CONCORD — A special panel considering whether New Hampshire should expand its Medicaid program to poor adults voted yesterday to recommend doing so, but with a catch.
The board voted, 8-1, to recommend that the Legislature meet in special session this fall and authorize the expansion beginning Jan. 1. The expansion could only take place, however, if a requirement is also put in place that poor adults with jobs participate in a program where the state pays to keep them on their employer’s private insurance plan if it’s more cost-effective than Medicaid.
Making that program mandatory would require a federal waiver.
Sen. Nancy Stiles, R-Hampton, proposed that the state get the waiver prior to starting the program. She said she was confident the state and federal governments would act quickly enough to implement the expansion Jan. 1.
The panel also backed an option for people who are ineligible for the program. It would give them individual assistance to purchase private insurance through the new online markets central to President Barack Obama’s health care overhaul law.
Last week, a majority of panel members agreed to recommend expanding Medicaid to add residents under age 65 who earn up to 138 percent of federal poverty guidelines. The majority agreed with the overall idea of expanding Medicaid for those earning about $15,000 a year for a single adult and $32,500 annually for a family of four, while relying as much as possible on private insurance.
The panel voted 6-2 with one member abstaining to approve a draft of a plan based on the votes taken last week and yesterday. The board meets next week to take a final vote on the report.
The panel rejected proposals yesterday to cap enrollment and end the program if the state’s costs rose higher than projected. They also voted against requiring recipients to work or actively look for work.
“We have to be able to put some kind of threshold on this,” said Sen. Andy Sanborn, R-Bedford.
New Hampshire’s current Medicaid program covers low-income children, parents with nondisabled children under 18, pregnant women, the elderly and people with disabilities.
The commission was established as a compromise in the debate over the state budget. Democratic Gov. Maggie Hassan and the Democratic-led House wanted to authorize Medicaid expansion in the budget bill, but the Republican-led Senate insisted on establishing a commission to study the issue first. Democrats need Republican senators to support expansion for it to take place.
Senate President Chuck Morse, a Republican from Salem, said last week that any expansion should provide better access to affordable care for the poor, use managed care, protect taxpayers from future unfunded costs, use private insurance and increase payments to health care providers.
Morse released a statement after the meeting yesterday, calling the recommendation to require people to stay on private insurance where possible as a good starting point.
The panel faces an Oct. 15 deadline to make recommendations to the Legislature, which must authorize the expansion.
If New Hampshire decides to expand its Medicaid program as part of the law, the federal government would pick up the full cost for the first three years and 90 percent over the long haul.
Most panel members favor requiring the Legislature to reauthorize the program if the federal government reduces its support.