EagleTribune.com, North Andover, MA

October 3, 2013

N.H. Medicaid commission narrows discussion

By Holly Ramer
Associated Press

---- — CONCORD, N.H. (AP) — A special panel considering whether New Hampshire should expand its Medicaid program to poor adults broadly agreed yesterday to recommend adding 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. They differed, however, on what circumstances should automatically trigger a shut down if the expansion became too costly.

New Hampshire's current Medicaid program covers low-income children, parents with nondisabled children under 18, pregnant women, elderly residents and people with disabilities.

The commission was established as a compromise in the budget debate. 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.

The panel faces an Oct. 15 deadline to make recommendations to the Legislature, and began voting on half a dozen key elements of a proposed expansion plan, including the covered population and involvement with the private insurance market.

Members backed expanding an existing program where the state pays to keep someone on his or her employer's private insurance plan if it's more cost-effective than Medicaid and making the program mandatory, though doing so would require a federal waiver. They also voted in favor of giving those who aren't eligible for that program the option to get individual premium assistance to purchase private insurance through the new online markets central to President Barack Obama's health care overhaul law.

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 also voted in favor of requiring the Legislature to reauthorize the program if the federal government reduces its support.

Rep. Neal Kurk suggested requiring the Legislature to reauthorize the program if the state's costs increased by more than 20 percent a year.

"There are very limited financial resources in this state and we need to make very sure we can afford what we do," he said, noting projections that show the state's costs increasing $20 million in 2022 and beyond. "That sounds like a new tax to me."

But other members disagreed, and no consensus was reached on the issue. The panel meets again Tuesday.