My Turn: Senate Republicans decide to study what we already know
In its proposed state budget, the New Hampshire House of Representatives included expansion of Medicaid eligibility. The Senate removed this expansion, deciding that we need an additional 18 months to study the issue. However, further study is unnecessary and poses a risk to thousands of citizens.
In 2012, the Department of Health and Human Services commissioned a study by the Lewin Group, a well-respected consulting firm, to evaluate the effect of Medicaid expansion on our state’s Medicaid program, health care system and economy. Lewin’s researchers gave several presentations to stakeholders and answered questions about the assumptions in their analysis.
According to Lewin, expanding Medicaid could provide health insurance to 58,000 New Hampshire residents who can’t afford to buy it or work for companies that don’t offer it. These people are already in our health care system. When they seek treatment they can’t pay for, they receive it, causing our businesses and families with private insurance to pick up the cost.
Over seven years, Medicaid expansion would bring $2.5 billion in federal money into New Hampshire. According to Tom Bunnell of NH Voices for Health, these dollars would reduce “current pressure for providers and insurance companies to shift uncompensated care costs onto the business community” and those of us with private insurance.
Although Medicaid expansion would cost the state $18.4 million, Lewin’s researchers identified ways we could reduce our obligation to zero over the next two years. In exchange, of course, we would receive $2.5 billion over seven years and provide health care coverage to 58,000 of our fellow citizens. By any measure, this is not a bad deal.
The Lewin report is not the only source on how we would benefit from Medicaid expansion. A 2013 study from the Robert Wood Johnson Foundation reports that up to 2,300 uninsured veterans and their spouses in New Hampshire will have incomes low enough to qualify for health coverage through Medicaid.
Aside from the financial aspect of choosing to expand Medicaid, we must consider the potential impact on the health and well-being of New Hampshire’s low-income, uninsured residents. The New England Journal of Medicine published a study last fall evaluating three states that had already expanded Medicaid to low income adults. The key result was that Medicaid expansion led to a statistically significant decrease in death among adults 35-64 over a five-year period.
Opponents of Medicaid expansion have made much of a recent study of expansion in Oregon, which found no significant impact on blood pressure or cholesterol scores. However, according to the authors, Medicaid expansion did “increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.” As Gov. Maggie Hassan recently noted, it defies logic to suggest that a family without insurance is no worse off than one with it.
Some observers have argued that Medicaid expansion is a partisan or ideological issue. However, such conservative governors as Rick Scott of Florida and Jan Brewer of Arizona support it. John Kasich, the conservative governor of Ohio, has pointed out that Ronald Reagan “expanded Medicaid, not just once but several times.”
Further study that will delay expanding Medicaid puts the health of low-income residents at risk and continues to drive higher costs to New Hampshire businesses and families with private health insurance.
(Stephen Gorin is a professor at Plymouth State University and outgoing chairman of the State Committee on Aging.)