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Medicaid shuffle: Best of a bad situation

February 21. 2018 10:20PM

Having made the decision four years ago to expand New Hampshire’s Medicaid program to able-bodied, low-income adults, it was all but inevitable that the Legislature would continue to extend the program.

No one at the State House wants to take away a government benefit once given, even if a third of the state’s new Medicaid recipients had private insurance before signing up for the freebies.

For the past four years, Senate Republicans have been trying to mitigate the financial burden of Medicaid expansion, even as the state’s share of the program increases.

The latest proposal from Senate President Chuck Morse and Majority Leader Jeb Bradley makes the best of the situation.

New Hampshire’s program had put new Medicaid recipients into the Affordable Care Act exchange, which is collapsing despite the extra 50,000 customers. The bipartisan extension now on the table shift those beneficiaries into a managed care plan similar to the standard Medicaid program.

It includes a work requirement long opposed by Democrats. It continues a trust fund to accept contributions from New Hampshire hospitals, the largest beneficiaries and strongest supporters of expanded Medicaid.

The plan would also reallocate the state’s alcohol fund. Current drug treatment and prevention programs would need to be backfilled with General Fund dollars. But this financial shuffle limits taxpayers’ exposure to higher Medicaid spending.

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