Fate of Medicaid expansion in NH?

The Senate Health and Human Services Committee is currently considering a proposal to make Medicaid expansion in New Hampshire permanent. The bill, SB 236, was a late introduction by Sen. Martha Fuller-Clark.

The move comes amid controversy on the federal level over the fate of the Affordable Care Act, which initially granted states the option to expand Medicaid eligibility.

New Hampshire temporarily authorized Medicaid expansion in 2014, and the program was eventually renewed through December 31, 2018. (Read more about the issue here.) SB 236 would eliminate that sunset date, making the program permanent.

Currently, 95% of the costs of Medicaid expansion are covered by the federal government, an amount set to decrease to 94% in 2018. Further decreases are scheduled , down to 90% of funding by 2020—that is, if the program remains unchanged at the federal level.

But with President Donald Trump’s administration, and the GOP-dominated Congress, avowed opponents of the Affordable Care Act, the continuation of that funding is far from a certainty.

“The success of New Hampshire’s Medicaid expansion law has been touted by both Republicans and Democrats. 50,000 people rely on Medicaid expansion for their healthcare and nearly 10,000 patients are able to treat substance addiction through this Medicaid,” Sen. Fuller-Clark said. “It’s reducing heath care cost-shifting onto our families and businesses, strengthening the health of our workforce, and boosting our economy.”

Though sponsored by a member of the Senate's minority caucus, the prospects for the bill are far from bleak. Gov. Sununu recently came out in favor of the program on an episode of NHPR’s The Exchange, where he told host Laura Knoy, “There's no doubt it's been helpful."

Republican Senate Majority Leader Jeb Bradley has also expressed some conditional support for continuing Medicaid expansion, noting  that the program “works for the budget of the state of New Hampshire” but citing concerns about taking action before the situation in Washington becomes more certain.

However, there are many who are more skeptical of the program—including Rep. JR Hoell, who has sponsored a bill in the New Hampshire House to repeal it. In the Senate, Sen. Andy Sanborn has historically opposed Medicaid expansion, arguing that the state should at least set stricter requirements for eligibility. “We’re going to have a debate . . . about whether or not we should spend $1 billion in the next budget giving able-bodied adults – who are choosing not to work full-time – free health care on other people’s money,” Sanborn said during last year’s Senate debate on a related bill. “Shouldn’t there be some requirement they try to pick themselves up from the boots?”

A hearing on SB 236 was held on February 21^st, and the committee has yet to issue a recommendation.

Do you think NH should make Medicaid expansion permanent? Join the discussion on Facebook or comment below. Comments will be included in a summary of this discussion and presented to legislators considering this bill. Only comments from NH residents will be counted, so please indicate if you are from NH in your response.