N.H.'s reimbursement rates for Medicaid are lowest in the country

To the editor,

What can I say? What can anyone say? The shocking and sorrowful news that LRGHealthcare has been forced to close most of its primary care offices to Medicaid patients had two immediate effects. One was of speechlessness and then outrage at the government forces that caused this action.

Most times I react immediately and respond with a letter to the editor, but I felt a waiting period was necessary to see what the fallout would be and see if on reflection I had some different view. You know what? Most times your immediate thoughts are the right ones or the ones you believe and you are only expressing honestly your reaction.

First, your thoughts and sympathy go out to all those who will be affected. They are the most important. Second, your thoughts and sympathy must go out to LRGH, which has struggled with losses for years to maintain these systems. Third, we must review the political process on both the federal and state level that is REALLY responsible for this crisis.

Over the past two years, I have written articles on the increasing danger of health care coverage and the need for all of us to do our part in preventing just what has happened. I pointed out the shortage of doctors, estimated now at a little over 50,000 but headed to 150,000. This recent action will probably double that number. I quoted national rates that doctors were not accepting new Medicare patients at about a 30-percent rate and new Medicaid patients at about a 50-percent rate. This was two years ago, and now we here in the Lakes Region are seeing what the continual cutting of reimbursements to the hospitals and doctors has done.

On top of cutting reimbursements, hospitals are now subject to a Medicaid Enhancement Tax (MET), which is currently 5.5-percent of net revenues. This will mean most hospitals would pay more in taxes than they receive in payments from the state for taking care of Medicaid patients. Remember when the state cuts funds, the feds cut the same amount, so the state has effectively doubled our cuts.

In the past, hospitals have passed this loss of revenue along to the privately insured to make up the difference. This could only go on so long. The insurance companies by continually raising rates to the private sector find that employers can no longer afford to carry their employees or find it necessary to cut their workforce. There has been a loss of 1,000 health care jobs with 100 at LRGH’s facilities. Of course, this puts more people out there without insurance and increases the Medicaid numbers.

In an editorial in the Concord Monitor, Friday, October 28th, they place the responsibility on the state, noting that N.H. reimburses hospitals less than any other state for caring for the poor.

To its credit, LRGH is reaching out to those Medicaid patients by referring them to four locations that will still take on these patients, mainly because they are in a situation that reimburses them more than LRGH receives for the same services. However, as their patient load increases, they too will be facing problems with overhead, enough doctors and equipment. However, LRGH will still receive ALL patients to the ER.

When you think of the long lines and waiting periods in the ER this means everyone suffers, not just the Medicaid patient.

Our state reps and senators must go back to the table and rescind their cuts. To say “everyone was cut” is not a valid reason. A building can be cut and no physical harm is done. To cut medical services to everyone is harming humanity.

Councilor Brenda Baer

Ward 4 - Laconia