Lisa Morris - Expand Medicaid in N.H.

  • Published in Columns

The mission of Lakes Region Partnership for Public Health is "to improve the health and well being of the Lakes Region through ... public health improvement activities." The expansion of Medicaid coverage to citizens in the region would be a public health action of immense consequence.

The Commission to Study Expansion of Medicaid Eligibility has recommended that N.H. expand its Medicaid program to cover uninsured adults with annual incomes up to approximately $15,900, about 4,000 of whom live in Belknap and Carroll Counties. The majority of these individuals are young adults between the ages of 18 and 40 who are under-employed and struggling to get by. They work as wait staff, janitors, classroom aides, in construction and in grocery stores as critical components of our local economy, but without access to a critical benefit.
Without access to health insurance, they pass up preventative care that would help them avoid medical crises. When a crisis does occur, these individuals must use the emergency room: the most expensive health intervention and one that provides no follow-up care to ensure that the patient continue on the road to recovery. We at the Partnership believe that extending Medicaid coverage to this population benefits more than just those 4,000 individuals.
Individuals with health insurance coverage see their physician for preventative care and remain healthier throughout their lives. The N.H. Center for Public Policy Studies has found that insured individuals are almost twice as likely to see a doctor regularly as the uninsured. The insured are five times more likely to have a colon cancer screening than the uninsured. Those with chronic illnesses such as diabetes or asthma can manage their symptoms more effectively and avoid medical crises when covered by insurance. With access to health coverage, these individuals have fewer absences from work or school, have healthier pregnancies and children and are able to participate in community activities. Health insurance coverage for this population could free up our emergency room resources to be able to treat real emergencies quickly and more efficiently. Our local physicians will get reimbursed for seeing these patients, reducing the cost shifting that leads to higher overall costs for everyone.

The commission was careful to recommend that individuals with access to health insurance through their employers stay on that plan rather than switch to Medicaid. The commission also recommended protecting New Hampshire from unsustainable expense should the federal government alter its level of financial support for the expanded population.
As the Partnership collaborates with colleagues such as LRGHealthcare, Genesis Behavioral Health, Lakes Region Community Services and Central NH VNA & Hospice, among others, toward our mutual goal of a healthy region that encourages healthy living practices, we envision the expansion of Medicaid coverage as a step vitally important to assuring all of our residents the opportunity to meet these healthy lifestyle goals.

(Lisa Morris is executive director of the Lakes Region Partnership for Public Health (LRPPH) in Laconia. She wrote this column on behalf of the LRPPH Board of Directors.)