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N.H. Panel Delays Vote On Medicaid

State Rep. Tom Sherman, D-Rye, center, and state Sen. Nancy Stiles, R-Hampton, listen to state Sen. Andy Sanborn Wednesday, Oct. 2, 2013 in Concord, N.H. during a break in the meeting of the special commission charged with recommending whether New Hampshire should expand Medicaid. The panel has an Oct. 15 deadline to file a report. (AP Photo/Jim Cole)

State Rep. Tom Sherman, D-Rye, center, and state Sen. Nancy Stiles, R-Hampton, listen to state Sen. Andy Sanborn Wednesday, Oct. 2, 2013 in Concord, N.H. during a break in the meeting of the special commission charged with recommending whether New Hampshire should expand Medicaid. The panel has an Oct. 15 deadline to file a report. (AP Photo/Jim Cole)

Concord — A plan to expand New Hampshire’s Medicaid program took shape Wednesday. But after three months of work, the special commission studying the issue put off any final vote for another week at least.

The commission will meet Tuesday, a week before its report is due. Chairman Jim Varnum said he hopes it can wrap up its work then.

Its members took more than a half-dozen votes Wednesday as they parsed and debated a plan drawn up by Rep. Tom Sherman, D-Rye, and commission member. They unanimously endorsed the principle that New Hampshire residents, ages 19 to 64, with incomes between 100 percent and 138 percent of the federal poverty line should get health coverage.

But those preliminary votes didn’t give much clue as to how the nine voting commissioners will line up on the final report, which is due Oct. 15 and will likely trigger a special session of the Legislature to debate and decide the expansion issue.

Gov. Maggie Hassan, a Democrat, and the Democratic-controlled House support accepting federal money that would cover most of the cost to expand the state’s Medicaid program, a pillar of President Obama’s 2010 health care reform law.

But the Senate, where Republicans hold a 13-11 majority, in June blocked Medicaid expansion from being enacted as part of the state budget. Instead, the study commission was appointed to recommend whether the state should expand Medicaid, and if so, how.

Five of the commission members were appointed by Democrats while four were appointed by Republicans, making it likely a majority will support expansion in the end.

Under Sherman’s plan, the state would expand its Medicaid program while providing several private options for newly eligible residents.

He’s proposed expanding the state’s existing Health Insurance Premium Program, to pay premiums for employer-provided health insurance when it’s available, as well as giving people the option of buying health insurance on their own, such as the plans available on the new exchange.

Sherman’s plan would include a so-called “kill switch” or “circuit breaker:” If the federal government ever stopped paying at least 90 percent of the expansion’s cost, the Legislature would have six months to reauthorize the expanded program before it would end automatically.

That proposal was tentatively endorsed yesterday on an 8-1 vote. But a proposal by Rep. Neal Kurk, a Weare Republican, to set up a similar “kill switch” if the program’s total net costs for the state began to balloon at an annual rate of 20 percent or more was rejected, 6-3.