Union Leader: House, Senate have dueling healthcare funding plans
CONCORD — The House and Senate introduced competing plans Thursday for expanding federally funded health insurance coverage to about 49,000 low-income adults, but say they will continue to negotiate over the next two weeks.
The Republican-controlled Senate wants private insurers to cover all the newly eligible adults beginning in 2015, while the Democratically-controlled House wants to use both private insurers and the state’s new managed-care Medicaid program. The Senate plan would have a “bridge year” when newly eligible recipients would be covered under the state’s Medicaid program.
Both bills would pull the plug on the program if the promised federal funding under the Affordable Care Act care does not materialize, although the Senate plan would end in three years, when the federal government stops paying 100 percent of expansion costs. The federal share would gradually reduce to 90 percent by 2020.
Gov. Maggie Hassan backed the Commission to Study Expansion of Medicaid Eligibility’s recommendations, which are essentially the House plan.
“We cannot let this opportunity for tens of thousands of our friends and neighbors pass us by,” Hassan said. “If we remained focused on the New Hampshire traditions of cooperation and bipartisan problem-solving, we can do the right thing to boost our economy, strengthen our health care system, and improve the health and financial well-being of our working families.”
Some advocacy groups were critical of the Senate’s Republican leadership for proposing an expansion plan.
“It’s very disappointing to see the liberal proposals offered by the House and Senate to bring ObamaCare to New Hampshire by expanding the state’s Medicaid program when there were better plans to cover these individuals available that would have protected our taxpayers,” said Greg Moore, AFP-NH State Director, adding both plans will result “in a slow motion income tax.”
Both the House and Senate plans use the commission’s recommendations as a starting point.
Under the proposals, adults under 65 who earn up to 138 percent of the poverty level — about $15,000 for an individual and $32,500 for a family of four — would be eligible for Medicaid health insurance, either through an employer’s private insurance or through the state’s Medicaid system beginning Jan. 1.
The plans are identical for the first year, but the Senate plan would transition those on Medicaid to private health insurance through the health insurance marketplace beginning Jan. 1, 2015. Medicaid money would pay the premiums and other required services not available on the commercial plans.
The House plan does not have a private insurance option until 2017, and then only if there are three insurers in the marketplace.
Under the Senate plan, expansion would end Jan. 1, 2015 if federal officials have not approved a needed waiver — a key sticking points between the House and Senate.
House Speaker Terie Norelli, D-Portsmouth, said she is not sure one year is enough time to obtain the waiver for private insurance.
“They are looking for a waiver we are not sure we’re going to get,” Norelli said.
Senate President Chuck Morse, R-Salem, said the Senate Republican proposal goes further than the commission’s recommendation to protect the state’s citizens, health care providers and taxpayers, while requiring personal responsibility.
“We need to work together to sit down and look to move this forward,” Morse said. “I continue to be hopeful that politics will not get in the way.”
Not all Republican senators attended Thursday’s news conference to discuss their proposal and Morse and Senate Majority Leader Jeb Bradley, R-Wolfeboro, declined to be specific about support. Morse said he wants a plan that is supported by all 24 senators.
Failing to reach an agreement in the next two weeks will not only leave about 49,000 low-income adults off the Medicaid rolls and without health insurance, but could cost the state’s health care providers about $2.4 billion in federal money over seven years.
New Hampshire is one of seven states yet to decide whether it will expand Medicaid eligibility.
Public hearings on the two bills will be held Tuesday. The House and Senate return Nov. 21 to vote on expansion.More online at www.UnionLeader.com/ACA