Gov. Chris Sununu made the case Friday to tie the reauthorization of Medicaid expansion to the state’s alcohol fund.

Medicaid expansion provides health insurance to about 50,000 lower-income Granite Staters. Sununu told commissioners who oversee the alcohol fund that tying the two together is a political necessity.

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“I mean, we could put lots of structures over at the Legislature,” Sununu said. “They’re just not going to pass. So we need to make sure that whatever we put forward is a path to success.”

The alcohol fund provides money for drug treatment and prevention services. Its commissioners are effectively the financial nerve center of the state’s efforts to combat the opioid crisis.

Using the alcohol fund to help pay for New Hampshire’s $30 million annual share of Medicaid expansion would allow State House Republicans to fulfill promises of no new taxes and no general fund dollars for the program.

But some are worried that the arrangement could shortchange the current system that’s chipping away at the state’s epidemic of addiction.

“I know there’s a lot of concern and a lot of discussion about how we are funding the non-federal share,” Health and Human Services Commissioner Jeffery Meyers said.

Meyers said current programs will get their money, but he hinted that setting up the Medicaid funding mechanism will be a delicate operation.

“We need to manage the budget very carefully,” he said. “We can’t create a hole in the budget for the current fiscal year.”

The discussions over Medicaid and drug treatment funding come in the wake of the collapse, retreat and financial hardship of at least three of the major service providers on the front lines of the opioid crisis.

“I think people need to remember that we’re still in a crisis,” said Tym Rourke of the Governor’s Commission on Alcohol and Drug Abuse. “We never intended or thought we could get out of this crisis overnight. It’s just a reminder that we all need to stay focused on how do we get people access to the health care services they need.”

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Sununu seeks to tie Medicaid reauthorization to alcohol fund