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Medicaid expansion: Who’s really at fault?

Conservatives are understandably unhappy with the emerging legislative compromise that expands Medicaid in New Hampshire. Those looking for someone to blame should focus on the right people: Gov. Maggie Hassan and her Democratic enablers in the Legislature.

Some conservatives, egged on by purity-minded advocacy groups on the right, are shooting at Republicans in the state Senate, as though they are responsible. The Manchester City and Rockingham and Strafford County Republican committees unanimously passed resolutions opposing the deal last week. A liberty movement activist has cited the compromise as the reason why he intends to run against state GOP chair Jennifer Horn at the end of the year, which is a political nonsequitur. It’s like blaming your team’s third base coach when the other team makes a good catch in the outfield.

Gov. Hassan has made expanding the health insurance program for the poor one of her top priorities. She has the support of a pro-expansion Democratic majority in the State House. The only thing standing in her way has been the Republican caucus in the state Senate, which holds a slender 13-11 majority.

Not every member of that caucus is unalterably opposed to any expansion of Medicaid in any form, but collectively the GOP caucus has used its one-seat majority to fight Medicaid expansion as much and for as long as it could. They have managed to prevent Medicaid expansion from taking the shape of a government-run entitlement program. They have conditioned expansion on using private sector providers. They have inserted sunset clauses that will force future Legislatures to vote to continue the program when the federal government reneges on its funding promises.

The Republicans in the state Senate, and specifically state Senate President Chuck Morse and Majority Leader Jeb Bradley, have been the good guys in the battle. They deserve praise, not scorn, from conservatives for maximizing what little leverage they have to prevent an even worse Medicaid expansion from being enacted.

Monuments aren’t built for those who stop worse outcomes, of course. Those who oppose the compromise would do well to put their energy into defeating the governor and some of the 11 pro-expansion Democratic senators, as well as electing a Republican majority to the House, in elections this fall.

Blaming Senate Republicans is misdirected and counterproductive.

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