Medicaid Expansion

An unexpected surge in Medicaid enrollments during the past six months is putting pressure on the state’s budget.

Medicaid has seen its enrollment jump by roughly 11,000 people since January 1. State officials attribute this to two main things: under the Affordable Care Act, there’s a streamlined application process, and that increased publicity surrounding the law brought out more applicants.

Health and Human Service Commissioner Nick Toumpas says it’s more than they expected, but that nearly 70% of the new sign-ups are children.

Todd Bookman / NHPR

Enrollment in Medicaid for as many as 50,000 newly eligible residents opens tomorrow, with health benefits slated to start August 15th.

Governor Maggie Hassan held a kick-off event on Monday at the Manchester Community Health Center, where she called the bi-partisan deal to expand the state’s Medicaid program the most significant health care legislation in decades.

New Hampshire’s Medicaid expansion program finally has a launch date. Coverage for an estimated 50,000 low-income recipients will start August 15, with an enrollment period beginning July 1.

“The bipartisan New Hampshire Health Protection Program is a historic step forward for the health and economic well-being of New Hampshire families, businesses and communities,” writes Governor Maggie Hassan in a statement announcing the new timeline.

Residents earning up to 138% of the federal poverty level, or about $16,000 a year, are eligible for the program.

What's New With The Affordable Care Act In N.H.

Jun 16, 2014
Taylor Shaw-Adams / Flickr/CC

Expanded Medicaid for low-income adults is coming, but may be delayed.  Meanwhile, four more insurance companies say they’re ready to join New Hampshire’s marketplace for coverage next year.  And as we head into this fall's elections,  the health care law remains a major point of political contention. 

GUESTS:

  • Todd BookmanNHPR’s health reporter
  • Jenny Patterson - health legal counsel at the New Hampshire Insurance Department

CALLOUTS:

istock photo

  The New Hampshire Department of Health and Human Services held a public info session in Manchester Tuesday night to demystify the state’s new Expanded Medicaid plan.

About 15 people, mostly care providers, attended the Manchester session. Questions ranged from how one qualifies for the program and ‘are refugees included?’ (they are), to the application process itself.

Hobvias via Flickr CC

New Hampshire residents who may be eligible for Medicaid when the state expands its program are being encouraged to attend one of a dozen public information sessions.

The state is seeking federal approval to expand its program to an estimated 50,000 poor adults by using federal Medicaid funds to buy private health care coverage for adults making less than 138 percent of the federal poverty limit.

The first informational session will be held Monday night in Concord. Others will be held around the state, with the last one scheduled for July 1 in Portsmouth.

The state is bumping up against an intended start date for Medicaid expansion sign-ups.

The bi-partisan plan agreed to earlier this year originally called for a two-month early enrollment period beginning May 1st with coverage starting in July, but the Centers for Medicare and Medicaid Services hasn’t yet signed off on the package.

Governor Hassan says her administration continues to work closely with federal regulators.

The number of Medicaid enrollees in New Hampshire is up 4% since last October, according to new data from the federal government. More than 133,000 people were enrolled as of February, compared with roughly 127,000 recipients before the launch of the Affordable Care Act.

ACA's Deadline Day

Mar 31, 2014
Pan-African News Wire Photos / Flickr/CC

Under the Affordable Care act, Monday is the last chance for uninsured Americans to choose a plan or pay a penalty.  We’ll get the latest on New Hampshire enrollments, and other aspects of this law in the Granite State, including the newly signed Medicaid Expansion and new players coming to the state’s insurance market next year.

GUESTS:

Josh Rogers / NHPR

Medicaid expansion is now state law, making some 50,000 poor adults in New Hampshire eligible for federal subsidies under so-called Obamacare.

Governor Maggie Hassan signed the expansion bill at a crowded public ceremony using 18 separate pens -- one for each letter of her full name.

She hailed the new law as a bipartisan proposal that moves the state forward.

“Today we are signing into law the most significant piece of health care legislation that the state of N.H. has seen in decades.”

Daniel S. Hurd via Flickr CC

The New Hampshire House has voted 202-132 to expand Medicaid to cover an estimated 50,000 low-income adults under the Affordable Care Act.  

The move comes after more than a year of debate, and while the vote in the Democratically-controlled chamber wasn’t a surprise, Republicans weren’t exactly ready to concede the point.

They put forward nine amendments on issues ranging from delaying the start date to capping enrollees, all of which failed.

The plan to expand Medicaid endorsed by the state Senate has cleared its first hurdle in the New Hampshire House, gaining the approval of the Finance Committee on a 15-10 vote.

The Democratically-controlled House has already voted to expand Medicaid three times, and leaders there want to pass this version as soon as they can.

House Republicans, though, continue to put up a fight.

After clearing a major hurdle last week by making it through the Republican-led Senate, debate began in the House Monday on a proposal to expand the state’s Medicaid program.

Daniel S. Hurd via Flickr CC

New Hampshire’s fault line for expanding its Medicaid program has always run through the GOP-controlled Senate. 

There, top lawmakers from both parties have tried and failed to reach compromise over the past year. And so now with a deal clearly in reach, Democratic co-sponsor Peggy Gilmour of Hollis reminded colleagues of all they’ve been through.

A bipartisan plan to expand Medicaid that is scheduled for a vote in the New Hampshire Senate this week has strong support from Granite Staters, according to a new poll.

New England College asked 774 registered voters if they would support a proposal backed by Gov. Maggie Hassan and a majority in the New Hampshire Senate “to extend private insurance to low-income residents, without passing the cost of coverage on to businesses.”

Gov. Maggie Hassan says she expects those eligible for insurance under a Medicaid expansion plan backed by a bipartisan group of State Senators will be covered in July.

The plan to insure as many as 50,000 low income residents by using federal money to pay for private coverage cleared a key committee last week.

The plan is expected to win full approval by lawmakers, but those votes have yet to be scheduled.  

Governor Hassan says she’s optimistic that will happen with enough time for the plan’s two-month enrollment period to begin May 1.

Todd Bookman / NHPR

 New Hampshire lawmakers moved a step closer to expanding Medicaid under the Affordable Care Act.

The Senate Health, Education and Human Services Committee voted 4-1 on Wednesday to approve a plan that includes a “premium assistance program” which would require newly eligibly Medicaid recipients to select private health insurance starting in 2016.

Republican Senator Andy Sanborn of Bedford was the lone dissenting vote.

During a Senate committee meeting in Concord on Tuesday, the public had its first chance to weigh in on the Medicaid expansion plan backed by leaders in both parties. 

A wide range of voices spoke favorably of the bill that relies on private insurance for new recipients, including medical providers, hospital executives and business owners.

Justin VanEtten of Meredith runs a private ambulance company, and says despite his philosophical opposition to Obamacare, he backs bringing federal tax dollars into the state.

Sara Plourde

Full details of a Senate plan to expand Medicaid under the Affordable Care Act are out.

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. 

DHHS Commissioner Toumpas

Jan 22, 2014
New Hampshire Public Radio / Flickr Creative Commons

You would think that the commissioner of the state’s largest agency has one of the biggest to-do lists of the year, and for Health and Human Services Commissioner Nick Toumpas, you’re probably right. A new year brings new challenges for Toumpas: with Medicaid, there’s the implementation of its managed care program, as well as the continuing debate over its expansion.

NHPR Staff

Lawmakers returned to Concord Wednesday, and House Democrats wasted no time passing a bill to expand the state’s Medicaid program.

Their latest Medicaid plan, which was tacked onto a different bill they’d planned to kill, would send some newly eligible recipients into the exchange for coverage, but not until 2017.  

The past few weeks served as a cooling off period after last November’s special legislative session failed to produce a deal on Medicaid expansion between the Democratically-held House and GOP-controlled Senate. 

The debate will roar back to life on Wednesday, though, when Democrats in the House say they’ll tack an expansion plan onto an unrelated bill.

NHPR

The State Senate couldn’t pass the plan favored by GOP leaders, and then rejected a plan embraced by Democrats on party lines. Ultimately, the Senate adopted a second GOP proposal, before laying it on the table. Two hours later it rejected a Medicaid bill passed by Democrats in the N.H. House.

John Reagan is a Republican from Deerfield:

"I can contend with combinations of vagaries and certainties, but my friends to be steered and rushed is an invitation leading to rueful decisions."

Gov. Maggie Hassan has spent the last several days taking her push to expand Medicaid out side of Concord, and into the districts of GOP Senators.

Speaking at SNHU, in the home district of Republican David Boutin, Hassan said the GOP needs to bend.

"Every time we put forward a compromise, we are told that it’s no good, it’s still their original plan."

Back at the statehouse, Senate President Chuck Morse insisted that’s not true.

"We are open to suggestions.'

House and Senate leaders continue to debate an expansion of the state’s Medicaid program to more low-income New Hampshire residents.

A key difference between the two sides is how quickly New Hampshire moves an estimated 35,000 individuals from Medicaid into the exchange to obtain private insurance.  

House leaders and the Governor say the GOP’s plan to shift people in 2015 won’t work. Republicans, including Senate Majority Leader Jeb Bradley, are defending their proposal.

Chris Jensen, NHPR News

Governor Maggie Hassan and House Democrats are offering to adopt the Senate’s plan for Medicaid expansion provided they make certain changes, but GOP leadership says the proposal falls short of a compromise.

On Wednesday, Hassan and House Speaker Terie Norelli outlined a package that would use the Senate’s language for expansion, but changes how and when individuals would access private insurance.

Todd Bookman / NHPR

On Tuesday, both the House and Senate held public hearings on competing Medicaid expansion bills. 

Supporters of growing the health program pulled out the same blue stickers they’ve worn at other recent public hearings. And many of the voices were the same, including doctors, nurses, advocates and citizens who shared stories about how access to health insurance would benefit low-income New Hampshire residents.

House and Senate committees are holding public hearings and work sessions on rival plans to expand Medicaid in New Hampshire this week.   The House holds its public hearing Tuesday morning while the Senate's hearing on its plan is that afternoon. The committees working on the bills will vote on a recommendation Thursday, but whatever they decide may be superseded by any compromise negotiated behind closed doors by legislative leaders and Gov. Maggie Hassan.   The House and Senate plans are essentially the same for the first year, but take different approaches after that.

Ben McLeod / Flickr Creative Commons

  Lawmakers returned to Concord Thursday to debate a major part of the federal health overhaul law: expansion of Medicaid. In New Hampshire, such a move would provide insurance coverage to an estimated 50,000 low income residents.

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