N.H. Houses Passes Medicaid Expansion Bill

May 3, 2018

New Hampshire State House. The House approved a plan to extend Medicaid expansion for five years.
Credit NHPR File Photo

In a swift vote with no floor debate, the New Hampshire House of Representatives approved a plan to continue the state's Medicaid expansion for at least another two and a half years — and potentially as long as five.

The relatively smooth path for the Medicaid expansion bill this time around marks a stark contrast from past years, when the issue drew much more prolonged and partisan debate. The inclusion of a work requirement and a new funding scheme to avoid using state tax dollars helped to win over more Republicans this time around.

The Republican-led House Finance Committee voted 24-2 to endorse the program while also recommending several important changes from the version of the bill that previously passed both the House and the Senate.

For one, the committee changed the timeline for the renewed program: Instead of extending it five years uninterrupted, they suggested extending it for two-and-a-half years and then leaving it to a commission to decide whether to renew it another two-and-a-half years from there.

The committee also recommended some changes to the new “work and community engagement” requirements the bill would impose.

Self-employment no longer counts as an activity that would make someone eligible for health coverage through expanded Medicaid — though job training, community service and caregiving are all still included in the list of approved activities.

And while a previous version of the bill included an exemption from those work requirements for parents caring for kids under age 13, the latest version lowered that to age 6.

When the bill came up for a vote in the full House on Thursday, it elicited little floor discussion — though one Republican lawmaker who opposed the program did try to insert a last-minute change to the legislation.

Rep. JR Hoell, of Dunbarton, attempted to add an unrelated provision that would allow people to carry loaded guns on off-road vehicles like ATVs. The House approved a bill to do just that earlier this year, but it was rejected in the Senate.

The House quickly shot down Hoell’s amendment before approving the expansion bill as amended by the finance committee, without mention of ATVs.

The House’s swift endorsement of Medicaid expansion this week came after months of lobbying from advocacy groups across the state — culminating in a last-minute push that included phone banking lawmakers, coordinated op-eds in local papers and a large rally outside the Statehouse.

One of those who showed up for the rally Wednesday morning was Joan Widemer, who leads the New Hampshire Nurses Association.

“My clinical career has been in emergency nursing, and I have seen firsthand what happens when people come into the ER because they’ve delayed too long because they didn’t have insurance,” Widemer said.

(This story was updated Thursday afternoon with additional reporting.)