CONCORD, N.H. – New Hampshire’s Republican Senate rejected plans to extend Medicaid coverage to an estimated 49,000 poor adults Thursday, ending hopes for expansion this year.

Democratic Gov. Maggie Hassan said afterward she will keep trying to win legislative authorization.

“Our providers are ready for expanded health coverage, our businesses are ready, our people are ready, and I am ready,” Hassan said in a statement. “We will keep working and there will be more votes. I hope that at some point, a few Senate Republicans will set ideology aside and step forward to do what is right. Until then, it is the people who are hurt, and it is the people whom senators must answer to.”

Senate President Chuck Morse, a Salem Republican, said he remains committed to working for a bipartisan solution.

“Unfortunately, while we are very close in principle, there are still significant details that separate us,” he said.

New Hampshire is one of seven states still undecided whether to expand Medicaid under the federal health care law. Twenty-five states and the District of Columbia expanded coverage, and 18 states have rejected expansion.

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The Legislature’s failure to authorize expansion does not preclude New Hampshire from considering the issue again as expected next year.

States can expand coverage and later drop it at any time.

The key hurdle was when to use the federal marketplace to buy private coverage.

The Republican-led Senate had insisted on implementing a private option sooner than Hassan and Democratic House members felt was practical to give additional insurers time to join the sole insurer on the marketplace.

Senate Republican leaders had the votes to reject plans offered by Senate and House Democrats, but not enough votes to pass a plan of their own. In the end, nothing passed.

State Sen. Peggy Gilmour, a Hollis Democrat, argued the Senate Democratic proposal incorporated many of the principles sought by Republicans to ensure private insurance was used to provide coverage to most of the adults newly eligible for Medicaid. Gilmour pleaded with Republicans not to let the moment pass without authorizing health coverage for the adults.

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But Senate Republican Leader Jeb Bradley of Wolfeboro said the Democratic proposal did not satisfy Republicans.

By the time the House took up the House Democrats’ bill, its fate in the Senate was clear.

State Rep. Steve Vaillancourt, a Manchester Republican, unsuccessfully tried to block consideration of expanding Medicaid, arguing the health care law – the Affordable Care Act – is flawed.

“This whole approach is leading us into an area that is best called the abyss,” he said.

Both House and Senate plans used federal funds to pay for private insurance for some adults who already are on employer-sponsored plans through an existing state program. Both plans originally proposed enrolling other people into a new state-managed care program temporarily.

Senate Republicans voted Thursday to bar implementing expansion until federal permission was received to use the option, a delay Democrats opposed.


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