Medicaid expansion bill clears key House committee in unanimous vote

March 29--Medicaid expansion bill clears key House committee in unanimous vote

By Dave Solomon

State House Bureau

March 28. 2018 10:24PM

* Tax credit plan for funding addiction recovery centers stalls in House committee

-- There may be opposition in the House to expanded Medicaid, but there was no evidence of it on Wednesday as a key House committee voted unanimously to endorse Senate Bill 313.

The bill reauthorizes the health insurance program for low-income households for another five years.

The House Health and Human Services Committee voted 21-0 to send the bill to the House floor with an "ought to pass" recommendation, after minimal debate and the quick adoption of five minor amendments.

Representatives had come armed with many more amendments, but Committee Chairman Frank Kotowski, R-Hooksett, asked them to be restrained for now with the understanding that the bill would still be subject to Finance Committee review.

"It behooves us all to move this along," said Kotowski. "We may not agree on every piece of this bill, but I hope we agree that New Hampshire is watching. We had a public hearing where 98 out of 100 people encouraged us to move this forward."

Kotowski encouraged each of the members present to speak briefly on the bill, and each one spoke in support.

Since the Legislature voted to expand the criteria for Medicaid eligibility to embrace a larger number of households, more than 50,000 New Hampshire residents who were previously uninsured have acquired government-funded health insurance through the program.

Several representatives commented on the fact that many of those newly insured have taken advantage of life-saving addiction recovery services as the state copes with an opioid crisis.

"This bill is allowing a number of services to come to the state that the state desperately needs, the most obvious being services to people addicted in the opioid crisis," said Rep. William Marsh, R-Wolfeboro.

The federal government initially paid for the entire cost of the expansion, but the state has had to pay 5 percent of the cost for the past two years, rising to 10 percent by 2020.

"We can provide these services with 95 percent federal dollars," said Marsh. "If we fail to pass this bill, we are still going to have to provide these services with general fund dollars, which would be exceedingly expensive. To protect our budget, we have to pass this bill."

Five minor amendments were passed by the committee, none of which were of concern to Senate Majority Leader Jeb Bradley, a key sponsor of the legislation, who observed the committee deliberations and vote.

The bill includes work or community service requirements for certain participants and conversion of the program to a managed care approach, instead of fee for service. Funding for the state share of the expansion would come in part from the state's Alcohol and Drug Abuse Prevention and Treatment Fund.

The bill passed the Senate in a 17-7 vote on March 9, but is likely to face some opposition on the House floor despite the unanimous House committee vote.

"We're very much against it," said Rep. J.R. Hoell, a member of the conservative Freedom Caucus in the House, which claims about 35 members, according to Hoell.

"The bill as drafted still incentivizes people to stay stuck at some level of income, and that's the worst type of social program out there," he said. "Instead of a hand up it's a handout and it offers a perverse incentive to stay stuck below the income limits. We want to see people working their way to prosperity and this doesn't do that at all."

The House is expected to vote next week on the bill, and if passed, refer it to Finance Committee for further review.

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