Mental health treatment and Medicaid expansion

The NH Health Protection Program, which now provides access to health care to over 47,000 people in our state, will sunset later this year unless the Legislature enacts a bill to reauthorize it. The program is New Hampshire’s version of Medicaid expansion – a unique, Granite State solution to providing health care to all our citizens with a bridge to the private marketplace. NAMI-NH and the NH Community Behavioral Health Association both strongly supported the 2014 legislation creating the program and we urge legislators to pass House Bill 1696, which will keep it going. 

Our organizations are committed to ensuring that all New Hampshire citizens have access to mental health care and substance abuse and addiction treatment. The NH Health Protection Program has helped to guarantee that. Over 70,000 individuals have used the program at one time or another in the past two years, which demonstrates that this is a true hand up for working people, not a handout. Most people using the program are the working poor.

The National Institute on Health estimates that one in five people has a mental illness, yet only about 50 percent of them seek help. Like any other illness, delaying treatment for mental illness or a substance use disorder creates a clinical problem: By the time an individual is in need of this level of care, their illness has likely worsened because they were not treated in the early stages, in an appropriate setting. This often results in extended stays in hospital emergency departments, for up to a week, while patients wait for an inpatient bed so they can receive the acute care they need. Hospital emergency rooms are only able to focus on the immediate crisis, to stabilize individuals, not to address their longer term, chronic conditions or problems.

Access to health insurance means that people get their care delivered in a more timely and appropriate way. This is more compassionate, humane and clinically recommended; it also saves money.

Not reauthorizing the NH Health Protection Plan will shift the costs of providing health care to the uninsured to other payers; this will increase both commercial health insurance premiums and Medicaid costs. It will also mean that New Hampshire’s community-based mental health system will be further strained by providing services to uninsured individuals.

Our mental health system already faces significant challenges and continues to operate under financial stress. And as anyone who follows the news knows, New Hampshire is in the throes of a serious opioid and substance use disorder crisis.

Addiction puts pressure on individuals and their families, and significantly and negatively impacts schools, courts, corrections, child protective services, and other costly state and community agencies. The NH Health Protection Plan offers a benefit for substance use disorder services and is therefore the front line in our efforts to stem the current drug crisis.

The NH Health Protection Plan improves outcomes for those with co-occurring conditions and helps reduce medical costs. 

We also want to add our personal observations that nothing puts families under more emotional and financial duress than serious medical conditions. The NH Health Protection Plan has helped lessen that stress for many of our fellow citizens and neighbors, by providing access to health care coverage, which means early detection and appropriate treatment of medical conditions, mental illness and substance use disorders. 

The NH Health Protection Program has given our state the opportunity to create a more equitable system of care. Keeping 47,000 enrollees insured helps the market and keeps costs down for all of us by increasing the size of the risk pool. And it helps individuals with mental health and substance use disorder problems get proper care for their conditions so that the other parts of their lives – family, work, housing, education and meaningful participation in the community – are not limited or stifled. 

Annette Carbonneau is director of adult and family programs for NAMI-NH. Suellen M. Griffin is president of the NH Community Behavioral Health Association and CEO of West Central Behavioral Health in Lebanon.

Categories: Opinion