Medicaid expansion is good for our state

What is the real reason opponents want to stop implementation of Obamacare?


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In 2009, there was consensus to expand health care access and affordability. Hundreds of millions of dollars were spent, protests and rallies were held on all sides of the issue, and the news media covered the subject extensively. In the end, Congress came to an agreement that was passed into law and upheld by the Supreme Court. That law is the Patient Protection and Affordable Care Act, affectionately referred to as “Obamacare.”

Many of the provisions of the ACA automatically apply to and benefit everyone with health insurance. Some of these provisions include prohibiting insurance carriers from rejecting coverage due to pre-existing conditions, requiring inclusion of women’s preventive services in new coverage, eliminating lifetime caps, expanding coverage to young adults 26 and under on their parents’ plans, and establishing the 80/20 rule – no more than 20 percent of your premium dollars can be spent on administration.

At the state level, the Medicaid Expansion portion of the ACA is “opt-in.” That means New Hampshire has the option to expand coverage to tens of thousands of additional New Hampshire citizens by raising the Medicaid threshold from 100 percent of the federal poverty level to 138 percent, or about $15,850 for an individual and $32,500 for a family of four.

This would make health care accessible for approximately 22,000 more Granite Staters who are working hard to provide for their families but are unable to afford health coverage. About 2,300 of them are veterans and their spouses.

Currently, the New Hampshire Republican Senate is saying they want more time to study the issue and/or they are concerned the federal government will fail to make good on their financial commitment to Medicaid.

Even prior to the passage of ACA there were numerous studies on expanding Medicaid. Since passage, there have been many more studies, including the comprehensive independent study conducted by The Lewin Group specifically for New Hampshire.

If Republicans are really interested in Medicaid expansion, there are 340,022,000 reasons to act now rather than later: the infusion of $340 million over the biennium into the New Hampshire economy through expansion and more than 22,000 men, women and children receiving the health care they need. If we delay or opt out, we can never recover the lives lost nor the investment in our economy turned away.

Many of my friends from the Senate majority have cited that they are very concerned that the federal government won’t deliver on its financial commitment with regard to Medicaid. In the more than 50 years Medicaid has existed, the federal government has failed to meet its commitment to New Hampshire exactly zero times. That’s right -- none.

In fact, in the most challenging economic times, they have exceeded their commitment, paying more than was expected. But never less. Never.

Since both of these concerns are non-existent, I am left to wonder what the real reason is to oppose implementation of the ACA including Medicaid expansion. We know what the best governing decision is for the state and citizens of New Hampshire.

It seems pretty clear that as in Washington, in New Hampshire there has been much demonizing of the ACA. In Washington they have held more than three dozen entirely symbolic votes to repeal Obamacare. We had similar bills to block implementation here in the Legislature. It is likely some will try to use this as a major issue in the 2014 elections, just as they did in 2012 -- when voters nationally and here in New Hampshire voted strongly for the side in support of Obamacare.

As we see the results coming in from the early adopting states, including dramatically lower than expected premium costs on the health care exchange in California, the choice seems clear. Expanding Medicaid and implementing the Affordable Care Act is good for New Hampshire. With regard to our health, our economy and our politics - we would all be better served by supporting Obamacare.

Terie Norelli, D-Portsmouth, is speaker of the New Hampshire House.

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