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Let's get behind the N.H. solution to providing health care for low income residents

On November 7th, the Legislature began a two-week special legislative session to address the issue of health care for low-income New Hampshire residents*. If you've been reading the newspapers, you probably know that this is a policy issue that has consumed much of our time this year and rightfully so.

The question of Medicaid expansion was among the most contentious issues discussed during this year's budget negotiations. You may recall that the governor included Medicaid expansion in her version of the budget but Senate Republicans removed the language and replaced it with a commission (Medicaid Expansion Study Commission) that called for a thoughtful, deliberative study of the issue before moving forward. (In at least three situations where Medicaid was expanded in New Hampshire in the past — 1989, 1992, and 1994), there was a five-month deliberative process — SB-195, SB-319, SB-774 respectively.)
Chief among our concerns about moving forward too hastily was the intentional act of putting more lives into an already broken Medicaid system and the potential for N.H. being forced to institute an income tax to pay for this very large expense if federal funding disappears. This issue was too important not to have a full study and public hearings.

With that provision removed, Senate Republicans led the way in passing a balanced budget with no new taxes, no new fees, and limited spending. I was pleased that our budget lived up to conservative principles and passed both bodies of the legislature on a nearly unanimous vote and signed into law by the governor.

The Medicaid Expansion Study Commission recently completed its work and while the commission offered a number of important ideas, what they offered, and what is now being offered as the House proposal (Special Session House Bill 1) is a not a New Hampshire solution.

After much research, we continue to believe that growing the Medicaid entitlement and accepting a Washington one-size fits all plan will not only provide substandard health care for the uninsured, it will also break our budget and lead to a broad-based tax. While the House plan contemplates a private sector option, it does little to protect taxpayers in the long-term and does not included necessary deadlines that will make reform a reality.

Instead of being led by Washington, the Senate took the initiative and sought out health care experts and asked them to work with us to create a viable plan for how we can work through the private market to get coverage for low-income residents who struggle to afford health insurance coverage. The result of that collaborative effort is the New Hampshire Health Protection Program and Special Session Senate Bill 1. This program will protect N.H. taxpayers, it will support our state's medical providers, and it will provide high quality insurance to thousands of N.H. residents who lack it today.

This proposed legislation will increase access to private insurance coverage for upwards of 58,000 low-income New Hampshire residents. By maximizing available federal dollars, we will provide better coverage for our citizens than would be offered under Medicaid and we can do so with a program design that will provide rock solid protections for New Hampshire taxpayers.

Moreover, unlike Medicaid expansion, our private option plan will not grow government. Unlike Medicaid expansion, our private option plan will not leave taxpayers on the hook for millions of dollars in new costs over the next 10 years. And unlike Medicaid expansion, our private option plan will require co-pays, deductibles, and limits to those folks receiving this coverage.

The plan we are presenting has received support from health experts in New Hampshire and we are pleased with their support. But make no mistake, for the N.H. Health Protection Plan to work, it will require our governor to roll up her sleeves and work with us to get this done. I have no doubt that Governor Hassan has the influence and ability to make this happen and we all look forward to working with her on this critically important issue. The New Hampshire Health Protection Plan is a plan that is right for N.H., and could be the model for health care reform.
Many, many thanks to all those citizens who volunteered their time and expertise, who stepped up to the plate and were willing to work with us to create a plan that provides better health insurance for low-income N.H. citizens, better payments to the health care providers, and protects NH taxpayers. I urge you to review the proposed legislation at http://www.gencourt.state.nh.us/legislation/2013/SSSB0001.html then call the governor at 271.2121 and ask her to support the New Hampshire Health Protection Program — the New Hampshire solution.
(*2013 Poverty Guidelines: 100 percent poverty for a family of four is $23,550; 138 percent of poverty for a family of four is $32,499; Source: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Downloads/2013-Federal-Poverty-level-charts.pdf)

(Meredith Republican Jeanie Forrester represents District 2 in the New Hampshire Senate.)

 
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