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Public Has Its Say On Medicaid Expansion Bill

Todd Bookman


New Hampshire’s Medicaid program currently insures poor children, the disabled and low income pregnant women.

But after a U.S. Supreme Court ruling on the Affordable Care Act, the state must decide if it wants to expand the program to adults that earn less than $15,000 a year: roughly 58,000 people in New Hampshire.

According to Representative Bill O’Brien, the state just can’t afford to cover those extra people.

He’s filed a bill that would prohibit the state from growing the program.

“I’m really asking people to come out of their partisan boxes and do what is right for New Hampshire tax payers. This isn’t something we ought to say, ‘I oppose it because I’m a Republican, I support it because I’m a Democrat. We have say, ‘is this an obligation that New Hampshire can permanently take on?’ And I’ll tell ya, it really isn’t.”

Expanding Medicaid will cost New Hampshire about $85 million. The Federal government picks up the rest of the tab: estimated at $2.5 billion through 2020.    

Beyond that, costs are unknown. O’Brien says that should give the state pause.

“It is like any other government program: it doesn’t go away. You put the Medicaid needle into your arm... that addiction is not going to go away.”

But inside the Health and Human Services committee hearing, which took place in the House chamber due to the crowd, the debate was framed in different terms.

“It is a blue collar issue, a poor issue,” says Mike Lessard, a cook from Dover.

“And who we fight for in the New Hampshire, are the people that can’t fight for themselves. You are fighting for the lowest common denominator in our state.”

Doctors, nurses and patient advocates also spoke in favor of expansion.

So did Steve Ahnen with the New Hampshire Hospital Association.

He said having 130,000 people uninsured in the state is unsustainable.

“The hospital emergency room is not the place to receive primary care. But unfortunately, more and more of our families, neighbors and friends across New Hampshire are turning to their hospital emergency rooms to receive care, because they have no place else to go.”

A small handful did speak in opposition to expansion. Pam Ean of Concord says the last thing health insurance needs is more government.

“When someone else is footing the bill, there is little reason for the patient to conserve the use of resources. And little incentive for the provider to keep costs low, and we’re witnessing this today.”

With Democrats controlling the House, a bill blocking Medicaid expansion isn’t likely to pass. Republican leaders in the state senate, meanwhile, call the future of Medicaid the biggest issue facing the state.

Governor Hassan is on record supporting expansion but has offered few details on how the state will pay for it. We may learn more about that when Hassan presents her budget next week.

Todd started as a news correspondent with NHPR in 2009. He spent nearly a decade in the non-profit world, working with international development agencies and anti-poverty groups. He holds a master’s degree in public administration from Columbia University.

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