Jim Monahan’s 2014 New Hampshire State House Predictions
1. The scope and tone of action on the Affordable Care Act, aka ObamaCare, will become much more about implementation than repeal. Slow but steady progress in 2014 will bake into the healthcare mix, exchange/marketplace, navigators and premium assistance and potentially the “coverage canyon” (see below).
2. Medicaid expansion will be a major part of State House policy and politics one way or another in 2014. If it fails to pass, the political advocacy around leaving billions of federal dollars on the table; tens of thousands of families without healthcare and the sad reality of the coverage canyonwill dominate the political season. The more likely route this issue will take is for a modification of Medicaid expansion to be adopted. This modified expansion will allow Medicaid dollars to be used to purchase marketplace health insurance for those not otherwise covered (e.g., between 0 and 138% of poverty). This action will begin in 2014 with the process of enrolling these folks in a bridge program, applying for a Medicaid waiver, and the use of carrots and sticks to attract more insurers into the exchange/marketplace.
3. The repeal of the death penalty will pass the legislature and be signed by the Governor.
4. An increase in the minimum wage will pass the House and come close in the Senate. While advocacy will not be as intense as during the right-to-work debate in the past, a lot of the same players will be involved and they know how to amplify an issue.
5. The Northern Pass Transmission project will remain über controversial in 2014. The project is not likely to gain much traction, as it will be stuck in the regulatory mud. Dollars will continue to be spent trying to trick people into liking it, but its progress will continue to be bogged-down.
6. The NH Legislature and Public Utilities Commission (PUC) will continue inching towards completing restructuring of Public Service of New Hampshire (PSNH) in 2014. The controversy surrounding the recovery of the over-budget scrubber costs will come to a head in Spring, at about the same time the PUC will issue a report on the so-called value of PSNH’s remaining power plants.
7. On the transportation front, a smaller modified gas tax increase will pass and legislation adding more restrictions to texting and use of cell phones while driving will pass.
8. Opposition to Common Core educational requirements will move from being a local issue to a State House issue in 2014, displacing energy now being expended on anti-ObamaCare and birther rhetoric.
9. The special election to fill Ray Burton’s Executive Council seat will be decided by less than 2% in the March general election.
10. Addressing the mental health crisis in New Hampshire will persist as a major policy matter in 2014. Funding the settlement of the Department of Justice lawsuit will likely eat-up surplus dollars. Positive investments in the Ten Year Mental Health Plan from the 2013 budget will take time to impact and reduce back-ups in hospital energy rooms; however, consensus opinion that the issue needs to be a top priority will continue.
 Under the ACA, if you have an income above 138% of poverty, you qualify for a marketplace premium assistance to purchase healthcare; but if you are below that level, you don’t qualify, because Medicaid expansion was designed to cover this population only. Thousands of folks will learn through the outreach and enrollment process that they are too poor to get healthcare. Ouch.