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Tentative Deal in New Hampshire Reached to Expand Medicaid

By Rebecca Adams, CQ HealthBeat Associate Editor

February 6, 2014 -- State lawmakers in New Hampshire recently reached a tentative bipartisan deal to expand Medicaid to about 49,000 New Hampshire adults.

Democratic Gov. Maggie Hassan supported the compromise worked out between her state's Senate Democrats and Senate Republicans. Republicans had initially resisted Hassan's calls to broaden the program.

The proposal would use Medicaid dollars to buy private insurance through the federal marketplace and through adjustments to an existing state program that subsidizes job-based insurance.

New Hampshire is one of a handful of states where closed-door negotiations on Medicaid expansion are continuing. Utah and Virginia are other states where the governor is pushing the legislature to accept expansion.

The New Hampshire deal was outlined to the state Senate Rules Committee, which then voted to introduce the bill. The agreement is expected to be fleshed out in legislation next week.

"Just a short while ago, Republican and Democratic leaders in the Senate announced that they have agreed to the framework of a workable, realistic plan to extend health care coverage to more than 50,000 hard-working Granite Staters," said Hassan in her recent State of the State speech. "These are real people and families who we all agree deserve the security of health insurance."

Hassan said that "with today's positive step forward, it's clear that we can work through this together and help working people access critical health coverage. I thank members of both parties, from both the House and the Senate, for their steadfast commitment to reaching a compromise. Now, let's get this done."

Senate GOP and Democratic leaders said they had worked hard to reach a compromise.

"It may come as a bit of a shock these days to see both parties working together, but that's exactly what we did here," said Democratic Senate Leader Sylvia Larsen in a statement.

"Since November, senators have continued to meet in a good-faith effort to resolve the outstanding questions remaining from the special session," said Senate President Chuck Morse, a Republican. "As a result of those productive conversations, we have agreed to a framework for legislation that we believe represents a truly bipartisan compromise, and accomplishes our shared goals of increasing access to private insurance coverage while protecting New Hampshire taxpayers."

The agreement would include a deadline for federal approval of using Medicaid funds to fund private insurance by June 30, 2015.
The deal would expire when federal funding drops below 100 percent in three years unless state legislators voted to extend it. Some Democrats had opposed a sunset, but have since signed off on that provision.

The health care law (PL 111-148, PL 111-152) allows states to expand Medicaid to people with income of up to 138 percent of the federal poverty line. For the first three years, federal officials will pay all the costs of people who become eligible for the first time under expansion.

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