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Lisa Morris - Medicaid expansion makes our mission more achievable

Just last month, the Lakes Region Partnership for Public Health expressed its support for Medicaid expansion in N.H. and explained how extending health care to the identified population is aligned with the Partnership's community-based mission.

Now that the Legislature's Special Session has failed to reach consensus on an expansion plan, the Partnership is reiterating its support for Medicaid expansion, given the critical impact such a move would have in the Lakes Region and on their health outcomes. The Partnership is hopeful that the Legislature can find common ground on this issue when it reconvenes in January.

Since the Affordable Care Act originally envisioned Medicaid expansion to be mandatory, no one foresaw that individuals who are not currently eligible for Medicaid but have incomes below $11,000 annually, are not eligible for health insurance subsidies on the Exchange and as a result, do not have access to affordable health insurance anywhere. The numbers are staggering. In N.H., approximately 40,000 people will be ineligible for a subsidy (In Belknap County, it's 1,980 people). That means that a young, underemployed worker in Laconia who suffers from asthma may miss days from work, try over-the-counter remedies to manage symptoms and may eventually end up in the emergency room with a full-blown asthma attack. Were Medicaid expansion in place, this individual would receive ongoing preventive care from a physician, be able to stay at work and avoid a costly, crisis-driven trip to the emergency room.

The Legislature wisely attempted to expand N.H.'s Health Insurance Premium Payment (HIPP) program that allows individuals to stay on employer-sponsored health plans with Medicaid picking up the cost differential to make it affordable for the employee. This is a win-win for all involved: the state saves money by not fully enrolling an individual in Medicaid; the employer has a healthier workforce; the employee has continuity of care with an affordable plan. Hopefully, this provision will be retained in the version of expansion that finally passes the Legislature.

The Partnership supports keeping individuals on employer-sponsored plans when possible especially because the Affordable Care Act mandates that such plans provide 10 "essential benefits". Too many employer-provided plans are catastrophic in nature: the deductibles and co-pays are so high that, while they pay catastrophic expenses and may keep a family from losing their home, covered individuals cannot afford routine, preventive care that helps them avoid those medical catastrophes.

The Partnership is especially supportive of the inclusion of substance abuse and mental health services in the provision of care under Medicaid expansion. Our Lakes Region communities are struggling to meet these needs for local individuals. Expanding Medicaid would not only mean our providers would receive reimbursement for services, but it would engage more underserved populations. Many of these individuals are currently being seen repeatedly in our emergency rooms. With Medicaid coverage and continuity of care, management of their symptoms, medication and behaviors could better be achieved.

The Lakes Region Partnership for Public Health's mission remains "to improve the health and well being of the Lakes Region." Medicaid expansion makes that mission more achievable as health benefits would be extended to many Lakes Region residents in need of dependable, available health coverage. Medicaid expansion would be good for the Lakes Region.

For more information and/or to receive enrollment assistance in the Health Insurance Marketplace, please contact the ServiceLink Resource Center in your area. ServiceLink's toll free number is 1-866-634-9412. To find a location www.servicelink.org.

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

 
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