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Medicaid expansion reauthorization bill takes shape

February 16, 2018

CONCORD, N.H. (AP) — New Hampshire would use liquor revenues to help pay for its expanded Medicaid program under a reauthorization bill released Friday by Senate Republican leaders.

The current expanded Medicaid program uses federal money to put about 50,000 low-income people on private insurance, but it will end in December if lawmakers don’t reauthorize it.

The bill released Friday would continue the program for five years but change its structure to a managed care model. That was the recommendation of a bipartisan commission that studied the issue last year, but the bill also includes new ideas, particularly regarding how the state would pay for its share as federal funding decreases. The current program relies on voluntary contributions from insurance companies and hospitals to cover some of the state’s costs, but federal officials have said that violates federal rules.

The bill calls for using 5 percent of liquor revenues to cover those costs and continuing to use money from a high-risk pool fund and an insurance premium tax.

Senate President Chuck Morse, of Salem, said he was proud to announce the New Hampshire Granite Advantage Health Care Program, which he said “will continue to provide health care for more than 50,000 Granite Staters without spending general fund dollars, raising or creating any new taxes or fees.”

“This is a completely new, redeveloped and re-energized program that maintains many of the New Hampshire-specific goals we’ve included in previous programs, but incorporates new ideas and strategies for improving overall health and providing key health care resources,” Morse said in a statement.

New Hampshire also is one of numerous states seeking a waiver from the federal government to add a work requirement for Medicaid recipients. The bill would require 100 hours of work or community engagement per month, with exemptions for people who are disabled or medically frail.

The bill also would create a program called Granite Workforce, which would use federal welfare funds to pay employers in high-need areas to hire Medicaid recipients and help participants with transportation, child care and other issues that pose barriers to work.

Senate Majority Leader Jeb Bradley, of Wolfeboro, said he expects there to be plenty of debate about the work requirements and other provisions.

“I think we have a good plan to reform the Medicaid system, to provide wellness incentives and better care and taxpayer savings, and funding plan that works. So I’m glad to have it on paper,” he said. “There are still some details to work out, but I think we will, and I look forward to trying to make sure we get it to the governor’s desk.”

Sen. Dan Feltes, a Democrat from Concord, said while his ideal bill would differ dramatically, “it’s important to work in a bipartisan way, important to build off the commission recommendations, ensure we don’t arbitrarily kick people off of coverage and that people get help and assistance on a pathway to work and better health outcomes, which benefits everyone.”

Morse said lawmakers were in frequent contact with federal officials as they drafted the bill.

A public hearing on the bill is set for Tuesday.

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