- Associated Press - Wednesday, February 12, 2014

CONCORD, N.H. (AP) - A bipartisan Senate agreement to expand Medicaid to at least 50,000 people in New Hampshire would begin offering subsidized coverage to most of the eligible adults as soon as July 1.

Republican and Democratic leaders released more details Wednesday of a compromise plan announced last week. A hearing could be held on it as early as Tuesday with a vote in early March.

The deal was negotiated in private over the months since the Senate killed plans to expand Medicaid during a special session in November.

Senate Republican Leader Jeb Bradley of Wolfeboro said about 12,000 people could get coverage sooner than July - perhaps within 60 days of the bill passing - if they qualify for an existing state program that subsidizes employer-based insurance. The 38,000 who did not qualify for that program would begin enrolling May 1 to get coverage starting July 1 in a managed care program.

Senate leaders said the key is getting a federal waiver by March 31, 2015, allowing New Hampshire to use federal Medicaid money to buy private insurance beginning in 2016 for the 38,000 people on managed care.

The entire program would end at the end of 2016 if the Legislature failed to authorize its continuation.

Democratic Gov. Maggie Hassan urged the House and Senate to pass the compromise as quickly as possible.

“The bipartisan legislation released today by the Senate represents a compromise plan that will allow us to use federal funds to extend critical health care coverage to more than 50,000 hard-working Granite Staters,” Hassan said in a statement.

The plan also includes a separate waiver to win federal reimbursement for services not currently covered, such as for prisoners and some mental health services. Bradley said reimbursement estimates have ranged anywhere from $25 million to several hundred million dollars to the state.

If New Hampshire were to expand the program, the federal government would pick up the full cost until 2017. The bipartisan agreement would end when federal funding drops below 100 percent unless the Legislature voted to continue it. It also would end on June 30, 2015, if the federal government failed to meet the state’s March 31, 2015, deadline to approve its waiver.

“A future Legislature is going to get a chance to see how this is working. This is not an open-ended entitlement,” said Bradley.

New Hampshire is one of six states that has not decided whether to expand Medicaid. Currently, 25 states plus the District of Columbia are expanding and 19 states are not.

Senate President Chuck Morse said the new plan encourages insurers to enter the marketplace, particularly the three managed care companies covering the state’s existing Medicaid population. Morse said the 38,000 people eligible under expansion to enroll in the transition plan to private insurance coverage would be automatically enrolled with the same managed care companies if those companies offer products on the marketplace.

New Hampshire’s current Medicaid program covers low-income children, parents with non-disabled children under 18, pregnant women, older residents and people with disabilities. The expansion would add anyone under 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,856 for a single adult.

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