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Panel: Expand N.H. Medicaid

Concord — A majority of a special panel voiced support Wednesday for expanding Medicaid to poor adults in New Hampshire but the details of what an expanded program would look like remain to be resolved.

The panel agreed New Hampshire would benefit from accepting $2.4 billion in federal funding over seven years beginning Jan. 1 under the federal health care overhaul law. Six of the nine members said New Hampshire should capture the federal money to provide health insurance to an estimated 49,000 poor adults. It was equally clear that the group would like to find a way to rely on private insurance for as much as possible.

Panel Chairman James Varnum said New Hampshire can’t fund a program on its own.

“We need to partner with the federal government,” he said.

State Sen. Andy Sanborn, R-Bedford, remained skeptical. “This commission has an obligation to prove to the people of New Hampshire if we do that that the money is well spent,” he said.

The group did not make any final decisions, and support for recommending that lawmakers expand Medicaid still depends on what the expansion would look like.

Some, like state Sen. Nancy Stiles, suggested expanding an existing program where the state pays an employee’s costs to remain on an employer’s private insurance plan. Stiles said she’d like that to be the first option instead of enrolling people into the existing Medicaid program. Other could get coverage through government-subsidized private insurance in a new insurance marketplace being established under the federal health care overhaul law, she said. Medicaid should be the last resort, she said.

Several also liked the idea of adopting a requirement that the program be reviewed either after a set number of years or if the federal government reneged on funding levels. Some thought the expansion should automatically be repealed if the federal government broke its promise.

The commission was established as a compromise in the budget debate. Democratic Gov. Maggie Hassan and the Democratic-led House wanted to authorize Medicaid expansion in the budget bill, but the Republican-led Senate insisted on establishing a commission to study the issue first.

The panel faces an Oct. 15 deadline to report to the Legislature.

States can choose to expand Medicaid as part of the new federal law, which would be implemented starting Jan. 1. That’s when an estimated $2.4 billion in federal funding the state would get over seven years would kick in. If New Hampshire were to expand the program, the federal government would pick up the full cost for the first three years and 90 percent over the long haul. States can withdraw from covering adults at any time.

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 percent of federal poverty guidelines, which is about $15,000 for a single adult.