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A Medicaid trigger: Protecting NH from Congress

At the state Medicaid Expansion Commission meeting on Tuesday, expansion supporter Sen. Peggy Gilmour, D-Hollis, inadvertently exposed the flaw in her own side with a pithy riposte to expansion opponent Rep. Neal Kurk, R-Weare.

Kurk pushed for a plan that would have the state expand Medicaid, but automatically revert to current eligibility levels if the state costs exceed estimates by 10 percent. Gilmour opposed any automatic withdrawal, saying, “I have confidence that future Legislatures can essentially think for themselves,” The Telegraph of Nashua reported.

They can — as can future Congresses. The pro-expansion case is that nearly doubling Medicaid eligibility from 63 percent to 138 percent of the poverty level will cost New Hampshire nothing because Washington offers to pay 100 percent of the cost for three years and 90 percent thereafter.

But because every Legislature can think for itself, an expansion of Medicaid eligibility would be a bet against the prospect of any future Congress reducing Washington’s share of Medicaid expenses. With the federal debt becoming an ever larger burden, the likelihood that Congress will continue funding 90 percent of the costs forever is next to zero. Kurk’s trigger idea is a smart one. It’s too bad the commission thought otherwise.

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