state Senate leaders announced a bipartisan deal Thursday to expand Medicaid
to an estimated 49,000 poor New Hampshire adults by using federal funds to pay for private insurance
Senate President Chuck Morse, a Salem Republican, and Senate Democratic Leader Sylvia Larsen of Concord announced the agreement in a presentation before the chamber's Rules Committee. The committee voted unanimously to allow their bill's introduction.
Gov. Maggie Hassan praised the agreement in her State of the State speech about an hour later.
"With today's positive step forward, it's clear that we can work through this together and help working people access critical health coverage," she said.
Morse agreed: "The bipartisan nature of this agreement shows what can happen when we work together to focus on the issues critical to the well-being of our state."
Larsen said the agreement is the culmination of private negotiations since efforts to expand Medicaid failed during a special session in November.
"At the end of the day, this is about expanding coverage for tens of thousands of mostly working, low-income citizens, supporting our providers, helping our state budget, and helping our economy. Our bill will do all of these things," said Larsen.
Morse and Larsen said the agreement's framework, which will be put into legislation next week, would expand access to private health insurance by using an existing state program that subsidizes employer-based insurance and by buying private coverage through the federal marketplace.
Morse said the key was setting a deadline for federal approval of using Medicaid funds to fund private insurance by June 30, 2015.
If New Hampshire were to expand the program, the federal government would pick up the full cost for the first three years and 90% over the long haul. New Hampshire's healthcare providers would share in an estimated $2.4 billion over seven years.
The bipartisan agreement would end when federal funding drops below 100% in three years unless the Legislature voted to continue it.
New Hampshire is one of a small group of states that has not decided whether to expand Medicaid.
The Republican-led Senate has insisted on using federal Medicaid funds to pay for private insurance, either through an existing state program or the federal insurance marketplace. The House passed a new plan last month similar to one the Senate rejected in November.
Hassan, a Democrat, and the Democratic-led House had argued last year that the Senate's timeline to move adults into the marketplace and off the state's new managed care
system did not allow enough time for new insurers to offer plans through the exchange. The two also differed on whether enrollment in Medicaid should end when the federal subsidy is reduced starting in 2017.
Morse and Larsen did not go into details on how the agreement resolved those issues. Morse said the framework lays out firm deadlines and approval process.
New Hampshire's current Medicaid program covers low-income children, parents with nondisabled children under 18, pregnant women, senior citizens and people with disabilities. The expansion would add anyone under age 65 who earns up to 138% of federal poverty guidelines, which is about $15,856 for a single adult.