Medicaid recipients tell Pappas they don't want to lose their independence

LACONIA — In a city where nearly a third of residents rely on Medicaid, Rep. Chris Pappas (D-NH) heard from recipients and others who work closely with the program regarding potential cuts during a roundtable discussion at Lakes Region Community Services on Monday afternoon.

“We want to make sure we’re doing everything possible to protect what’s important to New Hampshire and to individuals that deserve access to the best care and the best support services in the state,” Pappas said Monday afternoon. “We’ve taken some significant steps forward — this is not the time to interrupt the progress we’re making in New Hampshire on a number of different issues — but we can’t continue to do that if Medicaid is going to be facing deep cuts that we know will put a lot of pressure on our state budget and on community services.”

Medicaid is a joint federal and state program which helps cover the cost of medical treatment for people with limited income and other resources. While there are federal Medicaid guidelines state programs must follow, each state manages its own iteration of the program — eligibility requirements and benefits vary. 

Local stakeholders met Monday to discuss potential cuts to Medicaid, both at the state and federal levels. Pursuant to the expiration of an agreement between the state and hospitals systems, both the budgets proposed by the governor’s office and the House of Representatives would reduce allocations for Disproportionate Share Hospital Payments by 61% — $138.3 million, according to NHFPI. 

The House budget, now under consideration by the state Senate, calls for a 3% reduction in rates for all Medicaid providers, in effect reducing reimbursements for services. 

Kevin Brett of Laconia lives in Sunrise Towers, a Laconia Housing development, and relies on Medicaid assistance and the Choices for Independence program, which supports adults and helps keep them in their own residence rather than transitioning into a nursing home or assisted living facility. 

“When I first got on it, I couldn’t do much of anything — I was over 400 pounds, lost a leg, shoulder surgery and stuff like that. The help of Medicaid and the physical therapies and stuff like that got me to where I lost all that weight and with CFI, gave me a chance to live again,” Brett said.

“I think I’m the luckiest guy in the world, because I got everything that I need. But if we lose Medicaid and CFI, where are we gonna go?” 

The Medicaid program also offers benefits Medicare doesn’t cover, like nursing home and personal care services, for example. Beneficiaries on Medicaid generally don’t pay for covered services, but may be responsible for co-pays for some of them. One in every seven Granite Staters were enrolled in Medicaid in 2023, according to New Hampshire Fiscal Policy Institute, and among them were almost 30% of the residents of the City of Laconia. 

Medicaid eligibility is generally limited to pregnant women, children and teenagers, people who are elderly, people who are blind or otherwise disabled, or those in situations like leaving welfare and in need of health coverage, or families with children under age 18 who have limited access to resources, among other difficult scenarios. 

Partnership for Public Health Chief Executive Officer Tammy Carmichael likened Medicaid to an important, foundational piece of the health care system, and expressed concern regarding potential consequences of threats to the program. 

“One of the things in talking to the hospital is they’re going to get reduced funding for seeing uninsured patients, let alone Medicaid patients, and you’re going to get a greater number of uninsured patients if you take their Medicaid away from them,” Carmichael said. “The hospital’s already looking at cuts in that piece of funding. It’s a system that’s already very precarious, the game is already precarious, and pulling that piece out — I don’t know how our health care system and our safety net is going to survive.”