To The Daily Sun,
In response to your recent column on Medicaid expansion, Sen. Forrester, may I say, with all due respect, that I beg to differ.
I differ markedly from you in my perception of the work of the Commission to Study Expansion of Medicaid Eligibility. Its recommendations were indeed N.H. specific, building as they did on a unique N.H. program by which Medicaid enables individuals to remain on employer-sponsored health plans (and at the same time realize approximately $35 million in budgetary savings). Its recommendations offer taxpayer protections in terms of a "trigger" which would prompt legislative action should the federal match fall below agreed-upon levels. Most importantly, its recommendations were structured around deadlines that are reasonable, achievable and based on actual experiences of other states around the nation.
I also differ from you in your depiction of the Senate GOP alternative. The issue is not about "growing government"; it is about growing access to health insurance for N.H.'s uninsured with annual incomes below $16,000. The Senate GOP plan ignores the fact that N.H. currently has only one provider in our marketplace and does not envision having more until 2015. The Senate GOP plan does not include safeguards regarding cost effectiveness, quality control or consumer protection. And, should the Senate GOP plan not meet its challenging deadlines for enactment, including the necessary federal sign-offs, then the Senate GOP would abandon Medicaid expansion altogether and the 50,000 N.H. citizens who stand to benefit.
I also differ strenuously with you on your warning about an income tax. That is fear mongering at its worst. Expanded Medicaid expenses will be reimbursed by the federal government at 100 percent for the first two years (vs. the current 50 percent) and 90 percent after that. There is simply no scenario under which an income tax would be instituted in N.H. as a result of Medicaid expansion.
I do not differ with you over the need to extend health care benefits to this population. But I am disappointed that the Senate GOP has not rolled up their sleeves alongside Governor Hassan, Speaker Norelli and Minority Leader Larsen and come to the table in good faith to come to a workable solution that brings all the good ideas together within a reasonable and well-designed time frame.
The time is now, Sen. Forrester. The vote is Thursday. $500 million dollars a day is the cost to N.H. if we do not undertake Medicaid expansion as of January 1, 2014. I cannot imagine that is a financial hit you are willing to accept.
Barbara McElroy, RN