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Leaders: Medicaid expansion still possible in N.H.

State Sen. Peggy Gilmour, D-Hollis, left, listens as Sen. Jeb. Bradley, R-Wolfeboro answers her question during a special session the legislature Thursday, Nov. 21, 2013 at the Statehouse in Concord, N.H. The House and Senate are meeting to vote on plans to expand Medicaid to an estimated 49,000 poor adults under the federal overhaul law. (AP Photo/Jim Cole)

State Sen. Peggy Gilmour, D-Hollis, left, listens as Sen. Jeb. Bradley, R-Wolfeboro answers her question during a special session the legislature Thursday, Nov. 21, 2013 at the Statehouse in Concord, N.H. The House and Senate are meeting to vote on plans to expand Medicaid to an estimated 49,000 poor adults under the federal overhaul law. (AP Photo/Jim Cole)

Republican and Democratic legislative leaders remain upbeat about the odds of expanding Medicaid to an estimated 49,000 poor New Hampshire adults despite the recent failed vote.

Democratic House Speaker Terie Norelli said Friday that discussions will continue with Republicans and new legislation will be taken up next year. She said New Hampshire shouldn’t forget the people who continue to suffer because lawmakers failed to compromise on an expansion plan during a two-week special session.

The House passed a plan to expand coverage, but Senate Republicans killed it Thursday along with one offered by Senate Democrats. They also killed their own plan.

The key hurdle was when to use the federal marketplace to buy private coverage. The Republican-led Senate had insisted on implementing a private option sooner than Democratic Gov. Maggie Hassan and Democrats felt was practical to give additional insurers time to join the sole insurer on the marketplace.

Both sides expressed disappointment with the outcome.

“I really did hold out hope ultimately that we would get somewhere. Clearly, talks have to continue among everyone,” said Norelli, of Portsmouth.

Senate Republican Leader Jeb Bradley of Wolfeboro said Friday that senators should work on a bipartisan plan using the Senate Democrats’ idea as a framework.

“I think there’s a recognition on the Republican and conservative side that in a civil society helping people with their health insurance needs is appropriate when that help is necessary,” Bradley said. “All sides in the debate recognize that.”

But Bradley said the reforms Republicans sought must be part of any compromise. He said a proposal presented to Republicans on Thursday by Sen. Peggy Gilmour, a Hollis Democrat, might be a starting point.

If nothing is done, hospitals will continue to shift the cost of providing care to poor adults onto small businesses and people buying individual insurance, Bradley said.

“This is one reason why conservatives like me would want to try to find a solution,” he said.

Gilmour said the Democratic proposal tried to address Republicans’ demands that federal money pay for private insurance for the adults and that expansion not continue indefinitely without reauthorization.

“Certainly we have a starting point, maybe more than a starting point,” she said Friday. “I’m optimistic we can work things out.”

Tom Bunnell is a policy consultant for the nonprofit New Hampshire Voices for Health, which advocates for high-quality, affordable health care. He said anyone wanting an agreement needs to make their voices heard, given the political desire to find middle ground.

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