New Hampshire Senate Votes to Expand Health Insurance Coverage

CONCORD, N.H. - The state's Republican-dominated Senate voted Thursday to expand health care coverage to an estimated 50,000 adults using Medicaid funding made available through the Affordable Care Act.

The bill moves to the House, which has passed similar legislation. Gov. Maggie Hassan, a Democrat, praised the bill, calling it 'a New Hampshire-specific solution to making sure that we can have health care coverage for working men and women throughout the state who haven't had it before.'

New Hampshire would join a small group of states, including Arkansas and Iowa, that have opted to expand health care to low-income adults with programs that focus not on expanding their existing Medicaid programs, as 25 other states and Washington, D.C., have done, but on using federal Medicaid money to buy private health insurance.

The bill would allow adults younger than 65 who earn up to 138 percent of the federal poverty level - about $15,900 for a single person - to qualify for coverage. The first phase of the plan covers about 12,000 of those adults through a program that subsidizes employer-based coverage; a second group of about 38,000 would be covered by the state's existing Medicaid managed-care program in July. Those adults would transition to private health care plans at the beginning of 2016. Federal waivers must be approved for each step to take place.

The program would end in 2016, when the federal government's required contribution to the plan drops below 100 percent, unless it was reauthorized.

The bill passed 18 to 5 in the Senate, where a similar measure failed last fall. Lawmakers said they hoped the delay before putting people on plans in the private exchange would allow more competition to enter the marketplace. The measure's sunset clause was intended to address concerns about paying for the program when federal contributions to it decreased, but Senator Andy Sanborn, a Republican who voted against the bill, said it would be challenging politically not to reauthorize the program.

'I have never seen, in the political realm, any entitlement program ever end,' Mr. Sanborn said. 'And I think the suggestion that they would end is frankly ludicrous.'

Representative Cindy Rosenwald, a Democrat who is the vice chairwoman of the House Finance Committee, said she expected the House to pass the bill. 'We are on record as saying we're willing to use the commercial health insurance market for this population if it can be done efficiently,' she said.

Health care advocates in the state praised the bill.

'It's a compromise that achieves workable, affordable coverage for people who really need it in our state,' said Tom Bunnell, a policy consultant for New Hampshire Voices for Health.