New Hampshire clears major Medicaid expansion hurdle
By Reid Wilson, Updated: March 7 at 12:00 pm - Washington Post
New Hampshire Gov. Maggie Hassan poses for a
photograph at the start of the morning session of the National Governors
Association winter meeting in Washington, D.C., Saturday, Feb. 22, 2014. (AP
Photo/Cliff Owen)
After months of negotiations, the New Hampshire Senate on Thursday voted to
expand Medicaid to cover as many as 50,000 low-income residents using tens of
millions of dollars in federal aid.
About 12,000 residents who would qualify for coverage would be given
subsidies to pay for insurance through their employers. Thousands more would
receive subsidies to buy private insurance through the statefs health-care
exchange.
The state will now seek a waiver from the Department of Health and Human
Services to implement the modified program. HHS has granted preliminary
permission to several other states that wanted to implement similar programs,
rather than simply expanding Medicaid to cover those who made less than 138
percent of the federal poverty level, under the Affordable Care Act.
Senate Republicans had sought political cover to accept federal money under
the ACA. In recent weeks, several local Republican Party organizations have
voted on resolutions opposing Medicaid expansion, despite the fact that Senate
President Chuck Morse (R) was one of the leading proponents of the
compromise.
The debate is far from over: The proposed legislation expanding Medicaid
sunsets at the end of 2016, when the amount of federal money covering the
statefs costs decreases from 100 percent to 90 percent. Morse told
the Concord Monitor he was unwilling to allow New Hampshire to cover the
remaining 10 percent, because he said he didnft think the state could afford the
costs.
In a recent interview, Gov. Maggie Hassan (D) said the political cover the
compromise affords to Republicans was key to getting a deal done.
gWhat was important to conservatives was that we not permanently expand
Medicaid,h Hassan said. gOur goal was to get people covered as quickly as
possible.h
In the end, seven Republicans voted with 11 Democrats to pass the compromise
by an 18-5 margin. The measure will be sent back to the state House of
Representatives, which is controlled by Democrats; the House passed a straight
expansion of Medicaid last year and is likely to rubber stamp the Senate
compromise.
Once Hassan signs the bill, New Hampshire will be at
least the 28th state to expand Medicaid under the Affordable Care Act, and
the fifth — along with Iowa, Arkansas, Pennsylvania and Michigan — to move
forward with a customized version of its own. Debate is still ongoing in
Montana, Indiana and Tennessee, while other states are still actively seeking
waivers from HHS.