CONCORD, New Hampshire — The state Senate is set to take up a bipartisan agreement to use federal Medicaid money to buy private health insurance for an estimated 50,000 poor New Hampshire adults.
The bill is expected to pass the Republican-controlled Senate in Thursday's scheduled vote and has a good chance of passing the Democratic-controlled House by early April. New Hampshire is one of six states that have not decided whether to expand Medicaid under the federal health care overhaul law. Currently, 25 states plus the District of Columbia are expanding and 19 states are not.
Estimates vary of the number of adults who would sign up for coverage. The state believes about 50,000 will enroll while a 2012 study from the Lewin Group predicted that 58,000 would enroll.
"I think the House has been pretty clear that we have wanted to expand access to health care to 58,000 low-income residents through the use of the private insurance market," said Rep. Cindy Rosenwald, a member of a special commission that studied the issue last summer and fall.
Rosenwald, a Nashua Democrat, would not predict how the House would vote, but said Democrats have repeatedly voted to support the bill's principles of expanding access to health care with the use of private insurance.
Democratic Gov. Maggie Hassan supports the Senate plan, which is essentially a 2 ½ year pilot program using 100 percent federal funding to expand health care to the poor while also reducing the uncompensated care that drives up health care premiums businesses pay to cover their workers.
If approved, the state estimates 12,000 adults could begin receiving coverage in as little as a month under an existing program to subsidize employer-based coverage while 38,000 others would receive coverage through the state's Medicaid managed care program starting this summer. The adults on managed care would be moved onto private insurance in 2016 if a federal waiver is approved by March 31, 2015. If the waiver is denied, their coverage would be phased out over three months.
Critics argue the state should get any necessary waivers before enrolling the adults. They believe that once taxpayer subsidized coverage is provided, lawmakers will lack the courage to end it.
Under the plan, the expansion would end if federal funding drops below 100 percent and would end regardless at the end of 2016 if the Legislature failed to reauthorize it.
The plan also includes a separate waiver to win federal reimbursement for services not currently covered, such as for prisoners and some mental health services.
New Hampshire's current Medicaid program covers low-income children, parents with non-disabled children under 18, pregnant women, older residents and people with disabilities. The expansion would add anyone under 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,856 for a single adult.