Commission accepts final report recommending Medicaid expansion
After more than three months of work featuring sometimes pointed debate, a study commission recommended yesterday that New Hampshire expand its Medicaid program as authorized under the Affordable Care Act.
In a unanimous if qualified vote yesterday, the nine-member group approved a 115-page report endorsing expansion through a variety of private and public programs. Gov. Maggie Hassan said she planned to ask the Executive Council today to call the Legislature to a special session to address the issue, beginning Nov. 7 and ending Nov. 21.
In moving to approve the report yesterday, Rep. Cindy Rosenwald, a Nashua Democrat, said the report showed “even when we didn’t agree on the specifics, we’ve all recognized that we all share a very strong commitment to New Hampshire.”
Though all commissioners voted to approve the report, several were clear that they did not support the majority recommendation, which had been decided in a 6-2 vote last week. (Commissioner Charlie Arlinghaus, president of the Josiah Bartlett Center for Public Policy and one of the commission’s conservatives, abstained.)
Sen. Andy Sanborn, a Republican from Bedford, said the report is “rife with holes.”
“The real work,” Sanborn said, “will come down to what our goals are in the Senate.”
The majority recommendation encourages the Legislature to extend state support for health insurance to all adults earning up to 138 percent of the federal poverty level, about $16,000 for a single person. That would extend coverage to about 49,000 poor adults in the state.
Under the Affordable Care Act, also known as Obamacare, the federal government will pay the full cost of expanding the program for the first three years, and contribute at least 90 percent every year after that.
The commission also recommended that New Hampshire residents with access to insurance through their employer would be required to take that insurance, not Medicaid. The state would help pay for their portion of the premium costs under the existing – but currently voluntary – Health Insurance Premium Payment (HIPP) program.
Requiring HIPP enrollment for people who are eligible for Medicaid must be approved by the federal government through a waiver; the commission calls for making the receipt of that waiver a condition for expanding.
Within seconds of the commission’s vote, groups on both sides of the issue began releasing a flurry of statements.
Hassan, a Democrat who has long supported expansion, said in a statement yesterday that “accepting the $2.5 billion in federal funds available for Medicaid expansion is the right thing to do for the health and financial well-being of hard-working Granite Staters and for the future of our economy.”
She thanked the commission members “for their constructive, bipartisan work that has provided a roadmap for a plan that best represents the needs of our people and state.”
The New Hampshire Fiscal Policy Institute called on the Legislature to promptly adopt the report. Speaker of the House Terie Norelli called the plan “the best possible solution for New Hampshire.”
Americans For Prosperity, a conservative lobbying group, advocated instead for lawmakers to forgo expanding and continue looking for other ways to extend private health coverage to more New Hampshire residents.
The challenge still facing advocates of expansion in the special session is reconciling Democratic enthusiasm for expansion in the House with Republican reluctance in the Senate.
Senate President Chuck Morse, a Salem Republican, said in his statement that the use of private insurance, obtaining necessary federal waivers and protecting New Hampshire taxpayers from future liabilities are “items that will be of critical importance to the Senate.”
(Sarah Palermo can be reached at 369-3322 or firstname.lastname@example.org or on Twitter @SPalermoNews.)