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Senate approves Medicaid expansion in a divided vote

  • Republican Sen. Jerry Little, of Weare, speaks on the Senate Floor in support of a bill that reauthorizes medicaid expansion for two more years. The proposal passed the chamber in a 16-8 vote on Thursday, March 31, 2016. ALLIE MORRIS—Monitor staff



Monitor staff
Thursday, March 31, 2016

More than 48,000 low-income residents will keep their health insurance for two more years, after the Senate passed a bill Thursday that reauthorize’s New Hampshire’s Medicaid expansion program. 

The legislation now heads to Democratic Gov. Maggie Hassan, who says she looks forward to signing it into law.

The Senate approved the legislation Thursday in a 16 to 8 vote that divided Republicans who control the chamber. All ten Democrats backed the bill.

“Passage of this important legislation ensures that our neediest families will continue to receive private health insurance for two more years,” said Senate President Chuck Morse, a Salem Republican. 

Medicaid expansion covers adults making less than 138 percent of the federal poverty limit, or about $15,900 a year. The bill extends the health care program for two more years, institutes new work requirements for enrollees and covers state costs with premium tax revenue and voluntary contributions from hospitals and insurance carriers. 

The Senate vote marks an end to months of legislative debate over how to continue the state’s Medicaid expansion program, which was set to expire at the end of this year. 

While Republicans authored the reauthorization bill, the party’s lawmakers remain divided over the health care program. Supporters argue Medicaid expansion provides long-term cost savings, but opponents worry it shifts costs onto consumers with private insurance.

Senate Republicans sparred Thursday over work requirements, with some saying the bill doesn’t go far enough to ensure people enrolled in the health care program actually seek employment.

“We’re going to have a debate . . . about whether or not we should spend $1 billion in the next budget giving able-bodied adults – who are choosing not to work full-time – free health care on other people’s money,” said Sen. Andy Sanborn, a Bedford Republican. “Shouldn’t there be some requirement they try to pick themselves up from the boots?”

The bill calls for all “able-bodied” adults enrolled in medicaid expansion to meet a weekly 30-hour work requirement, which includes community service or job training.

But so far, federal overseers have denied such requests. Anticipating a similar rejection, New Hampshire’s bill includes a clause that allows the program to continue, even if the work requirement is turned down.

“We all support work requirements. Unfortunately, this administration so far hasn’t seen it that way,” said Senate Majority Leader Jeb Bradley, a Wolfeboro Republican and sponsor of the bill. “Are we going to put at risk 48,000 people, and hold them hostage?”

Sanborn argued the clause gives too much power to the federal government, and tried unsuccessfully Thursday to strip it from the bill. His amendment fell by a vote of 17 to 7.

In a fiery speech during the debate, Manchester Sen. Lou D’Allesandro pushed back against characterizations of people covered by Medicaid expansion.

“To portray people who are accepting the New Hampshire health care protection as something less than normal human beings and hardworking New Hampshire citizens is a discredit to the individual and a discredit to the state of New Hampshire,” he said. “The majority of them are working, but their wages are so low they are still under the poverty level.”

Roughly 43 percent of the people enrolled in Medicaid expansion are employed and 57 percent are not, according to recent data from the state’s Department of Health and Human Services. Almost one-third of the people enrolled in the program are young adults, between the ages of 25 and 34 years old.

Slightly more women than men are covered by the health care program, in a roughly 25,000 versus 23,000 person split. Geographically, the bulk of enrollees are located in the southern part of the state. But Coos County, which include towns in the northernmost part of New Hampshire, has the largest portion of its population enrolled in the health care program, at more than 5 percent. Hospitals report Medicaid expansion reduced uncompensated care costs by nearly $150 million last year.

The bill reauthorizes the health care program for two more years, meaning the debate will come up again next legislative session.

Meredith Republican Jeanie Forrester, the only Senator who has announced a run for governor, voted against reauthorization saying the work requirement isn’t strong enough.

The legislation will likely come to Hassan’s desk within the next two weeks.

“I look forward to signing this legislation into law so that we can continue this critical program that is strengthening the health and financial security of our people and boosting our economy,” she said in a statement.

(Allie Morris can be reached at 369-3307, amorris@cmonitor.com or on Twitter @amorrisNH.)