Republican concerns may halt permanent extension of expanded Medicaid
Expanded Medicaid, which provides health insurance to more than 60,000 Granite Staters, may have hit a roadblock to becoming permanent, despite its unanimous support in the Senate and passage last week in the House.
The program, Granite Advantage, is set to expire this year; it was implemented in 2014.
Concerns from House Republicans prompted a division of the House Finance Committee to vote 5-4 along party lines Tuesday to recommend the full committee hold onto Senate Bill 263, which continues the program permanently, for further work.
House Republicans who are unwilling to make the program permanent said they would consider an extension of two to seven years. As of now, lawmakers have only a two-year extension before them, in the House’s budget.
State House Democrats, state officials, and advocates whose communities rely on Granite Advantage have argued that two years is too little time to sign and implement such a huge contract.
Senate President Jeb Bradley, a Wolfeboro Republican, said on the New Hampshire Today radio show Wednesday morning that an extension of at least eight years is necessary.
“Hopefully that happens and happens quickly,” he told host Chris Ryan. “It’s vitally important. The program has worked and worked well.”
Granite Advantage has been credited with lowering the number of uninsured Granite Staters, improving health outcomes by allowing beneficiaries to afford preventative care, and lowering uncompensated medical care costs for hospitals.
Like traditional Medicaid recipients, those on Granite Advantage are low-income. But they don’t meet Medicaid’s other eligibility rules, which require they be younger than 19, pregnant, or have a physical or developmental disability, or are caring for children or other family members.
Bradley’s bill passed the Senate unanimously in March. It passed in the House last week, 193-166, over the objections of some Republicans who want to add a work requirement and drug testing to the program, among other things. The House rejected bill amendments that would have added those provisions.
Republicans have also expressed concern that the federal government will reduce its 90 percent contribution or increase income eligibility, making benefits available to more people; without a sunset date, they warn the state would not be able to end or modify the program should it become unaffordable.
Current state law includes a provision that would allow the state to end the program if the federal government reduced its contribution.
The program has always had a sunset date, requiring the Legislature to renew it. Advocates said it’s worked so well that it’s time to make it permanent.
If the House Finance Committee, which took a second look at the bill because it involves state spending, retains it, it will not come back before lawmakers prior to next year, at the earliest.
“There’s no question at all that Medicaid (expansion) will be renewed,” said Rep. Maureen Mooney, a Merrimack Republican, during the committee discussion Tuesday. “We have thousands in our state that rely and depend on it. To me, a contract this big that is so large, no matter what the content, should be renewed after a period of time.”
Advocates said they are concerned about the committee’s recommendation to hold onto the bill but still optimistic the program will be extended.
“Medicaid expansion is a lifeline for Granite Staters in need,” said Michele Merritt, president and CEO of New Futures, a state health policy and advocacy organization, in a statement Wednesday. “Without the Granite Advantage Health Care Program, many individuals and families would simply not be able to access the health care, mental health, and substance use treatment they rely upon.