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Capital Beat

House Democrats propose Medicaid expansion deal to break budget deadlock

Hoping to break the deadlock in budget negotiations over Medicaid expansion, House Democrats this afternoon proposed a compromise plan that would expand New Hampshire’s Medicaid program for at least three years.

After a two-hour break, Senate Republicans said they needed more time to discuss the proposal and craft a counter-proposal.

“I think this is going to take the Senate some more time. … I think it will take till tomorrow morning to draft something that’s acceptable to the majority of the Senate — because I think that’s going to be an important piece, just to make sure we have a majority that’s willing to support whatever we bring over here to give to the House,” said Sen. Chuck Morse, a Salem Republican and chairman of the Senate Finance Committee.

Morse had earlier called the House proposal “a good first step.”

The Democratic-led House and Gov. Maggie Hassan want to expand Medicaid under the 2010 healthcare reform law championed by President Obama. The Republican-led Senate instead proposed studying the option, which would add an estimated 58,000 people to the Medicaid rolls.

Until today, neither side had offered much sign of budging from those positions during final negotiations on the two-year state budget. The next biennium begins July 1, and the committee of conference faces a Thursday deadline to complete its work.

Rep. Mary Jane Wallner, a Concord Democrat and chairwoman of the House Finance Committee, said this afternoon that Senate Republicans have been talking with Hassan’s office about a Medicaid solution for more than two weeks, and Senate President Peter Bragdon had asked for a written proposal from the House.

Under the House’s proposal, a nine-member commission — three appointed by Bragdon, three appointed by House Speaker Terie Norelli and three appointed by Hassan — would begin studying Medicaid expansion within a week of the budget becoming law.

The commission would work to craft an expansion plan to cover newly eligible low-income residents either through private insurance or Medicaid. That plan would go before the Legislature’s Fiscal Committee in August for a vote.

The 10-member Fiscal Committee consists of five senators and five representatives and is evenly split between Democrats and Republicans.

If a plan isn’t approved by the committee, the Department of Health and Human Services would expand the state’s Medicaid program only through the end of 2016, taking advantage of the three years when federal money would cover 100 percent of the expansion’s cost. (After that, the federal government has promised to pay at least 90 percent,)

“We … understand that there are many members in the Senate Republican caucus that would like to see the state accept these federal dollars the taxpayers of New Hampshire have paid into, instead of having them support health care in other states,” Wallner said. “We believe that we could finalize details around a New Hampshire model in a relatively short period of time, not the extended time that the Senate’s version” of the budget envisioned, with a study commission facing a Dec. 1, 2014 deadline for its final report.

But Morse said the Senate may want a more direct say on the question.

“If it’s going to be that the Legislature isn’t involved in voting on this issue, I think we’re not going to get anywhere,” he said.

UPDATED, 6 p.m.: This article has been updated to include the Senate Republicans’ response to the House’s offer on Medicaid expansion.

(Ben Leubsdorf can be reached at 369-3307 or bleubsdorf@cmonitor.com or on Twitter @BenLeubsdorf.)

Ironically, a couple of hours before the Medicaid proposal was debated, Sen. Morse went off on a bit of a rant about study committees. He basically said— and I can't say that I disagreed with him— that these committees all too often serve as a substitute for actually dealing with issues.

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