Looks like New Hampshire is about to expand Medicaid

New_Hampshire_quarter,_reverse_side,_2000For a time, the Granite State and the Pine Tree State were joined on health policy. Neither had a state-run health insurance marketplace and neither had expanded Medicaid.

In Maine, the Democratic-controlled Legislature has supported expanding Medicaid and votes to do so have included Republicans and Democrats. But there haven’t been enough to overcome a veto from Republican Gov. Paul LePage

In New Hampshire, Gov. Maggie Hassan, a Democrat, and the House, controlled by Democrats, have supported expansion. But the Republican-controlled Senate opposed it.

Now there’s a bipartisan plan in New Hampshire for Medicaid expansion that’s expected to pass

State senators from both parties have gotten together and come up with a structure that would fully or partially fund purchases of private insurance plans.

As the Concord Monitor reports:

This bill would give new premium subsidies to about 12,000 people with employer-based health plans. An estimated 45,000 additional people would get federal money to help them buy plans on the state’s insurance marketplace.

Some in Maine have discussed expanding Medicaid through the period that the federal government would pay 100% of the cost. New Hampshire is choosing to do something much like that.

Coverage under this bill would stop if federal funding dips below 100 percent. The federal government only plans to fully fund the program through the end of 2016, dropping to 90 percent and then lower. This means the next Legislature will have to re-authorize the bill in order for coverage to continue.

Gov. Hassan has endorsed the plan and reports indicate that the House would be willing to support it.

Senate President Jeb Bradley, a Republican, a cosponsor of the proposal, argues there’s much to like.

Putting more people on health insurance plans will decrease uncompensated care payments that drive up everyone’s health care costs, [Bradley] said. This plan also likely would bring the Medicaid managed care providers onto the exchange, creating more competition. (The state cannot get a waiver with only one provider on the exchange.) The bill also includes “personal responsibility measures,” like requiring eligible unemployed adults to seek help securing employment.

The bill also seeks a waiver to get more money from the federal government on Medicaid services not already being reimbursed, such as substance abuse treatment or care for the incarcerated. To get the waiver, New Hampshire must show it’s pushing the trend of drug usage down. This extra money would also help complement the state’s mental health care system, Bradley said.

This is not a done deal – yet.

But Medicaid expansion appears to be moving forward in New Hampshire.

If the Granite State passes it and Maine doesn’t, the Pine Tree state will be the only state in New England without Medicaid expansion.

Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.