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Globe NH | Morning Report

The push for Medicaid expansion in N.H.: ‘Healthy people are employable people’

Medicaid expansion started in 2014 after the Affordable Care Act was passed. Since then, it’s helped more than 219,000 Granite Staters, according to the New Hampshire Fiscal Policy Institute.

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Buckle up because it’s going to be a busy day at the State House today. Both the House and the Senate are in session, so you can expect a slew of legislative activity. 

I’ll be watching the Senate vote on whether to expand eligibility for the controversial Education Freedom Account program, and Steven’s been following the parental rights bill, which is up for a vote in the House. You can get up to speed on the latest here.


The House will also be voting on Senate Bill 263, which would reauthorize Medicaid expansion. Without this legislation, that program is set to expire at the end of the year. 

Medicaid expansion helps more low-income people get access to health care. It started in 2014 after the Affordable Care Act was passed under President Barack Obama. Since then, it’s helped more than 219,000 Granite Staters, according to the New Hampshire Fiscal Policy Institute, which credits the program with providing 100,000 people access to health care in the last year alone.

That’s significant for a few reasons. It’s bringing down the number of people who are uninsured -- pre-2014 numbers showed that around 10.5 percent of Granite Staters didn’t have health insurance. That dropped to 4.9 percent after the program started.

It’s been particularly helpful to people who need mental health care, treatment for substance use disorder, to go to the emergency room, or to get pharmacy services, according to NHFPI.

It’s been linked to reduced mortality and food insecurity, better cancer detection, and improved birth outcomes. And last year alone it brought $502 million federal dollars to the state because the federal government foots 90 percent of the bill.  


Get ready for drama, though, because it’s arriving on the House floor today without a recommendation from the House Health, Human Services and Elderly Affairs committee! And there’s 31 amendments House members could try to add onto it - including one that would tack marijuana legalization onto the bill.

There’s also disagreement over whether to include a sunset date for Medicaid expansion or extend it permanently, as the Senate’s version did. The committee was evenly divided on this question, with half arguing in favor of a December 2025 sunset date, which they say would give time to make necessary updates to state law instead of addressing it now. But those in favor of extending the program permanently say doing so would bring stability and security to low-income residents and health care providers.

They have some powerful supporters from the business world, including the Business and Industry Association, the Greater Manchester Chamber of Commerce, and the Nashua Chamber of Commerce.

Health care providers like Lamprey Health, Ammonoosuc Community Health Service, and the N.H. Hospital Association agree, as does the AARP. After all, “healthy people are employable people,” as Senator Cindy Rosenwald, a Nashua Democrat, told the Senate Health and Human Services Committee. And our state certainly needs those.

The Big Picture

New Hampshire's Lake Winnipesauke at dusk in May, 2023, with Rattlesnake Island in the distance. Submitted by NHMR reader Rick Zach of Gilford, N.H.Courtesy of Rick Zach

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Amanda Gokee can be reached at Follow her @amanda_gokee.