Senate Approves Medicaid Expansion Bill as Amended by the House

On May 10, the New Hampshire State Senate concurred with the House of Representatives and voted to reauthorize Medicaid expansion for five years. Although certain circumstances might trigger the end of the program, this step toward reauthorization provides more assurance that the approximately 52,000 Granite Staters served through Medicaid expansion would not lose their health coverage at the end of 2018, when the current program expires. The bill now goes to the Governor for his signature.

The proposal, last modified by the House Finance Committee, would continue health coverage for those adults with incomes at 138 percent of the federal poverty threshold or less ($16,643 for an individual and $28,180 for a household of three in 2017) who do not otherwise qualify for Medicaid or Medicare.

The bill would reauthorize the program under the name “The New Hampshire Granite Advantage Health Care Program.” At least 90 percent of program costs would be paid for by the federal government, with the remainder paid through a combination of certain Insurance Premium Tax revenues, a portion of Liquor Commission sales profits, and an assessment paid by health insurance companies. Program implementation would be conducted through contracts with managed care organizations, private firms that contract with states to administer Medicaid health coverage operations, rather than having enrollees obtain coverage on the individual health insurance marketplace.

Following a May 7 preliminary approval from the federal government and beginning in January 2019, certain enrollees would face new work requirements to receive coverage. These requirements, which were modified by the House Finance Committee and include 100 hours per month of qualifying activities for non-exempt enrollees, would likely lead to coverage losses. A recent study from the Center on Budget and Policy Priorities found that, when faced with an 80 hour per month work requirement modeled after Kentucky’s system, which requires fewer hours than New Hampshire and applies to the Medicaid population as a whole rather than the expanded Medicaid population, close to half of all low-income workers would be at risk of losing coverage for one or more months.

For more information and background on this legislation, see NHFPI’s recent resources: