Few speak for O’Brien’s bill blocking Medicaid expansion
Rep. William O'Brien tells the Health, Human Services and Elderly Affairs Committee why he is sponsoring House Bill 271 that would block the expansion of Medicaid in New Hampshire; Tuesday, February 5, 2013. O'Brien, the former Speaker of the House, was one of five people who spoke in favor of the bill. ONe hour into the hearing there were 45 people opposed to the bill still waiting to be heard.
(ALEXANDER COHN / Monitor staff)
Former state senator Matthew Houde (left) was one of more than 100 people to attend a hearing at the State House on House Bill 271 that would block the expansion of Medicaid in New Hampshire; Tuesday, February 5, 2013.
(ALEXANDER COHN / Monitor staff)
Health, Human Services and Elderly Affairs committee member Thomas Sherman asks Rep. John Hunt a question after Hunt spoke in favor of HB 271. More than 100 people attended a hearing at the State House on House Bill 271 that would block the expansion of Medicaid in New Hampshire; Tuesday, February 5, 2013.
(ALEXANDER COHN / Monitor staff)
Rep. Bill O’Brien’s bill to block the expansion of Medicaid before lawmakers have debated the issue fully drew more than 100 people to the State House yesterday – nearly all of whom opposed O’Brien’s bill.
Several people in Representatives Hall laughed when O’Brien, a Mont Vernon Republican, said a large number of the uninsured in New Hampshire wouldn’t qualify for expanded Medicaid anyway because they are either “here illegally” or earn enough but choose to spend their money on things other than health insurance.
And O’Brien disputed estimates that 130,000 state residents are uninsured, saying he doesn’t believe the problem is “so widespread.”
An hour into the hearing, four people, including O’Brien, had testified for the bill and 45 others were waiting to speak against it. Opponents included the New Hampshire Hospital Association, the New Hampshire Fiscal Policy Institute, The Children’s Alliance of New Hampshire and the New Hampshire Medical Society.
A Deering nurse called O’Brien’s legislation a “heartless bill,” and described treating a man who tried to commit suicide because he was uninsured and couldn’t afford insulin to treat his juvenile diabetes.
“For those of us in this room who are healthy, please count your blessings,” she said. “Why must we in New Hampshire continue our race to the bottom? (This bill) keeps us on that path.” Mike Lessard of Dover talked about his brother, who has disabilities and doesn’t earn enough to pay for insurance.
“What we are talking about today is . . . a blue-collar issue,” Lessard told the House Health, Human Services & Elderly Affairs Committee. “It is a poor issue. And who we fight for in this state are the people who can’t fight for themselves.”
Under the Affordable Care Act, New Hampshire, like all states, has the option of expanding Medicaid coverage in 2014 to anyone under 65 who earns up to 138 percent of the federal poverty guidelines. For a single person, that would be about $15,000. A family of four would qualify if they earned $30,000 a year.
Currently, the state’s Medicaid program covers people with disabilities, low-income children, seniors and pregnant women. If New Hampshire expands coverage, an additional 56,000 people would be covered, according to the Kaiser Family Foundation.
The federal government would pay 100 percent of the costs for the first three years then gradually decrease the federal contribution to 90 percent.
Rep. Timothy Comerford, a Fremont Republican who co-sponsored O’Brien’s bill, told the committee the state can trust the federal government to fulfill its contribution promises.
“With special ed funding, (the federal government) said they’d pay 70 percent, and they don’t get close to that,” Comerford said. “And Medicaid is not even great coverage.”
Jennifer Horn, chairwoman of the state Republican Party, did not attend the hearing but she issued a press release opposing the expansion of Medicaid unless Gov. Maggie Hassan can show how she will pay for the state’s portion of the cost.
“We all want better quality health care and Republicans are eager to work toward solutions that will make health insurance more accessible to more people,” Horn’s statement said. “But we should not abandon good New Hampshire programs like (Child in Need of Services) in deference to a federal mandate that will not even be funded.”
The Republican-led Legislature eliminated the money for that program from the budget last session.
Rep. John Hunt, a Rindge Republican, testified for the bill on behalf of the House Republican leadership.
“It’s not because I don’t think (insurance coverage) is important,” Hunt said. “But this is not the right time to do it.” He warned the state’s portion of additional Medicaid coverage would come out of other state programs like higher education.
Pam Ean of Concord also spoke in favor of O’Brien’s bill, warning that increased governmental involvement in health care will increase costs for everyone.
For the next three hours, all but one person who testified spoke against the bill.
Former House member Alida Milham, a Gilford Republican, told committee members it was premature to rule out expanding Medicaid without studying it thoroughly. Paula Rogers, a lobbyist for Anthem insurance provider, agreed.
“To close the door now would be wildly premature,” she said. “If at the end of the day the governor and the Legislature decide we don’t need to expand Medicaid, so be it. But we need to have the discussion, and it needs to be inclusive.”
During his testimony, O’Brien said he worried expanding Medicaid to more people would create an “addiction” to Medicaid coverage.
That didn’t sit well with Sonia Prince of Nashua.
“If we are going to say we need health care, why can’t we say we need health care for everyone?” she said. “I don’t think health care is an addiction. Like clean air and clean water, everybody needs health care. A healthy community is a productive community, and I think that is the goal here.”
Steve Ahnen, president of the New Hampshire Hospital Association, said expanding Medicaid is “simply the right thing to do.”
A committee member asked Ahnen if the hospitals would welcome expanded Medicaid even though some of the state’s hospitals are suing the state over what they call unfair cuts to their Medicaid reimbursements. Ahnen said they would because increasing the number of people with insurance should decrease the number of patients who arrive at the hospital with no insurance at all.
“We believe those reimbursement rates need to be improved, and we want to work with the governor and Legislature to do that,” he said. “But we still want to expand this so (patients) don’t end in the emergency room with a crisis.”
(Annmarie Timmins can be reached at 369-3323, email@example.com or on Twitter @annmarietimmins.)