Paula Hancock isn't sure how the Affordable Care Act
and a proposed expansion of the Medicaid
health coverage program will work in New Hampshire
. The 60-year-old from Campton, N.H., would benefit from the expansion but doesn't know how long it will last or if she'll be left without insurance down the road.
She does know this: "I want it to work. I want to be enrolled in it. I want some healthcare assurance."
Hancock is one of about 50,000 people in the state who would get Medicaid if the Legislature passes a tentative deal announced two weeks ago. A hearing is set for Tuesday on the expansion, which would kick in as early as July 1.
New Hampshire is one of six states still undecided on whether to expand Medicaid as part of the federal health care overhaul.
Under the current deal, about 12,000 people could get coverage before July if they qualify for an existing program that subsidizes employer-based coverage. An additional 38,000 could start enrolling May 1 for coverage that would begin July 1.
If New Hampshire expands the program, the federal government will pick up the full cost until 2017.
The expansion would end when federal funding drops below 100 percent unless the Legislature voted to continue it. The entire program would be over at the end of 2016 if the Legislature doesn't authorize it to continue.
Senate leaders said the key is getting a federal waiver by March 31, 2015, allowing New Hampshire to use federal Medicaid money to buy private insurance beginning in 2016 for the 38,000 people on managed care.
Democratic Gov. Maggie Hassan urged lawmakers to pass the compromise as quickly as possible.
New Hampshire's current Medicaid program covers low-income children, parents with non-disabled children under 18, pregnant women, older residents and people with disabilities. The expansion would add anyone under 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,856 for a single adult.
Hancock is self-employed and earns less than $10,000 a year. She lives with her 89-year-old father and takes medicines to control cholesterol and high blood pressure — when she can afford it.
"If I could get a little bit of health care now, I'd be pleased," she said, putting her hopes on state and federal governments that she says could unravel the whole thing and leave her in limbo again.
There is reason for her to be cautious. The bipartisan deal that three Democratic and three Republican Senate leaders proposed still needs full Senate and House approval before it goes to the governor. Then, the federal government has to approve it.
"They've got to do something about us who are in the uninsured population," Hancock said. "But it's nerve-wracking when they start talking about the ACA and the added burden about who will accept us. I have a major amount of uncertainty. I want to come into something fairly solid."