The NH House Has the Right Plan for Medicaid Expansion

On Thursday November 21, the NH House and Senate will be meeting to vote on whether or not New Hampshire accepts $2.5 billion in available federal funds to offer affordable and reliable health care coverage to 49,000 of our hardworking fellow citizens. Voting yes will strengthen the health and economic security of thousands of friends and neighbors, voting no will most likely send those federal dollars – money we paid in taxes – to other states to improve their health care.

Fundamentally this is a battle between ideology and practicality. There are currently two similar – yet significantly different – bills pending in the legislature.  This summer a bipartisan commission studied Medicaid expansion and recommended New Hampshire take advantage of this unique opportunity and laid out a commonsense way to implement it.  The Portsmouth Herald, our Governor, Senator Nancy Stiles and I were all in support of the solution recommended by the committee.

Unfortunately, Senator Stiles backtracked after voting for the commission’s plan.  She chose not to co-sponsor the bill introduced in the House that would implement the very same recommendations that she voted for and instead has sided with Republican insiders supporting a bill in the Senate that includes many provisions that the commission she was a part of considered and – quite frankly – concluded were not right or practical for New Hampshire.

The New Hampshire Department of Insurance and independent experts have said this new scheme is simply unworkable and could even force people off their health insurance during the holidays next year.

There are several problems with this unworkable Republican approach.  First is the timeline.  Expanding health insurance access to 50,000 working New Hampshire citizens is a big job.  It is the right thing to do, but we need to do it the right way.  I have spent most of the last 30 years managing large health plans and know that with a change of this magnitude, ‘the devil really is in the details.” The Senate plan rushes the process, and puts everyone’s health care at risk.

The Senate plan also continues to give the federal government responsibility and authority over New Hampshire health care including, for example, having to continue to utilize the federal government’s Healthcare Marketplace (Healthcare.gov) that House and Senate Republicans forced us to accept in 2011.  I don’t know why Senate Republicans want to give up local control over health policy, but it’s not how we do things in New Hampshire.

Sadly, while this debate could be settled tomorrow, it will almost certainly drag on for the rest of the week.  The simple fact is that Republican Senators don’t want to compromise.  The Republican Senate President even said that he was willing to “delay expansion entirely.”  Those were his words, standing right here on the Seacoast less than a week ago.

It is stunning. It is the kind of recklessness we expect out of Congress not Concord.

In their rightwing crusade against anything and everything health care related, Republicans are willing to deny expanding access to affordable insurance options for thousands of working families and in the process deny our state a much needed  $2.5 billion investment in our economy.  I don’t know who they are listening to, but it is certainly not their constituents, the people of New Hampshire.  That’s not right and that is not how our elected representatives should behave.

Too many of our elected “leaders” in Concord have been posturing and obstructing, instead of moving forward with the recommendations of the bipartisan Medicaid expansion commission and the compromises offered by Governor Hassan and Speaker Terie Norelli.   By the end of this week, we will know where they really stand.   The time for delay has passed; the time to move forward in a reasonable, responsible and reliable manner is now.