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Medicaid expansion enrollees testify at State House



Monitor staff
Friday, January 29, 2016
Joy Martell used heroin for seven years before she ended up in jail on possession charges. Before that, the Manchester resident tried several times to get help, but without insurance, all the treatment programs were too expensive.

But when Martell got out of jail in September, things changed. She became insured through the state’s Medicaid expansion program and started receiving treatment.

The 28-year-old has now been clean for five months, and on Thursday she showed up at the State House to tell her story to lawmakers, a group that will decide this year whether to extend the health care program for two more years.

“Jail was where I finally detoxed, and then after that I wanted to continue being sober, because it’s first time in a long time that I felt that way,” Martell said. “Right now I am looking for a job, I have an apartment now, I am working on getting my license back and I spend every day with my kids.”

More than 45,000 residents are now enrolled in New Hampshire’s Medicaid expansion program, which provides health insurance for adults making less than 138 percent of the federal poverty limit, or about $15,900 a year. But their future is far from certain.

The health care program will sunset at the end of 2016 unless the Republican-controlled Legislature votes to reauthorize the program, known as New Hampshire health protection. While Democrats widely support a continuation of the health care program, Republicans are divided over its merits.

At a public hearing on a proposal to continue the program, several residents like Martell told lawmakers that Medicaid expansion helped them kick their addiction, or get on their feet after hitting an economic rough patch.

Peter Burwen is a self-employed single dad who has run his own business renting rehearsal studios in the Antrim area since 1989. But when business took a downturn after the recession, the 57-year-old said he couldn’t afford $735 monthly premiums offered on the health care exchange.

“I was at the point, like many families in New Hampshire, making the decision of whether I put food on the table for me and my son, or am I going to have health care, or not and pay the penalty,” he told a House Health and Human Services committee Thursday.

Ultimately Burwen qualified for Medicaid expansion, the insurance he uses now as a short-term solution, he said, warning lawmakers not to think that everyone on the program is a lifetime member.

“I look at New Hampshire’s health protection as a stop gap measure, something that I will be on temporarily,” Burwin said, adding he would like to know the program exists for others like him, who “fall through the cracks.”

The demographics of people covered by the Medicaid expansion plan vary widely.

While roughly 43 percent of the people enrolled in the program are employed, 57 percent are not, according to data from the state’s Department of Health and Human Services. A Republican-backed proposal to continue the health care program for two more years, would require all “able-bodied” adult enrollees to meet a weekly 30-hour work requirement that includes community service, and job training.

Nearly one-third of the people enrolled in the Medicaid expansion program are young adults, between the ages of 25 and 34 years old. But after that, enrollees are almost evenly distributed among all other age groups. Slightly more women than men are covered by the health care program, in a roughly 25,000 versus 23,000 person split.

Geographically, the bulk of enrollees are located in the southern part of the state. Hillsborough county alone is home to one-third of all people enrolled in Medicaid expansion, HHS data shows.

But Coos County, which include towns in the northernmost part of New Hampshire, has the largest portion of its population enrolled in the health care program, at more than 5 percent.

Nearly 4 percent of the population in Merrimack County is insured through Medicaid expansion. And in Concord, about 2,250 people are enrolled in the program, which equates to roughly five percent of the city’s population.

Hospital and health care officials said Thursday that Medicaid expansion has reduced the number of uninsured patients they see, and helped to reduce uncompensated care costs.

Since the program went into effect in August 2014, roughly 30 percent of enrollees per quarter are visiting primary care physicians, HHS Commissioner Jeffrey Meyers said. Eleven percent of enrollees in every quarter have accessed mental health services, he said, and about four percent of recipients have accessed substance use disorder services.

Ethan Anderson is one of those enrollees who used Medicaid expansion to address an addiction. Since age 12, Anderson had misused drugs and alcohol, he wrote in testimony for the House committee. By age 16, Anderson was selling drugs to feed a near-fatal habit and eventually, he was arrested.

After enrolling in Medicaid expansion Anderson was able to get treatment, and his life back on track. Now, he’s a business owner in New London, he wrote.

“After being a decade-long burden to my friends and family, I’m so proud to stand here today and tell you that I’m nine months clean because of the services I accessed through Medicaid,” he wrote.

But Anderson didn’t get a chance to stand before lawmakers. He delivered his testimony in writing because he couldn’t wait through the hourslong hearing. He had to get back to his job.



(Allie Morris can be reached at 369-3307 or at amorris@cmonitor.com.)