As lawmakers at the State House look to extend the Medicaid expansion program, House Republican leaders want to cut costs.

The expanded Medicaid program provides health insurance to about 50,000 lower-income Granite Staters. In a pre-emptive move to cut costs for the state, House Finance Chairman Neal Kurk said he wants to limit eligibility — from 138 percent of the poverty level down to 100 percent.

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The change would take about one-quarter of the people in the program and shift them into Medicaid Managed Care or to a plan under the Affordable Care Act.

“The net effect would be that the cost of most of the members of this group would be shifted from the backs of the state taxpayer to the backs of the federal taxpayer,” Kurk said.

But Democrats said that forcing those in need to pay more will essentially kick people out of the program.

“The problem is that we will have people lose eligibility, and although they might be eligible to try to purchase insurance on the exchange, it will probably be out of the reach of a number of individuals,” said Rep. Jerry Knirk, D-Freedom.

If Medicaid expansion continues in New Hampshire, the state is expected to pick up a greater portion of the costs. Even if elected officials can find creative ways around those costs, they still need approval from Washington.

“We’ve got to do the homework, but the big dog in the room is the federal government,” said Rep. Charles McMahon, R-Windham.

A number of changes to Medicaid are being considered by the House, but some officials said that if they’re looking for fat to trim, there’s none left.

“The bottom line here is if we have a long history of doing things on the cheap and you want to make it cheaper, there’s some reality we’re bumping up against here,” Strafford County Commissioner George Maglaras said.

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Lawmakers consider limiting eligibility to cut Medicaid costs