New Hampshire Democratic Gov. Maggie Hassan led the drive to expand Medicaid to about 58,000 more enrollees. But her efforts and those of the state's hospitals have run into opposition from the Republican-led Senate, which is scheduled to consider a budget this week that would study the expansion instead of approving it. A Senate panel had earlier rejected the expansion.
“They've raised a number of questions, particularly whether the federal commitment to financing be there,” said Steve Ahnen, president, New Hampshire Hospital Association. “We believe the answer is absolutely yes.”
Other concerns raised by Republicans in recent weeks, Ahnen said, stemmed from a May 2 study in the New England Journal of Medicine. That study found little to no physical health improvement among Medicaid enrollees in Oregon over two years, although their health spending and use of healthcare services increased. That study did find, however, that enrollees experienced financial relief from medical costs and a significant drop in depression.
Ahnen and other expansion supporters have countered that they expect long-term uninsured people who gain Medicaid coverage may take years to improve their health outcomes.
Meanwhile, Democrats backed off an expansion approach that critics saw as a sign of desperation. Hassan said at a Tuesday news conference that she would not pursue an administrative expansion of Medicaid because she appears to need legislative approval for growing the state Medicaid program.
In Maine, the proposal to add about 70,000 more enrollees to the Medicaid program has run up against the Republican governor's opposition. Gov. Paul LePage has opposed the Medicaid expansion until other actions are taken. The list of other required actions grew this week to include funding to remove 3,100 mentally disabled residents from a waiting list for care and stepped-up efforts to combat fraud.
“Until we crack down on the fraud and abuse that robs hard-working Mainers of their tax dollars, I will not discuss any efforts to expand welfare,” the governor said in a June 3 written statement.
LePage vetoed one attempt to expand the program and is expected to veto a second expansion measure, on which the Senate is voting later Tuesday. Both Maine legislative chambers are controlled by the Democrats.
Unlike in most other states, the Medicaid expansion has not been led in Maine by its hospitals. Steven Michaud, Maine Hospital Association president, said his group supports it but its legislative priority this year is collecting about $500 million in unpaid state payments to Medicaid providers.
Democrats had tried to garner Republican support for the Medicaid expansion by combining it with a measure to provide the back pay to providers. But that was not enough to overcome the governor's opposition. The repayment is now advancing as a separate bill.
Despite the continuing opposition from the governor and lack of votes to override his veto, Michaud gives the Maine expansion even odds. It could still be added to the budget before that document must be finalized by the end of the month.
“There's a whole bunch of issues still swirling around and expansion will stay in the mix until the very end,” he said.
