Medicaid Expansion Rejected by Senate

In this budget and Medicaid expansion debate, what counted in the end was the count: 13 to 11.

New Hampshire Senate President Peter Bragdon closed ranks in the 13-member Republican caucus and took to the floor Thursday to defeat an amendment to the $10.7 billion state budget to have New Hampshire expand Medicaid as a booster shot to the Affordable Care Act.

The budget, with an amendment to study Medicaid expansion instead, was adopted by the party-line 13-11 vote.

Bragdon (R-Milford) questioned whether the federal government would live up to its promises to fund the $2.5 billion possible for the state, echoing long-held complaints in New Hampshire about Uncle Sam not living up to promises to fully fund special education. He also questioned if benefits of Medicaid expansion were as great as some had argued.

He asked, "Can we get out without any strings attached?"

The potential loss of millions of dollars didn't sit well with Senate Minority Leader Sylvia Larsen (D-Concord).

"These federal funds would represent millions of dollars in savings to our state budget while saving millions of dollars in hospital charitable care," Larsen said in a statement after the vote. "These federal funds also hold the potential to add 5,100 new jobs, $2.5 billion to our economy over the next 7 years and to cover as many as 58,000 low-income New Hampshire citizens with reliable healthcare."

Sen. Martha Fuller Clark (D-Portsmouth) called Medicaid expansion a key issuing of getting the economy humming again. She said 58,000 residents would get health care insurance coverage with the expansion of Medicaid.

Senate Majority Leader Jeb Bradley (R-Wolfeboro) said there remain too many unanswered questions, however. "What we're proposing today is not 'no'," he said.

Just not now, according to the Senate GOP, in the party-line vote on Medicaid expansion.

Medicaid is a federal-state program that helps pay health care for the needy, elderly, blind, disabled and low-income families and children. The federal government reimburses a percentage of the state's expenditure.

Sen. Chuck Morse (R-Salem), the chairman of the Senate Finance Committee, lauded the Senate budget as a balanced plan that has no new taxes or fees. The It is approximately $400 million less than Gov. Maggie Hassan's budget proposal, and $300 million less than the House version, Morse said.

It also removes the 12-cent increase in the state gas tax, which Rep. David Campbell (D-Nashua) championed as a way to dedicate revenue to roads and bridges. It removes a proposed 20-cent increase in the state's cigarette tax. The state budget, House Bill 1 (House-passed version here), is for the two-year period that begins July 1, 2013.

The House position on the budget varies widely, so House and Senate conferees will at some point be selected to review the two budgets and negotiate changes that each chamber can support. Democrats in Concord, continued debate and hold out hope that Medicaid expansion is part of the final product.

Governor Hassan statement on the budget vote:

"While there are clearly areas of agreement around critical priorities such as higher education, mental health funding, and economic development, the budget passed by the Senate still falls short in a number of areas that are imperative to moving our state forward. The across-the-board cuts to Health and Human Services and employees will impact critical services and cause hundreds of layoffs, and the rejection of $2.5 billion in federal funds for Medicaid expansion undermines efforts to strengthen our economy and improve the health and financial wellbeing of New Hampshire’s working families. 

As the process moves forward, legislators will need to take a bipartisan approach, set ideology aside, and listen to the people of New Hampshire in order to reach a final a balanced budget that reinvests in the priorities needed to build a more innovative economic future.

I will continue to work with members from both parties in both the House and Senate to improve upon the Senate’s plan and finalize a balanced budget that will support job creation, help innovative businesses grow and thrive, and maintain New Hampshire’s high quality of life as one of the safest and healthiest states in the nation."

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House Bill 1 Roll Call in the NH Senate (Motion is: Ought to Pass with amendment):

Yeas (13)

David Boutin, R-Hooksett, Jeb Bradley, R-Wolfeboro, Peter Bragdon, R-Milford, Sharon Carson, R-Londonderry, Sam Cataldo, R-Farmington, Jeanie Forrester, R-Meredith, Chuck Morse, R-Salem, Bob Odell, R-Lempster, Russell Prescott, R-Kingston, Jim Rausch, R-Derry, John Reagan, R-Deerfield, Andy Sanborn, R-Bedford, and Nancy Stiles, R-Hampton.

Nays (11)

Lou D'Allesandro, D-Manchester, Martha Fuller Clark, D-Portsmouth, Peggy Gilmour, D-Holllis, Andrew Hosmer, D-Laconia, Molly Kelly, D-Keene, Sylvia Larsen, D-Concord, Bette Lasky, D-Nashua, David Pierce, D-Hanover, Donna Soucy, D-Manchester, David Watters, D-Dover, Jeff Woodburn, D-Dalton.