If the House and Senate approve the 2014-2015 state budget this week, they trigger a requirement to convene a Medicaid Study Commission by July 8.
Missing from the plan, however, is a date for a special session, which was removed in negotiations. Still, lawmakers are talking about calling a special session after the study commission reports in October.
The language agreed to by negotiators calls for a nine-member commission. Three would be appointed by the Senate, three by the House and three from members of the public – with the Governor, Senate and House each choosing one. Both the House and Senate must allow their respective minority leaders pick one of the three for each body. Provided everyone were to pick from their own political party, the commission would end up with five Democrats and four Republicans. The state insurance and health commissioners, or their designees, would serve as two non-voting members.
The commission has a specific list of duties under the general charge of studying the “potential costs and benefits of expanding Medicaid eligibility in New Hampshire.”
This includes looking at ways to expand Medicaid within a different framework than the one envisioned by the Affordable Care Act. The federal government has indicated some willingness to consider state-specific alternatives but there are limits. No state, for example, has been approved for a block grant.
One area of study will involve the availability of providers to cover an expanded Medicaid population and the potential impact of expansion on cost shifting and Medicaid reimbursement.
The commission must look at ways to protect New Hampshire if the federal government fails at any point to make good on its funding commitments.
All findings will be due in a report to the legislature by Oct. 15, 2013. The commission has $200,000 to pay for administrative support from the Department of Health and Human Services.
A second portion of the charge assumes the state moves forward with expanding Medicaid and calls for the commission to monitor and evaluate the results from 2014 onward.
This would include looking at health outcomes for new Medicaid recipients and at uncompensated care costs for providers as well as rates of uninsurance and whether there’s a reduction in the use of emergency rooms.
The commission is set to dissolve by law on Dec. 1 of 2016.