CONCORD— The House was still waiting at deadline Wednesday night for the Senate to respond to its proposal to have lawmakers hold a special session to vote on Medi-caid expansion.
A legislative vote on expansion has been a sticking point with Senate President Peter Bragdon, R-Milford, who has insisted expansion could not go forward without legislative approval.
But House Speaker Terie Norelli, D-Portsmouth, has said she believes she needs a path of Medicaid expansion for the House to pass the budget.
The House proposal would have expansion up and running by Jan. 1, 2014, allowing the state to collect all of its eligible money when the federal government pays 100 percent of the cost of those added to the program for the first three years.
"We believe this can be done without a drawn-out study that would delay implementation of expansion beyond Jan. 1, 2014, resulting in the state losing nearly $1 million per day and delaying long-overdue health coverage for thousands of working families who can't afford to wait," said House Finance Committee Chairman Mary Jane Wallner, D-Concord.
Tuesday night, the Senate proposed waiting until next year for lawmakers to vote on expansion while its proposed commission studies the issue.
Senate Finance Committee Chairman Chuck Morse, R-Salem, noted he has received letters saying the current system is broken and now the state could add 60,000 more people to the program.
He said the state needs to wait to put a plan in place that addresses New Hampshire issues.
"Managed care is not up and running," Morse said, "and we need managed care to be up and running for expansion to be successful."
Hospitals and other providers balked at joining the managed care networks of the three companies the state hired to run the program due to low reimbursement rates.
Budget writers believe managed care will save the state millions of dollars, but have not realized those savings.
Morse pushed for more time to study expansion, saying there are many unanswered questions and called the decision one of the most important policy decisions lawmakers will make.
The Senate is expected to make a counterproposal later today, but had not made any proposal last night at deadline.
The date of the special legislative session and the makeup of the commission are the major stumbling blocks to an agreement.
Under the Affordable Care Act, the state-federal health insurance plan would be expanded to 138 percent of the federal poverty level, which is about $15,000 for an adult. Expansion is projected to add 58,000 people to the Medicaid rolls and bring in $2.5 billion in federal dollars over seven years to health care providers while costing the state from $27 million to $85 million.
While Gov. Maggie Hassan and the Democratic-controlled House support the expansion, the Republican-controlled Senate wants to study expansion before deciding.