New Hampshire House, Senate panels consider Medicaid expansion

House and Senate committees are holding public hearings and work sessions on rival plans to expand Medicaid in New Hampshire this week.

The House holds its public hearing Tuesday morning while the Senate's hearing on its plan is that afternoon. The committees working on the bills will vote on a recommendation Thursday, but whatever they decide may be superseded by any compromise negotiated behind closed doors by legislative leaders and Gov. Maggie Hassan.

The House and Senate plans are essentially the same for the first year, but take different approaches after that. Both start by using private insurance for eligible adults already on employer-sponsored plans and enroll others into the state's managed care program. The House continues that for two more years while the Senate shifts people onto the exchange.

Both plans would require federal waivers and would end the expansion if federal financial support fell below promised levels. The Senate would give the government one year to approve its use of the marketplace or the expansion to adults would end.

The Senate plan also would end automatically at the end of three years when federal funding begins dropping unless the Legislature reauthorized it.

The main sticking points to a compromise are the length of time allowed to obtain a waiver before adults are sent to the marketplace and whether all the adults or just those earning between 100 percent and 138 percent of federal poverty limits must use the marketplace.

An estimated 49,000 poor adults in New Hampshire would be eligible for Medicaid under the federal health overhaul beginning next year, but legislative authorization is needed to enroll them.