N.H. to Debate Medicaid in 2016 Session
Concord — The debate over whether New Hampshire should keep more than 45,000 residents on subsidized health insurance is set to dominate the Statehouse when lawmakers return to Concord in January.
New Hampshire’s Medicaid expansion plan will expire at the end of 2016, when federal funding drops below 100 percent, if lawmakers don’t vote to reauthorize it. Officials estimate the state will be on the hook for at least $12 million in 2017 and more in future budgets.
Needing support from a Republican-controlled Legislature, the program’s future will depend largely on whether lawmakers can find a way to pay for the added costs without taxpayers footing the bill.
Alongside Medicaid expansion, top issues in 2016 will include the substance abuse crisis, school funding and shoring up the state’s highway fund. The session begins Jan. 6.
With the November election looming, Republican legislative leaders are wary of kicking more than 40,000 people off health insurance plans. But some elements of the party are strongly opposed to continuing Medicaid expansion, a signature piece of President Obama’s health care overhaul law.
New Hampshire’s program is unique in that it aims to use federal dollars to put low-income people on private health insurance plans. Come Jan. 1, most Medicaid expansion recipients will be on private plans.
Any funding solution is likely to involve the state’s hospitals, which are benefiting financially from Medicaid expansion because fewer uninsured people are coming into the emergency rooms. Senate Majority Leader Jeb Bradley, a chief architect of the plan, has been meeting with the hospitals, which could help pay for continued expansion. House Speaker Shawn Jasper said he will only support continuing the program if it does not cost taxpayers.
Substance Abuse
At least a dozen pieces of legislation focused on substance abuse prevention, treatment and recovery will come before lawmakers in 2016. Some, such as efforts to crack down on fentanyl dealers and mandate drug education in schools, are on a fast-track process, meaning they could reach Gov. Maggie Hassan’s desk by late January. Other efforts include upgrading the state’s prescription drug monitoring system, facilitating needle exchange programs and reducing the number of opioid-based painkillers prescribed by doctors.
Officials predict more than 400 people will die from drug overdoses in New Hampshire this year.
Road Toll
People who drive cars that get more than 20 miles per gallon could be subject to a new fee when they register their cars if a proposal by Republican Rep. Norman Major passes.
His bill aims to supplement the state’s gas tax, which he argues is paid disproportionality by people who drive less efficient vehicles. The tax helps pay for road and bridge projects, and the Department of Transportation is continually at risk of running out of money in the fund.
Major’s bill proposes a graduated fee scale based on how many miles per gallon a vehicle gets. Owners of more efficient cars that use less gas would have to pay an additional annual fee when they register their cars.
Major’s bill may face a difficult road in the Republican-controlled House, where many members of his party refuse to vote for any tax and fee increases.
Education Funding
Education funding is back in the spotlight after the city of Dover sued the state last year, claiming it’s not getting its fair share of payments.
The state pays districts on a per-student basis, but limits how much districts can receive at 108 percent of what they got the year before, a limit that may not keep up with rapidly growing districts.
Dover is seeking about $14 million in back payments, and a win for the district could require the state to make payments to other districts, as well. The recently passed state budget raises the limit to 160 percent in 2017, which still falls roughly $4 million short of predicted enrollments.
A bipartisan group of House members and senators is backing legislation to completely eliminate the limit.
