The program that was supposed to save the state millions of dollars by largely keeping Medicaid patients from going to emergency rooms for routine medical care is at a crossroads.

The program was supposed to be in place by July 1, but now the start-up date has been pushed back to Jan. 1, which leaves only six months in the current biennium to garner those savings.

Medicaid is the health insurance program for the poor, disabled and elderly people. The Department of Health and Human Services picked three companies to run the managed care program throughout the state, but the contracts, which together total the largest single contract award in state history, have stalled before the Executive Council.

The schedule lawmakers had envisioned for implementing the program had the contracts approved by the five councilors by the end of March. Instead, the issue has stretched into this month; on Friday, the council held another informational hearing to gather more information about the contracts and how the new system would work.

After hearing questions posed by councilors, several people who sat through the more than two-hour session in the packed rooms wondered whether the contracts would be approved at all.

The delay has caused other problems, too. For example, the Healthy Kids Program was scheduled to end July 1, when it was to be taken over by the new managed care program. Health and Human Services asked the Joint Legislative Fiscal Committee to approve new positions to oversee the administration of the program beginning July 1, but budget writers balked Friday, saying they did not envision a transition program between the end of the current contract and the new managed care program.

Senate Finance Committee Chairman Chuck Morse, R-Salem, told Health and Human Services officials, “We're very concerned about the actions of the department.”

The Executive Council is expected to vote on the managed care contracts Wednesday, but there is not a lot of optimism that will be the last word on the agreements.

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REFUGEES AND MANCHESTER: A Senate committee Tuesday will decide the fate of a bill that would allow communities to institute up to a yearlong moratorium on refugee resettlement.

The Senate Public and Municipal Affairs Committee will vote on what to do with House Bill 1405, which passed the House on a 190-109 vote last month, though the House Municipal and County Government Committee voted to kill the bill, 15-1.

Last week, a standing-room-only crowd filled a Senate hearing room mostly to oppose the bill, although Manchester officials, including Mayor Ted Gatsas, supported the bill along with the prime sponsor, Rep. Laura Pettengill, R-Glen.

At the hearing, the committee chairman, Sen. Jack Barnes, R-Raymond, urged resettlement agencies to work with Manchester officials to foster better communications, which he hinted could mean the bill would not be needed.

But the problem is Gatsas, who was a senator until he ran for mayor, still has friends in the Senate and wants the bill to stay alive to pressure the resettlement agency, the International Institute of New Hampshire, to slow down the influx of refugees coming to the city.

Barnes truly appeared perplexed last week about what to do with the bill. He urged anyone testifying at the hearing to help bring the parties together so they could sit down and discuss the situation and work something out.

Well, some folks took him at his word

Granite Staters for Strong Communities is a bipartisan group composed of residents, civic leaders, people of faith and business owners who employ the refugees..

“In New Hampshire, we value the strength and growing diversity of our communities,” said George Bruno, a Manchester immigration attorney who was asked to get involved. “New Hampshire's Senate leaders were clear in Tuesday's hearing. They asked me and others to step up and work it out. We are answering that call to action and intend to get involved in whatever way we can to protect this critical and long-standing program.”

Other members of the organization will be announced soon.

The group's organizers say the intent is to give a voice to the refugees.

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GAY MARRIAGE FALLOUT: On Friday, the National Organization for Marriage ran full-page ads in state newspapers criticizing Republicans who voted against repealing the state's gay marriage law.

The ads invited people interested in challenging Republicans who voted against the repeal to contact the NHforMarriage.com coalition.

“Interested in running for the State House?” the ad asked. “We're looking for faithful candidates — Republicans, Democrats and Independents — to run against these politicians.”

The eighty-seven Republicans who joined with Democrats to kill the bill on a 211-116 vote are listed, and people are urged to contact them.

“Dozens of House Republicans in New Hampshire betrayed the cause of marriage, betrayed the GOP Party platform in support of traditional marriage, and stood in opposition to every major Republican candidate for President,” said Brian Brown, NOM's president. “It's time for them to be held accountable for their vote.”

Brown said his organization spent more than $1 million helping to elect pro-marriage candidates in New Hampshire for the 2010 elections and has said the organization intends to spend $250,000 supporting pro-traditional marriage candidates in the upcoming election.

“The people of New Hampshire support marriage as the union of one man and one woman, and we will not rest until the Legislature corrects the mistake that was made in 2009,” Brown said.

The pro-gay marriage group Standing Up for New Hampshire Families said the Washington, D.C.-based NOM intends to empty its treasury to influence New Hampshire elections.

“NOM has never cared about what the people in New Hampshire want,” said Craig Stowell, Republican co-chairman of Standing Up for New Hampshire Families. “They've mocked every poll that's found a super-majority opposed to repeal. And now NOM's back to threatening our independent-minded lawmakers, who are part of the most representative Legislature in the country.

“Marriage equality has only accomplished one, fundamental principle — and that's treating all of our families equally and fairly under the law,” Stowell said, “nothing more and nothing less.”

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REMATCH IN DISTRICT 2: Former District 2 state Sen. Deb Reynolds, D-Plymouth, is holding an event at 12:15 p.m. Monday at Foster's Dining Room in The Common Man Inn in Plymouth.

Reynolds, who held the District 2 seat for two terms, is expected to announce she will seek the seat again in a rematch with Republican Jeannie Forrester of Meredith.

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BUDGET BRIEFING: The House and Senate Finance and Ways and Means committees will have a joint meeting Tuesday at 1 p.m. in Rooms 210-211 of the Legislative Office Building.

The group will hear from the National Council of State Legislators' chief counsel, Michael Bird, on what the state can expect if the automatic reductions are activated in the Federal Deficit and Federal Budget Control Act.

The agreement, which included automatic reductions in federal spending if a blue ribbon commission failed to find the needed savings, was part of a federal deficit reduction package that included raising the country's debt ceiling.

Garry Rayno writes State House Dome each week for New Hampshire Sunday News. E-mail him at grayno@unionleader.com.