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N.H. opts not to expand Medicaid

CONCORD, N.H. — New Hampshire’s Legislature will vote on a $10.7 billion, two-year state budget next week that increases funding to higher education and services for the disabled and mentally ill, but does not authorize expanding Medicaid as Democrats had hoped.

Expanding Medicaid was the last big hurdle negotiated Thursday to reach a compromise.

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Governor Maggie Hassan, a Democrat, applauded the bipartisan deal, but said she was disappointed it did not authorize expanding Medicaid to an estimated 58,000 poor adults.

The Republican-led Senate negotiating team and the House team led by Democrats traded several proposals on Medicaid expansion before agreeing to establish a commission to study the impact expansion would have on the state and possible alternatives, such as using federal funding to buy private insurance for some.

States can choose to expand Medicaid as part of a key component of the federal health care overhaul, which will be fully implemented Jan. 1. If New Hampshire were to expand the program, the US government would pick up the full cost for the first three years and 90 percent over the long haul. States can withdraw from covering adults without penalty.

New Hampshire’s Medicaid program covers low-income children, parents with nondisabled children under 18, pregnant women, senior citizens, and people with disabilities. The expansion would add anyone under age 65 who earns up to 138 percent of federal poverty guidelines, about $15,000 for a single adult.

Legislative leaders could call a special session to vote to authorize expansion after the commission files its report, but the Senate would not agree to a firm date. Hassan also could call lawmakers into special session, a move she indicated might be needed to ensure New Hampshire starts the program Jan. 1 to begin capturing the estimated $2.5 billion in federal funding the state would get over seven years.

‘‘While I believe we could move forward now with accepting the $2.5 billion in federal funds for Medicaid expansion, I respect the Senate’s desire to study a New Hampshire-specific model and appreciate its willingness to do so in a timely way,’’ Hassan said in a statement. ‘‘I am confident that once members of the Legislature see the results of the study, they will want to move forward as quickly as possible through a special session.’’

The House and Senate had largely agreed on spending priorities entering negotiations. The compromise budget increases funding for higher education and services for the mentally ill and disabled.

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