Senate committee to take up Medicaid expansion plan

As New Hampshire’s Legislature moves toward reauthorizing the state’s Medicaid expansion plan, several Republican lawmakers raised concerns Tuesday about the program’s effectiveness.

Roughly 48,000 low-income adults are insured through the program, which will expire at the end of the year if lawmakers don’t renew it. Advocates for the program say it is lowering health care costs overall by reducing uncompensated care at hospitals and call it a critical tool in fighting the state’s substance abuse crisis. But opponents suggest taxpayers aren’t seeing enough of a benefit from the program and question why adults who could be working need government-funded health insurance.

“I look forward to voting for it the day you can prove to me it works,” Republican Sen. Andy Sanborn of Bedford said during a public hearing after challenging aspects of the program.

Despite some concerns from GOP members, the bill has already passed the Republican-controlled House and faces favorable odds in the GOP-led Senate. The bill will likely be up for a Senate vote next week and head to Gov. Maggie Hassan’s desk if approved.

The reauthorization bill continues the program for another two years but sets up a payment mechanism for hospitals and insurance companies to cover the costs not picked up by the federal government. Starting in 2017, federal funding drops from 100 to 95 percent, and Republicans have said they’ll only continue the program if state taxpayers aren’t footing the bill.

It also creates a work requirement for recipients of the insurance, something the federal government hasn’t approved in any other states. Sanborn suggested the program should be discontinued if the work requirement isn’t approved.

Republican Sen. Jeb Bradley, a sponsor of the bill, highlighted the substance abuse benefit that is available to people on the insurance program, which he said roughly 6,000 people have used. New Hampshire is facing an ongoing heroin and opioid crisis, with overdose deaths topping 400 in 2015.

“Six thousand people have accessed this benefit,” he said. “But for that, you have to ask the question, what would the death toll be?”

Republican Sen. John Reagan pushed for details about the efficacy of the substance abuse benefit, saying he wants more evidence that it is saving lives.

The Business and Industry Association and the New Hampshire Hospital Association as well as many drug and alcohol prevention, treatment and recovery providers all support the bill.