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After more than a year of debates and discussion, lawmakers could take their final vote Thursday on whether to continue the state’s Medicaid expansion program for another two years. ... Currently 48,000 New Hampshire residents are insured through the state’s Medicaid expansion program. But the program, authorized through the federal Affordable Care Act, is scheduled to expire at the end of this year. The proposed program reauthorization is similar to the current one, with two key differences. For one, the state’s hospitals and insurance companies will be picking up the program cost that the federal government will no longer be covering starting next year. Second, the proposal requires participants to work or volunteer for 30 hours a week. (Sutherland, 3/31)

Democratic Gov. Maggie Hassan hasn’t said whether she will sign this specific proposal, but she says reauthorizing the health care program is a top priority and key to fighting the state’s opioid crisis, which claimed more than 400 lives last year. The bill will use voluntary payments from hospitals and insurance carriers to help cover the state’s share of program costs, estimated at roughly $50 million over the next two years. The federal government pays 100 percent of program costs now, but will start reducing its investment next year. (Morris, 3/30)

Speakers at the first formal public hearing on the state’s planned Medicaid overhaul said they wanted the government insurance expanded to cover more people, worried that increased paperwork would drive away doctors, and asked why the state was changing a system at all. The state Department of Health and Human Services is preparing to ask the federal government to approve major changes in Medicaid that will have most of its beneficiaries sign up for health plans run by insurance companies, hospitals or other providers. Medicaid privatization was a priority for legislators last year. (Bonner, 3/30)