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N.H. House rejects attempt to block Medicaid expansion

Gov. Maggie Hassan’s plan to expand Medicaid in New Hampshire got a boost yesterday when the Democratic-controlled House killed legislation that would have blocked the expansion.

“It doesn’t matter at this point whether you are for or against Medicaid expansion. This discussion will be cut off today if we pass this. If we don’t pass it, then it will continue as a discussion,” said Rep. Thomas Sherman, a Rye Democrat and physician. “So now, let’s defeat this bill for the sake of our many uninsured New Hampshire citizens. These are New Hampshire people, our constituents. These are your family, your neighbors and my patients.”

The bill was then killed on a 206-155 vote, largely along party lines. Seven Republicans joined 199 Democrats to kill the bill, while two Democrats joined 153 Republicans in support of it.

Expanding Medicaid, a joint state-federal program for low-income and other Americans, is a key provision of the 2010 federal health care reform law that was championed by President Obama.

Last year, the U.S. Supreme Court, while upholding the bulk of the law as constitutional, gave individual states the choice to opt out of the Medicaid expansion. According to the Kaiser Family Foundation, 26 governors have come out in support of expansion in their states and 17 are opposed, with seven still weighing their options.

Hassan, a Democrat, is a supporter. She included Medicaid expansion in her proposed two-year state budget, saying federal money would cover the bulk of the cost.

The House held a public hearing on Medicaid expansion earlier this month and 30 people testified, all in favor of expanding the program, Speaker Terie Norelli and other House Democratic leaders wrote in a March 13 letter to Hassan.

But Mont Vernon Rep. Bill O’Brien, the Republican former speaker of the House, had earlier filed a bill to block the expansion.

Rep. Richard Meaney, a Goffstown Republican, argued yesterday that the state budget could face a huge burden if the federal government changes the rules in terms of funding the program.

“Medicaid expansion is unaffordable,” Meaney said. “It is unaffordable for the citizens of New Hampshire. It is unaffordable for the New Hampshire budget. It is unaffordable for America.”

But Rep. Laurie Harding, a Lebanon Democrat, said turning down federal money to expand access to health coverage would be a mistake.

“The money is there, and will be there unless there is an act of Congress and the president agrees. It’s written into the law,” she said, adding, “The federal government has had a very good track record in meeting their Medicaid obligations. They haven’t done so great in other areas, but in meeting their Medicaid obligations to the state they’ve done exceptionally well.”

O’Brien took the floor to remind representatives of an old saying: If it’s too good to be true, it isn’t true.

“Well, the federal government has a deal for New Hampshire that is too good to be true,” O’Brien said, calling Medicaid a “failed system” and saying it would be “pure fantasy” to think the federal government will keep its word and pay for the program.

“The problem we have here is that we’re taking on unsustainable financial obligations, both at the federal level and at the state level,” he said.

After about 40 minutes of debate, the full House voted, 206-155, to kill O’Brien’s bill.

The question of whether New Hampshire will, in fact, expand Medicaid probably won’t be answered until the state budget for the next two years is finalized. The next biennium begins July 1.

If New Hampshire does agree to expand the program, the federal government is expected to pay 100 percent of the cost for three years, between 93 percent and 95 percent for the next three years and at least 90 percent in subsequent years.

A study from The Lewin Group last year found Medicaid expansion would cost the state an additional $85.5 million over seven years, and factoring in other changes under the 2010 health care reform law, provide coverage to 22,300 residents who otherwise would remain uninsured.

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

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