CONCORD, N.H. – GOP Gov. Chris Sununu said Tuesday he’s not “signing on” to the health care overhaul offered by Republicans in Congress, mostly because of concerns over Medicaid money and coverage.

“The bill that’s been proposed in Congress gives us concerns on a lot of different levels,” Sununu told reporters after a press conference on another topic. “Expanded Medicaid is part of that discussion. There’s no doubt expanded Medicaid has provided (drug) recovery, treatment options for a lot of folks that otherwise may not have had that option available.”

The Congressional Budget Office estimates 14 million fewer people will be insured in the first year if the GOP plan passes. State health and insurance officials say it’s unknown at this time how many New Hampshire residents may lose coverage. But 52,000 low-income people who have insurance through Medicaid expansion are at risk – the Republican plan proposes ending that program. Beyond Medicaid, about 91,000 people had individual plans on the health exchanges as of February, according to information provided by the state insurance department.

New Hampshire is one of 31 states that expanded Medicaid under President Barack Obama’s health care overhaul law. State health officials say about 115,000 have, at one time, participated in Medicaid expansion since it passed in 2014. The Congressional Budget Office estimates $880 million less in federal money would be spent on Medicaid over the next decade. In addition to phasing out Medicaid expansion, the Republican plan would cap how much money states receive for traditional Medicaid. Health Commissioner Jeff Meyers said Medicaid expansion has delivered nearly $1 billion in federal money to New Hampshire since it began in August 2014.

The future of Medicaid expansion has always been uncertain in New Hampshire. Sununu’s Democratic predecessor, the current U.S. senator Maggie Hassan, signed the plan into law in 2014 after working with Republican legislators, who have approved it in two-year increments. Right now, the law is set to expire at the end of 2018 if it’s not reauthorized. The law also explicitly states that the program will end if the federal match drops below the promised 94 to 95 percent reimbursement.

Sununu said his administration would work with Republican President Donald Trump’s team and the New Hampshire delegation to get across that the state needs a “flexible” and “nimble” health care program. Until then, Sununu said, the Republicans’ plan is “definitely not a bill I’m signing on to, to be sure.”


Senate Majority Leader Jeb Bradley, a Republican, said he’s in favor of a block grant system, which would provide each state a capped amount of money for Medicaid to spend how it chooses. Republicans wanted to require Medicaid expansion applicants to work at least 30 hours per week, but the federal government rejected that proposal.

“I think we have an opportunity to design a program that’s a little bit more New Hampshire specific and still insure 50,000 people,” he said.

A bill is before the state Senate on Thursday to extend Medicaid expansion beyond 2018, but Bradley expects it to be tabled.

“It’s premature; we need to wait and see exactly what comes out of Washington,” he said.

The substance abuse and mental health benefits covered by Obama’s health overhaul law are also of critical concern to New Hampshire. The state is in the throes of an opioid abuse crisis, with nearly 500 people dying from drug overdoses in 2016. Roughly 6,000 Medicaid expansion recipients have accessed treatment, Meyers said.

Sununu recently told The Associated Press that he told Trump that continuing to require such coverage is a necessity.

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