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Sen. Andrew Hosmer - N.H. can't wait; expanding Medicaid helps taxpayers, businesses & our hospitals

Last week, the New Hampshire Senate Finance Committee rejected expanding Medicaid in New Hampshire and instead opted to delay and study.  This politically motivated decision is fiscally short-sighted and will hurt our health care system and our entire economy.
The Medicaid program is a partnership between the federal government and the states. It primarily covers poor children, senior citizens, expecting mothers, and people with disabilities. Today, New Hampshire covers about 132,000 people, and the costs are split 50-50 between the state and the feds.
However, under the Affordable Care Act (ACA), states now have the option to extend Medicaid to working adults with annual incomes up to $15,856. And instead of splitting the costs evenly for this new group, the federal government will pay 100 percent from 2014-2016, and then after 2020 it will pay 90 percent.
According to non-partisan studies from the Lewin Group and New Hampshire Fiscal Policy Institute, the economic impact of this extended coverage is overwhelmingly positive.  It’s estimated that over the next seven years, New Hampshire will receive $2.5 billion in federal funds, New Hampshire’s hospitals will save $400 million, and the economic spinoff will create upwards of 5,000 jobs and $2.8 billion in gross state product.  
And how much will this cost New Hampshire? Zero, once managed care in Medicaid is implemented in the coming year.  
So where’s the opposition coming from?  Despite the huge benefits, some have argued that there is still a risk for New Hampshire, since the federal government might somehow renege on its promise.  The history of Medicaid is contrary to this fear, as the federal government has never failed to fully fund Medicaid in more than 45 years.  Also, if they ever do, New Hampshire can pull out at any time.
Others say that it makes financial sense to stop and study for a year.  This is unnecessary as expansion has been studied by non-partisan groups and their conclusions are quite similar. In fact, delaying a year costs us $340 million, drives up costs for businesses, and leaves tens of thousands of people in New Hampshire without coverage.
Putting politics aside and even beyond the clear economic and fiscal benefits, extending Medicaid coverage is important for our entire health care system.  Our current system, with skyrocketing insurance costs, increasing demands for charity care, declining Medicaid reimbursement rates and an inadequate understanding of mental health issues, is broken and in need of immediate, substantive reform.  Expanding Medicaid, regardless of how one feels about the ACA, is an opportunity to address and begin reforming our health care system.
Even fiscally conservative governors from across the country, including Chris Christie (R-NJ), Jan Brewer (R-AR), John Kasich (R–OH) and Rick Scott (R-FL), support Medicaid expansion, because it just makes so much sense for their states, and they are willing to look past the short-term politics.  If New Hampshire doesn’t take advantage of expansion, our hard earned tax dollars will go to subsidizing health care in these other states.  How ironic that N.H.’s healthcare system is struggling, yet Granite Staters will be paying for other states’ health care.  If this happens, New Hampshire will be 50th out of 50 states in the return of federal tax dollars to the state — the biggest “donor state” in the whole country.
The human cost is also staggering.   Medicaid expansion would cover 58,000 hard-working New Hampshire tax-payers (including 1500 veterans and 800 of their spouses).  These people are our neighbors, people we see at church, ball games and the grocery store — people who work multiple jobs trying to keep a roof over their head and food on the table.  
When I campaigned for the State Senate I remember well how many people told me they were tired of hyper-partisan politics.  I promised that I would remember those conversations and put them into action when elected.  This doesn’t have to be a partisan issue: we have a genuine opportunity to work together as pragmatic problem solvers.  It’s rare that a real, genuine solution is open to us.  Let’s grab it. Let’s put Granite Staters first and do what’s best for our healthcare providers, our business community, our economy and the hard working taxpayers of New Hampshire.
(Democrat Andrew Hosmer of Laconia represents District 7 in the N.H. Senate)
 
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