NH House Stalls on Making Expanded Medicaid Program Permanent

Hospital ER room.Photo byPaul Cuno-Booth

In a recent legislative session, House Republicans in New Hampshire rebuffed a bill aiming to permanently extend the state's expanded Medicaid program. The bill, Senate Bill 253, was defeated by a 191-183 vote, leaving the program intact for the next seven years, as per a compromise established last year.

This decision mandates a reevaluation by lawmakers in seven years to determine the program's continuity. The vote witnessed a rare bipartisan split, with Republican Rep. Dan Wolf siding with Democrats to advocate for the program's permanence, while Democrat Rep. Matthew Coker aligned with Republicans in opposition.

The Medicaid expansion, known as the Granite Advantage program, has been hailed by the New Hampshire Fiscal Policy Institute for significantly reducing the number of uninsured residents in the state. It has also notably enhanced health outcomes by affording beneficiaries access to preventive care while concurrently mitigating hospitals' costs linked to uncompensated medical care.

Granite Advantage beneficiaries, akin to traditional Medicaid recipients, belong to the low-income bracket. However, they do not meet Medicaid's conventional eligibility criteria, which typically require recipients to be under 19 years old, pregnant, possess a physical or developmental disability, or serve as caregivers for children or other family members.

The financial burden of the Granite Advantage program is shared between the federal government and the state, with the federal government contributing a portion of the costs.

House Republicans have consistently opposed initiatives seeking the permanent establishment of the program ever since its inception in 2014. During the recent session, they reiterated their stance, expressing the desire to maintain flexibility in assessing the program's viability. Republicans cited concerns about potential reductions in federal contributions or changes in federal policies as reasons to retain the option for future reconsideration.

This rejection of a permanent extension underscores an ongoing debate about the program's longevity and financial sustainability. While supporters highlight its positive impacts on healthcare access and outcomes for low-income individuals, opponents remain cautious, emphasizing the need for flexibility in response to potential federal policy shifts that could affect the program's financial framework in the future.