State Senators Bragdon, Forrester, Morse, and Odell recently voted to pull Medicaid expansion from the state budget, sacrificing billions in federal dollars and hundreds of jobs. This article is a counterpoint to those Senators’ positions.
Medicaid Expansion addresses the two core health care issues of equity and efficiency as well as, additionally, provides derivative economic and social benefits and gives us back a return on our tax dollar investment.
Equity: Medicaid Expansion would cover 58,000 otherwise uninsured NH residents. We’re talking about the lowest-income and most vulnerable NH adults who don’t have access to quality affordable health insurance coverage. The expansion population includes low-income working NH residents who, for example, serve meals in restaurants, fix your car, cut your hair, work in a full range of local shops and stores in our communities...
Efficiency: Expanding Medicaid will decrease the uncompensated care currently being provided by hospitals, doctors, and other community health care providers. As a result, the expansion will help relieve the current pressure on health care providers and health insurers to shift uncompensated care costs onto NH’s business community, and onto all of us who pay the cost of private health insurance premiums.
Derivative Economic and Social Benefits: The Medicaid expansion is good for NH’s economy. According to a study by the Lewin Group, commissioned by the NH Department of Health & Human Services, Medicaid expansion would pump a staggering 2.5 billion federal dollars into NH’s economy over the first seven years.
Return on our Tax Dollar Investment: NH taxpayers now send more dollars to Washington than we get back, and this Medicaid coverage opportunity gives us the chance to change that dynamic and get back more of our fair share. If our state says “No” to the Medicaid expansion, NH taxpayers will be paying for and subsidizing the Medicaid expansion in other states across the nation.
Conclusion: This Medicaid coverage solution is good for working families, good for health care providers, good for NH’s business community, and good for NH’s economy.
I would like to add that health care should not be considered a privilege but a fundamental human right. The health care debate and its reform should be framed around this premise. This is the issue of equity; to deliberately decide to leave 58,000 of our fellow New Hampshire residents without health insurance coverage is already an ideological decision, as I have stated above, not a fiscally responsible one, and counters the existing social compact.
From the standpoint of efficiency, it makes absolutely no fiscal sense to pass up federal dollars which we have paid into and then allow this shortfall to be cost-shifted to the provider community, our small business, and ultimately to our policyholders. 
This should be less a matter of a debate than a matter of common sense and concern for the members of our community and Medicaid Expansion should remain in the state budget and be enacted into legislation.