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Many people who voted for Punturieri can't understand the change

To The Daily Sun,

To Moultonborough Selectman Paul Punturieri:

Civility at town meetings is very important. Civility is also important when you are dealing with people whose opinions differ from yours. Civility is something you failed to demonstrate this weekend, when you accused an entire group of people as being conspirators in an attempt to hijack the town meeting for our own purposes.

I understand that perhaps by now you realize that you arrived at the wrong conclusion because the "ringleader" of this so-called conspiracy has offered an explanation for his decisions at town meeting. What is really very damaging in this situation is that you have used your blog as the platform to spew vitriol about the town citizens at the meeting who were there to vote "no" on Article 2, and you just cannot accept that the "no" vote prevailed. There were many mistakes made at that fiasco of a meeting, but most of them occurred on the stage, not among the voters.

The moderator did the best he could, but neither motion to reconsider should have been accepted, as we "lay" people now know, and the town attorney was of limited help in this situation. That aside, it was just plain wrong of Chris Shipp, who chairs the Board of Selectmen, to make the motion to reconsider in the first place since the "no" vote was so overwhelming, 348-220. It is no wonder the audience erupted in fury when he made the motion and you seconded it. It was clear to many that neither of you could even pretend to be objective. This action by you and Chris was a flagrant violation against the will of the legislative body.

The next item is this: it is not the function of an elected town official to push any personal agenda, which you have done consistently within the past year or more with your enthusiasm for a gym/rec. center/community center. Under the guise of providing clear and accurate facts to the voting public, you have demeaned anyone who fails to share your views, referring to our inaccurate information and so forth. I stand by the points I made in my recent letters to the editors of two local papers, as well as the content in the ad sponsored by the 21 "conspirators."

I am not alone in my disappointment in you, and recent events have prompted my decision to say something about it. Many people who voted for you two years ago cannot understand your changes in position and your obstinate attitude of brushing aside those who don't share your views. You are entitled to change your mind, and you of course are free to vote whatever way you choose, but pushing your views on voters is just plain wrong. Your claim to represent everyone is not borne out by your actions. You can disagree with me on this, and I am sure you will.

It would be appreciated, I am sure, if you would apologize to those you so maliciously maligned.

Sent with civility, on behalf of the responsible citizens who attended Town Meeting.

Judy Ballard

Moultonborough

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State Sen. Jeanie Forrester - Our vulnerable need health insurance but taxpayers also need protection

One of the biggest decisions the legislature will make in this session is whether or not to reauthorize the New Hampshire Health Protection Plan (aka Medicaid Expansion). I wanted to give you a brief update on this important and complex issue.

In 2014 the legislature passed the New Hampshire Health Protection Plan (NHHPP). This plan, crafted by the Legislature, provides private health insurance to approximately 48,000 low-income, uninsured New Hampshire residents using 100 percent federal funds.

The plan provides access to primary and preventive care, including cost-effective management of chronic illnesses and mental health and substance abuse services. Prior to the NHHPP, uninsured folks accessed free care through emergency room visits to their local hospital. This care did not include preventive or primary care. In 2014 alone, prior to the implementation of NHHPP, the amount of free care provided by the hospitals was $427 million. The cost of that "free" care is shifted to taxpayers in the form of higher premiums on their own plans.

Because of the NHHPP, there has been a significant drop statewide in the number of people without insurance seeking care. As of September 2015, there has been a 30 percent decrease in uninsured emergency room visits, a 38 percent decrease in uninsured inpatient visits, and a 28 percent decrease in uninsured outpatient visits.

Health care coverage provided by the NHHPP substantially reduced uncompensated care costs, thereby reducing the health care cost shift, or hidden tax, to businesses and taxpayers. In 2015, the cost to New Hampshire of treating uninsured patients dropped more than $142 million.

The NHHPP is due to expire on December 31, 2016 and the legislature is now working on a plan to extend that coverage. House Bill 1696 reauthorizes the NHHPP for another two years (January 1, 2017 through December 31, 2018). It requires the federal government, New Hampshire insurance companies and the 26 New Hampshire hospitals to bear the cost of this reauthorization. Per the federal government's promise, it will pay 95 percent of the cost for private health insurance plans in 2017 and 94 percent in 2018. The hospitals and insurance companies have agreed to split the remaining balance (5 percent in 2017 and 6 percent in 2018).

If the NHHPP isn't reauthorized, 48,000 Granite Staters will lose coverage to primary and preventive health care services, but will still have access to emergency care. As a consequence, uncompensated care will go up and the burden of this care will again be shifted to businesses and taxpayers.

There are taxpayer protections in HB-1696. The NHHPP ends if the federal government reneges on its commitment to paying 95 percent in 2017 and 94 percent in 2018. The NHHPP ends if the hospitals or the insurance companies renege on their promise to cover the balance in either of those years. The program must again be reauthorized at the end of 2018.

The bill also requires extensive information gathering and a plan for the future by setting up a commission to look at the efficacy of the program and long-term funding.

The bill requires the recipients of the NHHPP contribute co-pays for misuse of emergency rooms. It also has work requirements for able-bodied childless adults. These adults must spend at least 30 hours a week at work, training, community service or one of several other qualifying work activities.

HB-1696 is a good start, but it needs some work. First, I don't believe New Hampshire's budget should be negatively impacted by the NHHPP. HB-1696 proposes that the insurance premium tax (the tax paid by the insurance companies for the NHHPPs) will be used to help fund the program. Currently the insurance premium tax ($9 million) goes into the state's general fund. Those funds should continue to go to the general fund. The Department of Health & Human Services also testified that they expect to spend $1 to $2 million a year in administrative costs for this program. I believe that cost should be also borne by the insurance companies and the hospitals.

Second, there needs to be transparency. HB-1696 should require every hospital and medical office publish all of their pricing for procedures (cash vs. insurance) and post any other valuable data like success rates or infection rates. We need to provide good information to consumers so they can make informed choices about their health care.

Finally, there should be an accountability measure to assure that the payments made by the insurance companies and the hospitals are not cost-shifted to taxpayers through higher premiums or services.

I look forward to working with my colleagues in creating a final package that provides private health insurance to those who can least afford it, while assuring that New Hampshire taxpayers are protected.

(Meredith Republican Jeanie Forrester represents District 2 in the N.H. Senate.)

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