New Hampshire consumer advocates and supporters of Medicaid Expansion are waking up today to a new chapter in coverage for New Hampshire residents. With bipartisan support, Senate Bill 413 passed yesterday 18-5 in the Republican-controlled Senate. It is expected to pass the House without much fanfare and land on Governor Maggie Hassan's desk by early April. New Hampshire will join its New England brethren (with the exception of Maine) in embracing Medicaid expansion and in doing so will provide affordable coverage to an estimated 50,000 New Hampshire residents. Real people—neighbors, parents, working people—who make up our community. We applaud the work of all stakeholders in the campaign for New Hampshire Medicaid expansion in passing this hurdle en route to the finish line.
The proposal is modeled after the premium assistance program in Arkansas—it uses federal dollars to offer private insurance options through its state Marketplace. This process will take time to implement, but should be in place by 2016. In the meantime, New Hampshire won’t keep its residents waiting for coverage. Some expansion eligible consumers will gain coverage through an existing program that subsidizes employer-based coverage and all others will get coverage through the Medicaid managed care program. If the federal government approves a waiver next year, the managed care population will move into the Marketplace where they would purchase private insurance plans.
Of course there are caveats. If the waiver is not approved, coverage will be phased out over three months. If the federal match is reduced prior to 2017, the program ends. Regardless, the program must be reauthorized by the Legislature in 2016.
Tweaks were necessary to obtain bipartisan support of Medicaid expansion - and advocates agree that getting consensus and support across the aisle goes a long way for its residents. As advocate Tom Bunnell succinctly put it to The New York Times, “It’s a compromise that achieves workable, affordable coverage for people who really need it in our state.”
Case in point—Republicans this morning who voted for Medicaid expansion are defending it:
"When I go and talk to business leaders, they tell me the largest problems they face are, Number 1, the high cost of health care, Number 2, the high cost of health care and Number 3, the high cost of health care," said Sen. Jeb Bradley, R-Wolfeboro. ”This hidden tax is larger than any other tax we have in New Hampshire, and who's paying it? We're all paying it, and business leaders are crying out for help."
And this is what progress looks and sounds like.
We are particularly fortunate to support New Hampshire advocates through the Community Catalyst’s ACA Implementation Fund. In addition to philanthropic support, Community Catalyst worked in partnership with advocates to execute multiple strategies—policy analysis, messaging and communications, coalition building, and grassroots support—all of which culminated in this step toward more expansive coverage.
Way to go New Hampshire - and here's hoping that our friends in Maine hear your calls for expanded coverage to all hard working New Englanders!