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That Medicaid waiver: Shaheen didn't get the memo


During the debate over Medicaid expansion last year, proponents said the Senate Republican plan, which could have been started last summer, was "unrealistic" because it would move Medicaid-eligible people onto the Obamacare exchanges before the federal government could possibly grant a waiver to approve the move.

Under the GOP plan, instead of putting people who make up to 138 percent of the federal poverty level on Medicaid, the state would give them the Medicaid money and let them buy their own private insurance. That part of the plan would kick in during the second year of the two-year transition.

Democrats said the federal government was too slow and inefficient to approve that plan within a year. And they said they did not want people going to the exchange when only one insurer offered coverage there.

The Republican plan "lacks workable, achievable and realistic time lines and includes no measures to ensure competition and cost-effectiveness on the exchange," Gov. Maggie Hassan's communications director, Marc Goldberg, insisted last fall. "Instead, it would delay critical health coverage for thousands of families...."

Republicans relented and agreed to the Democrats' plan to put eligible people on Medicaid for three years, after which they would transition to private insurance on the exchange. That plan passed the House Tuesday (just after the state Insurance Department approved another insurer for the state exchange). When Medicaid expansion passed, Sen. Jeanne Shaheen released a letter to Health and Human Services Secretary Kathleen Sebelius urging her to "expeditiously develop and approve any waiver necessary to ensure a successful expansion of the Medicaid program in the state."

But according to New Hampshire Democrats, that is not possible. They said repeatedly that there is no way HHS could approve a waiver "expeditiously," it would take years.

Maybe poor Sen. Shaheen did not speak to Gov. Hassan and thus remained unaware that her request is impossible to fill.

Or maybe, given that Shaheen's request came on the same day the entirely politically run HHS department issued yet another delay of an Obamacare mandate, the New Hampshire Democrats' claim that the bureaucracy waits for no one was always a ruse.

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