House Rejects Medicaid Growth Ban

N.H. GOP Sought to Block Expansion

Concord — The House of Representatives moved a step closer to expanding Medicaid to cover as many as 58,000 more low-income adults, rejecting a bill aimed at bringing that reform to a halt.

When Rep. William O’Brien, R-Mont Vernon, was speaker of the House, he vowed to block this expansion under the federal health care law since the U.S. Supreme Court ruled states have the voluntary choice of whether they wish to do it. O’Brien said federal promises of at least 90 percent federal reimbursement for those in this expanded coverage won’t be kept and health costs will soar still higher for those already insured.

“All of us will come to hate it, as taxpayers and purchasers of private insurance we will pay more,” O’Brien said.

But Rep. Thomas Sherman, D-Rye, said this expansion will give insurance to the poor without children who often end up in emergency rooms after a catastrophic illness.

“These are New Hampshire people, our constituents, your family and my patients, most of them struggling with one or more low-paying jobs,” said Sherman, a physician. “Without your help, we know they will get sick more often and die younger at higher rates than us.”

After 40 minutes of debate, the House voted, 206-155 to kill O’Brien’s bill, but it doesn’t end the debate.

Gov. Maggie Hassan included Medicaid expansion in her proposed, $11 billion state budget and that policy will remain in the version the House Finance Committee is expected to complete by the end of the month.

But Senate Republicans have not committed to the change being part of the two-year spending plan the Senate will take up in May.

Currently, 132,000 in the state are on Medicaid and consist of low-income women and their children, expectant mothers and poor adults with disabilities.

The state receives 50 percent federal support to give Medicaid insurance to this population and it’s the single, largest item in the state budget.

The expansion would offer this coverage to adults or couples with or without children who make no more than $18,000 a year or 138 percent above the federal poverty level.

The Lewin Group for the Department of Health and Human Services has concluded expansion would bring to the state $2.5 billion more in federal grants over the next decade.

New Hampshire Hospital Association President Stephen Ahnen said his group favors expansion and noted many of those now without any insurance end up in hospital emergency rooms at even greater cost to the hospital’s bottom line.

Americans for Prosperity NH Director Greg Moore said those same consultants have concluded the state will face higher costs of its own, at least $85 million for administration and up to $126 million total over the next six years.