Yes, expanded Medicaid is working

Coverage is helping working poor with mental illness

When New Hampshire made the decision to expand health care coverage to low-income, working families in 2014, it was estimated that the number of people who would enroll in the NH Health Protection Program might reach 50,000 over a five-year period. But only six months after the law took effect, there are already 39,500 Granite Staters enrolled and getting access to health care. Nearly 2,000 of these newly insured individuals are now covered for care at the state’s ten community mental health centers.

The growing enrollment numbers alone are cause to celebrate the success of the program, but a paper recently released by the NH Hospital Association further underscored the progress made, reporting that the NHHPP is “driving a reduction in inpatient admissions, emergency visits and outpatient hospital services among the uninsured.”

Hospitals, like community mental health centers, do not turn away people in need, and uncompensated care is a major financial issue for providers. When Gov. Maggie Hassan visited Genesis Behavioral Health in Laconia recently, she heard that Genesis has seen a 30 percent increase in the number of individuals receiving services and a corresponding 30 percent drop in uninsured clients. The expansion of health coverage, as predicted, has helped to lessen the financially destabilizing factor of uncompensated care that impacts all health care in our state.

Many of the 2,000 new consumers receiving services at the community mental health centers are low-wage workers who would simply not get the care they need without the NHHPP. While the highest priority of the centers is to help those with mental illness get clinical services, there is also the benefit of helping people who are living with mental illness keep their jobs, enjoy productive lives and stay in their communities.

Beginning in 2016, the NHHHP provides that the newly covered population will move into the commercial insurance market and get coverage through private managed care companies. Any delay in reauthorizing it may make it harder for the private market to absorb this group of newly insured.

The requirement for reauthorization of the NHHPP by April 2016 was put into the 2014 law to ensure that the state could see the benefits of the program before it was locked in. The rationale was, “We need to see if it works.” Well, it does work.

Letting the NHHPP go out of business after one year, defunding emergency services for community mental health centers and delaying the opening of beds at New Hampshire Hospital – all of which are decisions the House made in its budget plan – is like taking one step forward and two steps back.

On behalf of the community mental health centers and the 50,000 consumers we serve, we encourage the Legislature to let practicality, not ideology, guide their decisions on the budget and on expanded Medicaid. We urge the Senate and the House to work on a spending plan this year that continues the success and the momentum we are already seeing in the NH Health Protection Program.

Jay Couture is executive director of Seacoast Mental Health Center, Inc., in Portsmouth, and president of the NH Community Behavioral Health Association. This letter was also signed by the nine other community mental health centers.