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N.H. Senate Deal Opens The Door For Medicaid Expansion

Representatives Hall in Concord.

Governor Maggie Hassan's first State of the State Address touched on a wide range of issues, including energy, infrastructure, and  education.

But the biggest news of the speech was a deal to expand the state’s Medicaid program, announced by Senate President Chuck Morse and Senate Democratic Leader Sylvia Larsen shortly before the governor's address. 

Talks on Medicaid broke apart last November  during a special legislative session over the timeline of expansion. Republican leadership in the State Senate wanted to see newly eligible recipients transition within a year into private insurance through the exchange that the federal government would pay for. Democrats rejected that idea as unworkable, though it did get behind the private insurance option.

It's not clear yet how this timeline issue was bridged, but the governor's announcement of the deal received one of the longest and loudest applause of hear speech.

"Let's get this done"

We also don't know yet how long could it be before the state expands the health program to an estimated 50,000 low income residents. But we do know that the bill, which hasn’t even been written yet, should be coming out sometime next week.

The deal still needs approval from both the House and Senate, and then it would still need a waiver from federal health officials in Washington, because expansion using private insurance is not what the Affordable Care Act called for. The feds, though, have already given the okay to a similar plan from Arkansas, so the question is likely when, not if, the Senate proposal will go ahead.

Accomplishments and challenges

Compromise was the running theme throughout the governor's remarks. Early on Hassan pointed to the bi-partisan budget deal reached last summer as proof that Concord functions better than Washington.

She also highlighted the state’s rising export economy and overall rebound in the housing market. She touted some other initiatives, including a freeze in in-state tuition at state universities and community colleges and an expansion of broadband services to rural New Hampshire.

But Hassan’s speech also pressed for accomplishments she was denied last year. That includes a casino that the Democratically-held House rejected in 2013.  With Massachusetts set to open a facility in the coming years, she cautioned lawmakers against letting $75million in revenue go south across the border.

And that issue is still far from resolved; just today, there was heated testimony in the House on a new casino bill.

Todd started as a news correspondent with NHPR in 2009. He spent nearly a decade in the non-profit world, working with international development agencies and anti-poverty groups. He holds a master’s degree in public administration from Columbia University.
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