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Garry Rayno's State House Dome: Battle likely on expanding Medicaid eligibility
One of the key elements of the act is expanding Medicaid, she says, although it is optional for states thanks to a U.S. Supreme Court ruling on the ACA.
Will the percentage of federal matching funds remain the same for those previously eligible for Medicaid that now enroll in the program?
What percentage of the nation's new enrollees in the expanded Medicaid program were previously eligible for the program?
"As senators representing South Carolina and New Hampshire, we want to understand fully the underlying costs to states' Medicaid programs," Ayotte and Graham wrote.
State Health and Human Services Department officials expect about 1,657 people who were previously eligible will be added to the Medicaid program in 2014, and the number will grow to 3,208 by the year 2021.
But the agency also predicts about 2,000 people will leave Medicaid and go on private insurance and the number to grow to slightly less than 4,000 by 2021, saving the state $71 million.
LITTLE STEPS: Another week passed and Democratic and Republican lawmakers inched only a little closer to an agreement on expansion of Medicaid eligibility with the crucial vote Thursday. Neither side is willing to give on the "essential components" of their plans.
Key words left out of the spin are budget neutrality, something the federal government is not likely to bend on. The cost of private insurance and the additional services required for the Medicaid program such as transportation cannot be more than it would cost in the "regular Medicaid program."
Medicaid currently pays providers about 54 cents on a dollar, while private insurers would have to pay something close to 100 percent of the cost or more. That makes budget neutrality difficult to achieve.
Currently, there are about 150 people on the Health Insurance Premium Payment Program (HIPP), which has saved about $1 million annually, DHHS officials told lawmakers last week.
Until the real cost of the private insurance is known, it is impossible for either side to make a convincing argument. Lawmakers need real data, but that will not come until the program is expanded.
House Democrats and Gov. Maggie Hassan want the program to continue in perpetuity unless the feds renege on the promised money or require more expensive benefits.
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NO HIDDEN AGENDA: Senate Republicans agreeing to the leadership's plan are between a rock and a hard place.
On the other hand, the right-wing of the GOP does not want Medicaid expansion or any part of the ACA.
Several weeks ago at a press conference, Aaron Day, the new chair of the Republican Liberty Alliance, warned Republicans they will have a primary if they vote for Medicaid expansion.
"Join the team that's helping to stop Obamacare's Medicaid expansion and prevent a New Hampshire state income tax," is displayed prominently on the group's Home Page.
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