Why Medicaid expansion should be supported


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Health care should be accessible to all New Hampshire residents, regardless of income. Regular, consistent health care will improve the health of state’s residents, manage chronic conditions such as diabetes and high blood pressure better, and result in lower use of hospital emergency department and inpatient visits. The end result should mean healthier residents and lower health care costs for the state as a whole. 

As a not-for-profit health services company serving more than 1 million members in New England, Harvard Pilgrim Health Care works very hard to keep our rates as low as possible while providing a high level of customer service and quality offerings to companies and individuals.

There is an important debate going on in our Legislature – one that could negatively impact upwards of 50,000 lower-income residents and have ripple effects across health care insurers, providers and businesses. 

Today, more New Hampshire residents have health care coverage, due in part to the passage of the NH Health Protection Plan, commonly known as Medicaid expansion, or MedEx.

Since March 2014, 43,900 New Hampshire residents have signed up for MedEx. The law uses federal funds to cover the cost of insuring these individuals, whose incomes were above the level where they would qualify for traditional Medicaid, but below the level where they would qualify for a subsidized plan. 

The law sunsets on Dec. 31, and the Legislature is beginning the debate around extending MedEx. The federal government will continue to pay 100 percent of the premiums through 2016, but this will drop to 95 percent on Jan. 1, 2017. There is bipartisan support for the legislation, a growing set of data on potential savings and benefits of the MedEx program, and active discussions on how to cover the state’s potential 5 percent share if it is reauthorized.

Renewing Medicaid expansion in a timely fashion enables health plans to predict the health care needs of individual members and file individual rates that more accurately reflect costs.

To add to the intrigue, the timing of this conversation is crucial. In order to set rates for 2017, a key piece of information is whether or not those rates will include 2016 enrollees. That information can only come at the hands of the Legislature.

The state of New Hampshire and taxpayers benefit from year-to-year pricing stability in public health plans. It enables them to anticipate and budget for health care costs on a more long-term basis. While some rate adjustments each year are to be expected, health plans would like to avoid large pricing variations, particularly price increases because of unexpected costs. 

In addition, Medicaid expansion may be changing the insurance landscape by attracting more insurers to offer plans on the NH Health Insurance Marketplace. The exchange began with one insurer in 2014 and that number has grown to five for both 2015 and 2016. 

Medicaid expansion led to modestly higher premium rates for individuals in 2016 as Medicaid expansion members were added to the risk pool. However, in the long run, better health care access for all New Hampshire residents leads to improved health care outcomes and, eventually, lower costs in total. 

I urge businesses, citizens and lawmakers to take this big-picture approach on health care and come together to support Medicaid expansion. We will be a healthier state that benefits from more individuals receiving quality care as needed and proactively. We will have fewer people without insurance using hospital emergency rooms and driving up costs. And we will help stabilize health care costs. It’s a win-win for New Hampshire. 

Beth Roberts is senior vice president, senior markets, for Harvard Pilgrim Health Care.

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