For Kristina Amyot, Medicaid has been a consistent support for her when she’s needed it.
When Amyot was seeking addiction recovery support, many treatment centers only offered 28-day programs, which Amyot said were not long enough for her. Continuing treatment would have cost her thousands of dollars out of pocket.
“I was denied extended care, left without aftercare, and eventually, found myself incarcerated,” Amyot said.
For Amyot, getting coverage through Medicaid helped her stay at a six-month recovery center called Hope on Haven Hill. She said she needed the long term center as she was trying to focus on her health so she could take care of her child.
“I gave birth to my daughter, graduated from Hope, and moved into their sober living facility where I lived for two years,” Amyot said.
Amyot relied on Medicaid again when she was laid off from a job that provided private health insurance. It kept her going until she got a job at S.O.S. Recovery Center.
“It’s just a stepping stone to get you where you need to go and it’s extremely helpful,” Amyot said. “If I lost my Medicaid, I would have lost access to treatment, therapy, [medication]-assisted treatment. It’s just a trickle effect that affects all aspects of your life. So, you take that away and it’s just so disheartening.”
New Hampshire’s Republican-controlled Legislature is considering some big changes to Medicaid, including work requirements, as part of the state’s budget bill. The Senate’s version of the bill would require some patients to pay monthly premiums, while the House’s version, passed in May, includes a 3% cut in reimbursement rates for Medicaid providers.
Lawmakers in the New Hampshire House and Senate have until Thursday to reach agreement on the next state budget.
Health care advocates gathered on Tuesday at the State House to share how it could impact the roughly 180,000 Granite Staters covered by Medicaid, including seniors, children, people with disabilities, and adults who have low incomes.
Amyot shared that many of the people S.O.S. Recovery Center serves are on Medicaid or do not have any health insurance coverage. She urges lawmakers to consider the impact these changes could have on people, especially amidst an ongoing opioid crisis. She said work requirements could be especially difficult for people with substance use disorder to sustain, and people who are unable to work while seeking treatment could face disenrollment, cutting off life-saving care.
Amyot said people in recovery already face challenges in seeking employment, including stigma and discrimination.
“Imposing rigid Medicaid work requirements without adequate, adequate consideration for unique challenges faced by individuals in recovery can undermine our efforts to achieve and maintain sobriety, hindering my ability to access essential treatment and support services,” Amyot said.
Sue Durkin, Co-CEO at Lamprey Health Care said that roughly 19% of their 17,000 patients don’t have health insurance. They have three health centers in Newmarket, Raymond and Nashua, along with 40 different communities throughout the southern religion of New Hampshire.
Durkin said that while they’re thrilled that the House’s proposed cuts to reimbursement rates were put back into the budget by the state Senate, the potential work requirements and cost-sharing provisions could affect their patients with poorer health outcomes, loss of care access, more possibly more hospitalizations.
For Lamprey Health Care, Durkin said Medicaid reimbursement helps cover costs of service.
“If that reimbursement goes away, we’re still going to take care of those patients, but we don’t get reimbursed for our services, so it really puts us in a tough financial situation where we may be faced to make choices about what we can continue to do to keep our doors open,” Durkin said.
Andrew Harmon, lives in New Hampton, a rural town in the North Country. Harmon said he is on disability and Medicaid, which help him get the specific diabetes supplies he needs. He worries the proposed work requirements, which would impose a minimum of 80 hours of work per month, could disrupt his care. Harmon’s job offers hours that vary from assignment to assignment, so he doesn't have consistent stable income or work hours.
The House and Senate will have until this Thursday to reach an agreement on the budget, before it heads to both chambers for a final vote next week.