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[MM Curator Summary]: NH may not be re-upping its Medicaid expansion. Egads!
The head of the state’s Medicaid program, Henry Lipman, talks to House Finance Committee’s Division III Tuesday about Senate Bill 263, which would reauthorize the Granite Advantage Health Care Program permanently.
By GARRY RAYNO, InDepthNH.org
CONCORD — A House Finance Committee’s subdivision wants to hold a bill reauthorizing the state’s Medicaid expansion program for a year.
Meeting Tuesday, the committee Division III voted down party lines to retain Senate Bill 263 although the Senate passed the bill unanimously and the House passed it 193-166 last week with no limitation on the program’s length.
The Granite Advantage Health Care program provides health insurance to the state’s “working poor” who earn too much to qualify for regular Medicaid, but not enough to purchase private insurance.
The program, which was part of the Affordable Care Act, provides Medicaid coverage to those from 133 to 100 percent of the federal poverty level with the federal government paying 90 percent of the cost.
The subcommittee voted down party lines, 5-4, to retain the bill, and the recommendation will go before the full House Finance Committee June 1 for its recommendation to the House for its June 8 session.
During last week’s session, Democrats and a handful of Republicans defeated about 20 of the 30 Republican proposed amendments to the bill, before passing it.
Many of the amendments defeated last week were brought up at the subcommittee meeting, including a work requirement, which the US Supreme Court had found unlawful in the past, as well as co-pays for services, drug testing, capping the length of time a person can be on the program and a clawback provision.
The list of concerns was developed by Rep. J.R. Hoell, R-Dunbarton, and read by Rep. Jim Kofalt, R-Wilton.
Rep. MaryJane Wallner, D-Concord, questioned why the subcommittee was bringing up the issues again.
“As I listen to the list it sounds sort of familiar to me. Many came forth last week as amendments and the House voted to reject them,” she said. “To bring them up at this point is not necessary and most of the things on the list are not related to finances.”
The bill received initial approval pending financial review by the House Finance Committee before a final vote on the bill.
But Rep. Erica Layon, R-Derry, who was a substitute member of the subcommittee, told Wallner debate was limited last Thursday when the bill was debated and many of the issues brought up were not debated on the floor.
“They were not thoroughly considered by limiting House debate,” she said.
Subdivision chair Rep. Jess Edwards, R-Auburn, said he talked with the bill’s prime sponsor, Senate President Jeb Bradley, R-Wolfeboro, who could not attend Tuesday’s meeting and said he told Bradley he was disappointed the House did not approve a six-year extension for the program.
Edwards said Bradley said a five-year contract with the Medicaid providers is best financially for the state, but contracts are often extended for a year or two.
Edwards said he could agree to a seven-year extension to accommodate that situation.
Henry Lipman, head of the Medicaid program for the Division of Health and Human Services, said the last contract had to be extended while the Executive Council sought additional information and input.
“Having that flexibility,” Lipman said, “makes sense.”
But Layon asked if it were more expensive to have the extension clause in the contract, but eventually Edwards said they probably would not know that until the final bids are known.
The chair of House Finance, Rep. Ken Weyler, R-Kingston, asked Lipman if there were no sunset provision in the bill, would it encourage the federal government to change how much it would pay for the cost..
Lipman said if the federal government drops its contribution to less than 90 percent, the current law requires the program to end regardless of what the legislators wanted to put in the current bill.
Kofalt said he believes a program as expensive and complex as the Medicaid program needs a sunset that would allow legislators to review it
He said there is often “creep” in programs as bills are introduced to add more benefits.
“This is a very, very expensive program to begin with,” Kofalt said. “(There needs to be) some kind of period to review the scope and complexity of the program. It really merits that.”
After a short caucus, Republicans moved to recommend the bill be retained with Layon saying work requirements are being debated in Washington now in negotiations over raising the debt ceiling, and there may be other changes, so they would be wise to hold the bill for a year.
The bill has broad support among the business community, health care organizations and health care access advocates.
The subcommittee also voted down party lines to retain Senate Bill 239, which also passed the House last week.
The bill would have the state use harm reduction services to treat alcohol and other substance misuse and includes reauthorizing the needle exchange program.
But the subcommittee did recommend Senate Bill 172 pass, which allows court-appointed guardians to receive Temporary Assistance for Needy Families benefits for a child they are taking care of, such as grandparents or a mother’s sister.
The House has to act on these bills by June 8.
Garry Rayno may be reached at email@example.com.