Medicaid Questions: Summer School begins for Legislators

Grant Bosse

July 7, 2013

As originally published in the New Hampshire Union Leader

The New Hampshire House and Senate may have adjourned for the summer, but a handful of lawmakers have some serious studying to do before their colleagues come back this fall.

A key compromise in the new state budget deal was the establishment of a study committee to examine whether New Hampshire should accept $2.5 billion from the federal government to raise the income eligibility limit for Medicaid.

While the Affordable Care Act originally forced states to expand Medicaid, the U.S. Supreme Court made that decision optional for each state.

The Obama administration promises to pay 100 percent of the costs of expansion for the first three years, and almost all of the costs after that.

Gov. Maggie Hassan and the Democratic House pushed hard to take the free money right away.

The Republican Senate is skeptical, both of the consequences of massively expanding an already troubled program and of Washington’s record of broken promises. The compromise is a nine-member study committee tasked with finding a New Hampshire solution.

It is to give its recommendation to the full Legislature in October.

The members of the newly formed study committee all likely have strong feelings on the issue.

They are not likely to learn much this summer that would change their recommendations. But they should take their task seriously and answer some key questions about this expansive decision:

. How many currently insured Granite Staters would drop their private coverage for free federal insurance?

. How much more would New Hampshire hospitals lose by treating thousands of new Medicaid patients? Hospitals are currently suing the state for its low Medicaid reimbursement rates.

. Do the results from states that choose to expand Medicaid right away line up with the rosy predictions of the Obama administration? The percentage of uninsured people in Maine didn’t budge the last time that state expanded its Medicaid rolls.

. Is the Obama administration’s promise to let New Hampshire Medicaid expansion sunset legally binding, or could Uncle Sam change its mind and block any attempt to bring Medicaid back to its current levels?

Getting these answers will help the Legislature make an informed decision with billion dollar consequences this fall.