Granite Benefit Program Clears First Home Hurdle

By GARRY RAYNO, InDepthNH.org

CONCORD — The state’s Medicaid growth program cleared its first hurdle within the Home unscathed after three hours of debate Thursday.

The Granite Benefit Well being Care Program cleared the Home by a 193-166 vote after program supporters defeated greater than 25 proposed amendments to alter this system or to show the invoice right into a Christmas tree by including payments the Home handed and the Senate killed.

One of many key points this session with Senate Invoice 263 is whether or not to take away the statute’s sundown clause to make it everlasting and that isn’t prone to be settled because the Home Finance Committee will overview the invoice earlier than the Home takes ultimate motion.

The state’s two-year working finances the Home accepted final month incorporates solely a two-year extension for the medical insurance program for the state’s working poor who make an excessive amount of cash to qualify for normal Medicaid providers, however not sufficient to afford particular person or household well being care plans.

Quite a few plan opponents sought to incorporate a piece requirement though about 70 % of the roughly 70,000 individuals work and others are on this system to allow them to return to work. Lots of these amendments additionally would have allowed neighborhood service to substitute for work.

Rep. Lucy Weber, D-Walpole, reminded proponents of labor necessities that the Supreme Courtroom discovered such necessities illegal as a result of Medicaid is a well being care program and a piece requirement is a separate entity.

However that didn’t cease many invoice opponents from bringing their amendments to the Home ground.

Rep. Barbara Comtois, R-Heart Barnstead, stated her modification would make of us work for one thing which might assist them get again into the workforce.

“Authorities packages ought to be giving individuals a hand up and never a hand out,” she stated, which was echoed by many proponents of the work requirement.

The Senate accepted the invoice unanimously earlier this yr. The invoice would take away the sundown date on this system, however later Senate President Jeb Bradley, R-Wolfeboro, stated the Senate would conform to an eight-year extension, however was involved the Home modification solely would approve it for 2 years, which might be extra pricey and never present consistency for enterprise and healthcare suppliers.

The Home responded by writing over 30 amendments to the invoice, a lot of which might basically finish this system or change it to scale back the variety of individuals eligible for it.

Different amendments would have hooked up the hashish legalization program the Home handed this yr, in addition to one other invoice coping with the federal government’s emergency powers.

Home Republicans first tried to increase this system for six years, with Rep. Erica Layon, R-Derry, saying well being care is a shifting panorama and it’s far too early to make this system everlasting.

“And not using a sundown, it’s a a lot larger hurdle to make it the very best program it may be,” Layon stated, noting extending it for six years “hits a candy spot for the managed care contracts.”

However Rep. Joe Schapiro, D-Keene, argued this system serves tens of hundreds of granite staters by offering inexpensive well being care, preventive care, and a few specialty care, whereas lowering uncompensated care to hospitals and different suppliers, and lowers value shifting to insurance coverage premiums.

He stated the longer the managed care contracts, the better the financial savings to the state when it negotiates with insurance coverage administrative suppliers.

And he famous this system is an important life line to individuals being handled for substance abuse and psychological well being points.

“This program offers safety for low-income residents and well being care suppliers,” he stated, at a time when “the well being care system is beneath appreciable stress.”
J.R. Hoell, R-Dunbarton, launched plenty of amendments coping with the general well being care system within the state saying laws are crushing the system with too few physicians and too few beds. He additionally proposed eradicating the severability clause in statute so if one part of the legislation is rejected by the courts, your complete invoice can be in danger.

Others tried to extend the variety of individuals in a right away household when figuring out a person’s eligibility for this system in addition to home companions and single roommates.

All of them failed, the most important failure was including the hashish legalization invoice.

Invoice supporters additionally defeated a number of makes an attempt to desk the invoice. After a couple of dozen amendments had been heard and debated, Weber proposed efficiently to restrict debate to only one brief speech on both facet and the vote.

Republicans defended their makes an attempt to alter the invoice saying Medicaid is a rising state expense.

“We already handed Medicaid Growth with a sundown provision, and Medicaid spending has grown to over one-third of our state’s finances, and continues to develop as a proportion of our state finances,” stated Rep. Jim Kofalt, R-Wilton. “A program this massive, this advanced, and this costly deserves a periodic overview and reauthorization by the individuals’s elected representatives.”

Home Majority Chief Jason Osborne, R-Auburn, targeted on the vote to restrict debate on the quite a few amendments but to be heard.

“Home Republicans put ahead plenty of amendments at this time with a view to make the New Hampshire Granite Benefit Well being Care Program a greater program. Sadly Home Democrats didn’t need to hearken to all of the methods this program is flawed and our concepts to enhance it,” Osborne stated. “As a substitute they moved to restrict debate, treading roughshod on the historic traditions of this as soon as august physique, and betrayed our historic bipartisan finances compromise that beforehand handed on a voice vote.”

The finances contained a two-year extension for this system.

After the session, Home Democrats issued a press release that stated, “The growth of Medicaid has supplied healthcare to over 200,000 Granite Staters – our associates, neighbors, and colleagues are served by this program and the well being of your complete state of New Hampshire is healthier for its existence.”

They stated regardless of the Republican makes an attempt to dam the invoice, Home Democrats and different supporters held sturdy.

“Granite Staters’ healthcare shouldn’t be contingent on unreasonable necessities or arbitrarily ended after a random variety of years,” in line with the assertion. “Medicaid sufferers, suppliers, and so many within the healthcare and enterprise neighborhood consider this program ought to be everlasting and we’re glad to have been in a position to ship a powerful vote at this time.”

The invoice had huge help from enterprise organizations and well being care suppliers, who all stated a long-term extension would offer stability and consistency and permit for investments within the well being care infrastructure.

This system started in 2014 to offer well being care protection to the state’s working poor beneath the Reasonably priced Care Act. Lawmakers first failed to achieve settlement on any plan, however a bipartisan group of senators labored to provide you with a compromise, which is actually the identical as what’s in place at this time.

This system now has about 70,000 residents on this system and elevated through the COVID pandemic when eligibility was expanded to cowl extra individuals.

Garry Rayno could also be reached at [email protected].