A U.S. Supreme Court ruling on the Affordable Care Act has made it optional for states to expand Medicaid coverage to include adults with family income up to 138 percent of federal poverty guidelines. For the first three years, from 2014 trough 2016, the federal government will cover 100 percent of the state's cost for the expansion. In subsequent years, the federal government would cover at least 90 percent of the state's cost.
The case for expanding Medicaid eligibility is compelling. For a relatively nominal state investment, we can improve our state's health care system by increasing access to essential care and reducing charity care and uncompensated care for those who are uninsured.
I have the privilege of being a board member at Mid-State Health Center in Plymouth, whose mission is to provide health care to the community accessible to all regardless of the ability to pay.
However, I have the unfortunate distinction of living in a state where some lawmakers fail to listen to their district constituents regarding some issues. In particular, I am referring to Medicaid expansion. Some lawmakers say they are concerned over the number of underinsured who would leave private insurance for Medicaid. My response is that Medicaid is a very restrictive program when it comes to those who qualify. Expanding Medicaid will bring the two programs closer together. These are the people who could not afford to buy health care even if they had an option. Some lawmakers say they are opposed to expanding Medicaid because they don't pay providers as much as private insurance. My response is that a lower payment is better than no payment.
Some state senators are opposing the expansion for fear the federal government may renege on funding the program as promised. My response is that if for some reason the federal government does not fund the program at 100 percent, N.H. can immediately go back to the previous levels. The U.S. Supreme Court already ruled that Medicaid expansion was not mandatory. Therefore, N.H. can walk away at any time if the program fails.
I implore the N.H. Senate to listen to the people of NH who need your help and who will benefit from this expansion. I ask the N.H... Senate to listen to the community health centers and hospitals that are in favor of the expansion because some reimbursement is better than no reimbursement. I urge the N.H. Senate to agree with the governor and the House and authorize Medicaid expansion!
Jim Dalley, Board President
Mid-State Health Center