive proposal in place even before it was made tougher, according to the Center on Budget and Policy Priorities, which compared New Hampshire’s work requirement to Arkansas’s.
New Hampshire will require at least 100 hours of work per month, compared to 80 hours in Arkansas. The work requirement in the Granite State will apply right up to age 64, versus 49 in Arkansas. It will also be applied to parents of children age 6 and older in New Hampshire, whereas Arkansas’ policy excludes parents.
“Also, the policy approved by the Centers for Medicare and Medicaid goes beyond New Hampshire’s revised waiver application in that, starting in May 2020, it doesn’t allow beneficiaries to maintain their coverage if they need more than one month to make up missed hours from a previous month,” according to Jessica Schubel, a policy analyst with the CBPP.
Democrats went along with the work requirement as part of a bipartisan deal to extend the expanded Medicaid program for another five years.
The Executive Council is also facing two controversial issues it will have to settle in its final meeting of the year on Dec. 19, or punt to the new council that will take office in January.
The first is whether to authorize funding for a new program to include data on maternal opioid use in birth records, with so many New Hampshire babies coming into the world with NAS, neo-natal abstinence syndrome.
The proposal was first delayed when Councilor Andru Volinsky raised questions about whether the information would be included on publicly available birth records.
DHHS Commissioner Jeffrey Meyers assured him by letter on Nov. 20 that aggregated and statistical information would be publicly available, but not personally identifiable information.
Volinsky had more questions on Dec. 5 and the matter was again tabled. “I asked Jeff a couple of follow-up questions and he asked for more time,” said Volinsky. “The delay is mostly my fault. I assumed Jeff would know answers off the top of his head, but he wanted time to go a bit deeper in response.”
Also left hanging is the fate of a key amendment to the deal with Vail Resorts to take over the lease to operate the state-owned Mount Sunapee ski resort.
Vail would like the same option to develop adjacent properties that the previous lease-holder had, while development opponents see the changeover as a chance to squash the likelihood of expansion once and for all.
Councilor Russell Prescott suggested that matter might best be resolved by a vote of the Legislature, and the amendments were tabled for a second time.
Opponents of the so-called West Bowl expansion at Sunapee were upset that the amendments were not available for public viewing before the Dec. 5 council meeting, and will likely be lobbying councilors aggressively in the run-up to their Dec. 19 vote.