Medicaid panel lays groundwork for bipartisan agreement

Having more people insured helps everyone, including those not on Medicaid


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For the past three months, I have had the honor of serving on the state’s bipartisan Commission to Study the Expansion of Medicaid Eligibility. I wanted to explain what we decided and why I voted for the expansion plan.

Medicaid is a joint state-federal program that gives health care coverage mostly to low-income children, but also to some senior citizens, pregnant women and people with disabilities.

Under the federal Affordable Care Act, aka Obamacare, our state is allowed to expand the program and offer health insurance coverage to low-income adults making up to about $16,000 per year -- people like waiters, janitors, landscapers. About 60,000 state residents – mostly working, taxpaying citizens with no health insurance – would be eligible. The federal government will pay the state all the costs for the next three years, and then slowly decrease their amount to 90 percent after seven years.

Earlier this year, the governor wanted to accept the federal money to offer the coverage, while a majority of the Senate wanted to study the opportunity and then decide. The two sides compromised on a short-term study commission, which finished its work last week.

What we ultimately learned is that the benefits of expanded Medicaid for New Hampshire are substantial. Expansion will bring $2.4 billion in federal dollars -- $340 million next year alone. It grows the economy by almost $400 million and creates 700 new jobs. It will save our state’s own budget $45 million over the next seven years and save consumers $100 million in what they pay for health care.

Having more people insured helps everyone, including those not on Medicaid. Currently, hospitals and health care providers must absorb the bill when people have no insurance. That adds up to hundreds of millions of dollars every year, and pushes everyone else’s health insurance premiums up to cover this uncompensated care.

If we get uninsured people health care coverage, we will help bring premiums down for everyone else.

As a nurse, I know that access to insurance is good for people’s health. Preventive care, monitoring chronic conditions and treatment in the most appropriate setting are the goals of health care. These goals are rarely met when people lack insurance.

The commission emphasized having people in the private market for health insurance when possible. All of us wanted to make sure our state is protected financially. And we want to make sure we are taking every opportunity to reform traditional Medicaid and make it as efficient as possible.

To address those concerns, we agreed to use Medicaid dollars to keep people who are newly eligible for Medicaid on private insurance, if it is available from their employer. Then, we are going to give everyone else who is eligible a future option, as long as it is cost-effective, to get onto a private insurance plan in the health care marketplace, with Medicaid paying their out-of-pocket costs.

To achieve greater efficiency, we are already moving to a privatized Medicaid system. We are going to put new enrollees into coverage through these private companies. That should make things more efficient and keep costs down. And finally, we supported a so-called “circuit breaker” to protect our state financially. If the federal government doesn’t pay the share they’ve promised, we get out.

At the end of the day, what we saw was a bipartisan compromise on a uniquely New Hampshire plan. It passed on a 6-2 vote, and I was proud to support it.

The Legislature will go into a special session in November and, hopefully, we can get this up and running. If we delay beyond Jan. 1, the state stands to lose about $1 million a day and all of the associated economic and health care benefits. The commission worked hard to create a New Hampshire plan. Our Legislature should work together to agree.

Peggy Gilmour, D-Hollis, represents District 12 in the New Hampshire Senate.

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