House Gives Initial Approval To Expand Medicaid for Immigrants, Pregnant Women

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Paula Tracy photo

Members of the House are pictured meeting Wednesday in Representatives Hall.


CONCORD — The House voted to initially approve expanding Medicaid coverage for immigrants and pregnant women and their children.

The House also decided to increase funding for charter schools and public schools with students on the free and reduced lunch programs.

The House approved House Bill 565, which expands Medicaid coverage for maternity care benefits from the current 60 days to a full year and House Bill 282 which would add children and pregnant women who are immigrants lawfully residing in the state and eligible for Medicaid coverage.

Opponents of the bills said the health care and the Medicaid system both would be impacted by the two bills and both need fixing, claiming they would increase private insurance premiums.

But supporters said the additional coverage comes at a time when prevention and early detection would prevent much greater expenses in the future when the medical issues involve critical care.

The added coverage under HB 565 is allowed under a federal option and many states have added the additional time under the American Rescue Plan, supporters said.

Rep. Joe Schapiro, D-Keene, said the bill did not come out of thin air, but is an option from the Center of Medicaid.

The services in the bill would address some of the common problems women face after birth such as depression and substance use, he said.

He noted the mortality rate per birth in the United States is much higher than it is in many other countries.

There is growing recognition that postpartum extends to a full year and that many women lose coverage at a critical time, Schapiro said.

“This is a common sense fiscally responsible remedy for the high rate of mortality and morbidity,” Schapiro said. “It is a wise investment in the health and wellbeing of New Hampshire families.”

But Rep. Leah Cushman, R-Weare, argued there is no income requirement so a woman could return to work, be making $100,000 and be on Medicaid, although another representative reminded her there is an income limit for Medicaid.

Cushman said the large pool of Medicaid recipients stretch hospital resources as they have less beds due to low Medicaid reimbursement rates.

“We should be focusing on the broken health care system,” she said, “and how to make it more solvent.”
She said the bill would shift more and more of the cost of health care to taxpayers and adding more programs grows government and she hopes it does not lead to Medicare for all.

“It’s a house of cards,” Cushman said, and “we should not add another unjustified program (to it.)”

The bill passed on 184-179 vote and will be reviewed by the Finance Committee before a final House vote.

During debate on House Bill 282, to add some immigrants to the Medicaid program, Rep. Erica Layon, R-Derry, said they should be looking to charities to cover the cost for immigrants, not the state.

“The Legislature looks to government to solve problems and often misses the people who are not helped or actually harmed when you expand programs,” Layon said. “All we are doing is changing who pays and adding costs to families on the margins.”

But Schapiro noted the bill would cover about 300 people at a cost of about $200,000 a year.

He said the bill would save money through prevention and timely diagnosis and would reduce uncompensated care for healthcare providers.

The bill passed on a 186-170 vote and will be reviewed by finance before coming back to the full House.

Lawmakers however drew the line at resurrecting a program cut more than a decade ago to help balance the state’s budget during the great recession.

House Bill 574 which would have provided about $300,000 for people on the Women, Infants and Children program to buy fresh fruits and vegetables at Farmers’ Markets or farm stands.

Opponents argued the program is not needed as those on the WIC program can buy fresh fruit and vegetables at grocery stores today and they said it was under used when it was in place before.

But supporters said it would help families with children and farmers as well.

But the bill was killed on a 185-179 vote.

Education Funds

The House passed two bills that increase per-pupil education grants Wednesday.

House Bills 272 and 529 will now go before the Finance Committee for review before a final House vote.

HB 272 would increase per pupil state aid to charter schools by $1,000 and HB 529 would increase the disparity aid determined by the number of students on free and reduced lunch to $2,000 for property poor communities. 

“The House Education Committee recognized the need to increase funding to New Hampshire’s public schools and public charter schools, and strongly recommended these bills to provide that needed long-term support,” said Rep. Mel Myler, D-Hopkinton. “I thank the House for its strong, bipartisan votes today, and look forward to continuing conversations about support for our public schools as these bills move along the legislative process.”


The House also initially approved House Bill 534, which establishes a clean water fund of $5 million over two years to help people whose wells or water sources have gone dry due to a natural disaster like a drought.

The bill passed on a 179-177 vote and will be reviewed by the Finance Committee before a final House vote.

The House meets again Thursday at 11 a.m.

Garry Rayno may be reached at

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