Policy battles over Medicaid expansion ramp up ahead of hearing

Senate Majority Leader Jeb Bradley is known for saying “don’t let ‘perfect’ be the enemy of ‘good.’”


The version of Medicaid expansion unveiled at the end of last week could be the ultimate expression of Bradley’s motto, as it attempts to thread several political needles, most notably by using the state’s alcohol fund to help pay for the program.

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The unique plan would reauthorize Medicaid expansion for another five years while meeting Republican demands for no new taxes or fees and no general fund dollars.

“It is very different, and New Hampshire is known for doing some things that are different when it comes to our Medicaid expansion program, which is a benefit,” New Futures president and CEO Michele Merritt said.

New Futures is one of the leading advocates for both Medicaid expansion and funding for addiction treatment programs.

Merritt said this isn’t about choosing one issue over the other.

“What we’ve heard from leaders on both sides of the aisle is that there are solutions that are in play to make sure, again, that the integrity of the alcohol fund and Medicaid expansion remain intact,” Merritt said.

This is a Republican plan that includes more stringent means testing and a controversial work requirement to obtain benefits, but it still faces conservative skepticism.

“Ultimately, at the end of the day, the work requirements aren’t as strong as they need to be,” said Greg Moore, of Americans for Prosperity.

Moore said he expects the bill to get a conservative overhaul in the House.

“The idea of extending Medicaid for another five years at a time when the president is defunding it in his budget, and the speaker of the House is saying that the funding can’t last that long — it seems a little frivolous,” he said.

There is some worry in the drug treatment community about this use of the alcohol fund, but Medicaid expansion is such an integral part of the fight against the opioid crisis that those complaints may take a back seat to reauthorization.

The first hearing on the plan is set for 1:30 p.m. Tuesday.

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