, Kingston, NH

Letters to the Editor

August 22, 2013

Medicaid Expansion

Medicaid Expansion

Under the 2012 Affordable Care Act the federal government will provide states with money to expand Medicaid eligibility. Expanding Medicaid in New Hampshire to include anyone under age 65 who earns up to 138 percent of federal poverty guidelines is estimated to add 59,000 people to the program. The federal government has promised to pay 100 percent of the cost in the first three years and 90 percent until 2020, which would mean $2.5 billion in the next seven years for New Hampshire. Governor Maggie Hassan has convened a nine member Medicaid Expansion Commission to report their recommendations by October 15, 2013.

Rejecting Medicaid expansion will not only result in lost dollars but it will also cause unnecessary hardships for some of our most vulnerable citizens.

I was an emergency medicine physician for 20 years . Poor uninsured people use hospital emergency departments for medical care because they usually aren’t welcome elsewhere. If we can keep any uninsured people out of the emergency department we will be saving hundreds of thousands of dollars a year. Not only is this delivery of care costly and inefficient, the rest of us pay for these costs in the form of uncompensated care, impacting hospital and private health insurance premiums. The planned Medicaid expansion to 59,000 Granite Staters will help end their reliance on emergency departments, improve their health, and will boost our state’s economy. Participating in the Medicaid expansion will provide savings to the state budget by reducing free or charity care estimated to be in the amount of $85-175 million.

There is no clear link between health insurance and better health but we do know that people on Medicaid end up with significantly better mental health. They get something crucial to long-term health that the uninsured don’t have peace of mind. Just ask anybody who has had to face medical bills without insurance. This is good fiscal policy, given the enormous costs that mental health problems pose on society by reducing productivity, increasing the incidence of violence and self-destructive behavior.

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