Thursday, January 28, 2016
Republican lawmakers presented their plan for reauthorizing Medicaid expansion Wednesday, outlining a proposal that includes work requirements for recipients and asks insurance companies and hospitals to help foot the state’s share of the program’s costs.
“This is an important debate to many of my constituents,” said Republican Rep. Joe LaChance of Manchester, the bill’s prime sponsor. LaChance said he’s seen the positive effects of the program, which insures more than 45,000 New Hampshire residents, in his home city.
New Hampshire crafted a version of Medicaid expansion in 2014 that uses federal dollars to put people on private insurance plans. The program insures people who make up to 138 percent of the federal poverty line, or about $16,000 a year for an individual.
But federal funding for the expansion is set to start dropping next year, and the state’s plan will sunset at the end of 2016 if lawmakers don’t vote to reauthorize it. Republicans, who control the Legislature, have long said they won’t make taxpayers foot the state’s share of the bill.
LaChance’s proposal, also backed by GOP Senate Majority Leader Jeb Bradley and House Speaker Shawn Jasper, relies on an insurance premium tax as well as voluntary contributions from insurance companies and hospitals to pay the state’s costs, estimated to be $25 million in 2018. The New Hampshire Hospital Association supports the plan, saying Medicaid expansion has decreased uncompensated care costs because fewer uninsured people are showing up in emergency rooms.
Beyond the payment structure, the bill makes several other changes to the program that will need approval from the federal government. For example, it requires “childless, able-bodied” adults on Medicaid expansion to spend 30 hours per week working or performing other activities such as job training or community service. No other states have been given the okay to include such work requirements.
It requires $8 copayments for people who unnecessarily visit the emergency room and $25 copays for every unnecessary emergency room visit thereafter.
The bill’s first public hearing will be Thursday in Representatives Hall.
Democratic Gov. Maggie Hassan did not have a comment on the bill Wednesday but said she will continue to work with lawmakers to reauthorize the program. Several outside organizations back the plan, including New Futures, a nonprofit working to fight the state’s drug crisis, and the Business and Industry Association.
Democrats are introducing their own plan to maintain the program, but Bradley said he’s confident the GOP’s plan will gain traction.
“Rep. LaChance’s bill is the train that’s going to leave the station,” Bradley said.