CONCORD — A unanimous New Hampshire Senate gave preliminary approval Thursday to continuing the state’s expanded Medicaid program and making it permanent.

The 24-0 vote to send the bill to the Finance Committee highlighted the Legislature’s evolution on what initially was a tough sell when lawmakers first considered expanding health care coverage for low-income residents. Though it eventually passed with bipartisan support in 2014 and was reauthorized in subsequent years, Republicans were not always on board.

Several senators acknowledged their changes of heart Thursday, saying they were wrong to believe the program would discourage participants from working. Sen. Regina Birdsell, R-Hampstead, described hearing from a woman who used the program temporarily when she was laid off during cancer treatment and a man who went on to start his own business after getting coverage for substance use disorder treatment.

“This what I thought in the past: It was a program that would be disincentivized people to work,” she said. “What I heard in the testimony was this is actually a stopgap measure to get people back to work.”

Sen. Kevin Avard, R-Nashua, said in the past, he did not trust the federal government to keep its word and provide 90% of the program’s funding. And he did not realize the cost associated with uncompensated care in hospitals.

“I probably even signed something in 2014 that says, ‘Yup, I’m against it,’ ” he said. “I grew up a little bit. I’m looking at the big picture … this is the right way to go.”

The program currently has 50,000 to 60,000 enrollees, and advocates say since 2014, Medicaid has helped more than 219,000 people access health care services including preventative and primary care, mental health care and substance use treatment.

Sen. Cindy Rosenwald, D-Nashua, called Thursday’s vote an incredible step forward for the Senate and the state.

“Too often we find ourselves divided over deeply important issues, unable to come together,” she said. “But Senate Bill 263 is proof that in New Hampshire, we can get this done.”

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