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Providers, Public, Push for Medicaid Expansion in NH

By Aditi Mukherji, JD on August 29, 2013 | Last updated on March 21, 2019

Hospitals, nurses, doctors and other medical providers have urged New Hampshire to expand Medicaid to an additional 49,000 poor adults under the Affordable Care Act.

But the state legislature must pass a law in order to expand Medicaid -- and they're deadlocked in a split.

Democrats hold a 42-seat majority in the House, while Republicans carry a two-seat majority in the Senate. Democratic Governor Maggie Hassan will sign the expansion into law if Democrats can manage to convince two Senate Republicans to sign on.

New Hampshire Medicaid Expansion

In its current form, New Hampshire's Medicaid program covers low-income children, parents with nondisabled children under 18, pregnant women, senior citizens and people with disabilities. The expansion would add anyone under age 65 who earns up to 138 percent of federal poverty guidelines, reports The Associated Press.

Providers claim that expanding Medicaid would result in more cost-effective care to the poor and more efficient use of state resources.

Without the expansion, there is concern that uninsured people will have no choice but to seek costly emergency room care.

Opposition to Expansion

In 2012, the Lewin Group compiled a report on whether or not New Hampshire should expand its Medicaid program. Critics who oppose Medicaid expansion, like Forbes' Avik Roy, have relied heavily on the findings of the Lewin Group study done for the state last year, to push back on expansion efforts. Analysis based on the Lewin study showed that hospitals will lose revenue and income if New Hampshire expands Medicaid.

But proponents for the expansion, like Henry Lipman of the New Hampshire Hospital Association, have called the study's credibility into question, claiming it used old information when it estimated hospitals would be better off financially without Medicaid expansion, according to The AP.

Federal Funding

States can choose to expand Medicaid as part of the federal health care overhaul law, which will become effective on Jan. 1. That's when an estimated $2.4 billion in federal funding the state would get over seven years would kick in.

If New Hampshire were to expand the program, the federal government would cover 100 percent of the cost for the first three years and gradually scale it back to 90 percent by 2020. States can withdraw from covering adults at any time without penalty, according to a statement by New Hampshire Voices for Health.

Stay tuned as the plot thickens in this classic state v. federal tug-of-war.

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