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N.H. medical providers unite in support of Medicaid expansion

Dr. Frederick Kelsey, a fellow with the American College of Physicians, addresses a special commission in support to expand Medicaid in New Hampshire during a meeting at the State House on Tuesday, August 27, 2013.

(JOHN TULLY / Monitor staff)

Dr. Frederick Kelsey, a fellow with the American College of Physicians, addresses a special commission in support to expand Medicaid in New Hampshire during a meeting at the State House on Tuesday, August 27, 2013. (JOHN TULLY / Monitor staff)

Medical providers – hospitals and community mental health centers, doctors and nurses – presented a united front yesterday in support of expanding New Hampshire’s Medicaid program.

“We see it both as a public health and an economic imperative for our state,” said Henry Lipman, senior vice president for financial strategies and external relations at LRGHealthcare, to the state commission studying Medicaid expansion as it met in Representatives Hall. (LRGHealthcare operates Lakes Region General Hospital and Franklin Regional Hospital.)

Under the 2010 health care reform law, federal money is available to help states expand their Medicaid programs to cover adult residents up to 138 percent of the poverty line. The federal government would cover 100 percent of the expansion’s cost for three years and at least 90 percent a year after 2016.

According to the Kaiser Family Foundation, 23 states plus the District of Columbia are moving ahead with expansion, while 21 states are not. New Hampshire is one of six states still debating the issue.

Gov. Maggie Hassan, a Democrat, and the Democratic-led House support expansion. But the Republican-led Senate blocked it from being part of the new state budget. Instead, a commission began studying the expansion option this summer and will issue its recommendation by Oct. 15.

Yesterday, the commission members heard testimony from the public, with hundreds of people turning out for the hours-long hearing.

But first, the commission heard from nine members of New Hampshire’s medical provider community, representing groups including the New Hampshire Hospital Association, the New Hampshire Medical Society, the New Hampshire Nurse Practitioners Association and insurer Anthem Blue Cross Blue Shield.

All nine expressed strong support for Medicaid expansion.

The New Hampshire Community Behavioral Health Association “supports Medicaid expansion for three reasons,” said Suellen Griffin, president and chief executive officer of West Central Behavioral Health in Lebanon. “One, it will help improve access to mental health care and substance-abuse treatment. Two, it will help address the issues of parity. . . . And three, it will help sustain New Hampshire’s community-based mental health delivery system.”

The medical providers said the state’s health care system has the capacity to treat tens of thousands of newly insured patients without compromising care for existing patients.

“Medicaid expansion is not an inconvenience for us,” said Tess Kuenning, president and CEO of the Bi-State Primary Care Association. “This is what we do. These are who we serve. And this is our expertise and our core business.”

In fact, they said, many of those now-uninsured people are already patients, receiving treatment at emergency rooms and generally failing to receive basic preventive care.

“I do think this will make for better, more cost-effective care,” said Dr. David Green, Concord Hospital’s chief medical officer.

The commission also heard yesterday from lawmakers, interest groups and members of the public, many of whom were supportive of expanding the Medicaid program.

“I believe Medicaid expansion will save lives,” said Claira Monier, speaking on behalf of the state chapter of AARP.

But Rep. Jack Flanagan, a Brookline Republican, said while he understands the stress created by the weak economy and rising health care costs, expanding Medicaid wouldn’t be a cure-all.

And, he said, in future years the state will have to pay part of the cost. That, he warned, could lead to a state income tax.

“I don’t know where we’re going to come up with the money,” Flanagan said. “I really don’t.”

(Ben Leubsdorf can be reached at 369-3307 or or on Twitter @BenLeubsdorf.)

Legacy Comments12

I just read an article about the state of WA and how they had to take steps because of what they call ER Abuse. They have had problems with many folks covered by Medicaid or Medicare coming to the ER for things like colds, strep throat, hayfever, and even diaper rash. They have started turning them away and telling them to go to a walk in clinic or see their doctor. Many insurance companies have also started getting wind of folks using the ER for non emergency issues. Of course the uninsured have no choice. But one has to wonder how much ER Abuse costs.

ER abuse (and I'm sure it happens with both Medicaid and private insurance customers) is a critical thing to address and curb. It can be done with patient education and protocols that, as you say, allow ER staff to turn people away when then have insurance. There's the thing - if they have insurance, they can be ethically redirected to their PCP's. If they don't have insurance (because Medicaid wasn't expanded), they can't, and we all pay. I would be curious too about how much ER abuse costs. I know that my commercial insurance has a much higher co-pay for using the ER than it does for using my PCP - about 5 times as high, so I thought twice even when my ankle was swollen 3x and immobile. Unfortunately, you can't use ER co-pays with Medicaid... or can you? Hm.... Perhaps a copay that is waived if the patient is admitted, or is deemed a true emergency that couldn't have waited until morning?

Even if we all pay as we do today, it is still less costly in dollars and in increased insurance costs over Obamacare. Democrats and progressives sold Obamacare as cheaper than those without insurance using the emergency room. It was all misguided propaganda.

I wonder how the right will feel when they realize that when they finaly eliminate Social Security and Medicare that they eliminate it for them selves and trei families too ?

I thought that LRGH dropped Medicaid patients last year. Did they change their mind?

Flanagan represents the myopic, stubborn, political can't-do that prevents this great state from reaching its fullest potential. How brave of him to represent the right's crusade against all reason and common sense.

YIPPEE !!!! FREE federal money is available........ to be properly informed on the topic readers should Google this headline.... "Oregon Study: Medicaid 'Had No Significant Effect' On Health Outcomes vs. Being Uninsured"... this is a massive game changing study.

Check out a non-right-wing interpretation of the Oregon study.

Do you have the ability to answer a direct question? Exactly who do you think pays for people who use emergency rooms when they have no insurance? So your plan is to just keep on sending NH money to Washington but get nothing in return?

where does Federal Freeeeeeee Obama Monopoly money come from?

Sail - you're the only one here saying that Obamacare money is "free." We all know, as tillie pointed out, that the money comes from federal taxes that we have paid. And as we keep pointing out, if we don't use the money that we've already ponied up, it's going to get sent somewhere else. We know it's not magical free money. The question is, why do you think we should just say goodbye to our money and never see it again, to the detriment of our own citizens?

I knew you didn't have that ability. Only people with no answers, try to answer a question with another question.

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