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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.<br/>(ALEXANDER COHN / Monitor staff)

    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. <br/>(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. <br/>(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. 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.<br/>(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. <br/>(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. <br/>(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, atimmins@cmonitor.com or on Twitter @annmarietimmins.)

Legacy Comments21

NOW THIS IS MORE LIKE IT! Honest, open, healthy debate on the pages of the online Monitor. I'm getting all nostalgic . . . and a littler verklempt.

Hey Bruce, you brought up his name. Why don't you enlighten those who are uninformed some of his other quotes. Prove me wrong that he was not a socialist.

It's hard to "prove" a negative. Why don't you enlighten us on how you define "socialist"? And while you're at it, why not define your notion of "extremist" as well? It's a label you and some others on here throw around with reckless abandon. Yet when push comes to shove, it seems your "extremism" label amounts to whatever you happen to disagree with, while at the same time you and other 'conservative' posters on here are the ones who hold the truly extreme positions.

Following up on your comment below regarding FDR and the Great Depression, and why "it went on for so long": the 4 years between 1934 and 1937 saw the fastest peace-time economic growth in our history. Unemployment went from 21% when FDR took office to 9% in 1937. When FDR tried to balance the budget in 1937, the economy went into a recession. When federal spending was increased the next year, unemployment dropped again to about 11% in 1939. The federal government spent too little to combat the Great Depression--not too much. Those who advocate austerity measures now should take note, and see the example of the U.K. as well. http://www.newyorker.com/online/blogs/johncassidy/2013/02/uk-shows-how-austerity-policies-lead-to-more-borrowing-and-debt.html

I don't know what makes this guy tick. So only "illegals" and people who chose not to have it are the only people without health insurance. Try a 60 year old woman who has worked for 40 years and gets laid off when her company closes. Who do you think is going to hire her and give her insurance until she is eligible for medicare in 5 years. And there are many more like me. This man has no conception of people who aren't like him and no empathy everything is about money. And Mr Fearless who do you think will pay for people who go to emergency rooms because they have no insurance? It will still be taxpayers.

O'Brien and the poster below bring to mind 2 adages: that some people know the price of everything, and the value of nothing; and this gem from the late, great J.K.Galbraith: "The modern conservative is engaged in one of man's oldest exercises in moral philosophy, the search for a superior moral justification for selfishness."

Well said, Bruce.

The fact that you quote Galbraith Bruce gives us great insight to how you think. Galraith was a radical keynesian. Very anti capitalism. Felt govt could fix everything. As far as selfishness goes, I think the never ending spending spree the Dems have been on forever is pretty darn selfish. The young folks today should be up in arms about how much they will end up paying for all this spending. What will be left to them is selfish.

There you go tossing around labels like "radical" and "anti-capitalism". It's a practice called "name-calling" and is used as a substitute for dealing factually with a topic. You've defined the terms in your own mind, and use these labels as epithets to toss around as substitutes for real thought.

Actually Tillie, I do not know what makes you tick. Your arguments are based on pure emotion. We all know that doctors are dumping medicare and medicaid patients in droves because of the low reimbursement payments for services they receive now. Now you tell me what happens when 17 million more folks are put on medicaid. Eventually the ACA wil drop the amount paid to providers even more, down to about 52% reimbursements. So do you actually believe that providers will be fine with this? I see it as more providers refusing to accept medicare and medicaid patients. Nice to have insurance, but what if more people are on it and we have less providers accepting it?

Unintentional ironic comment of the day: " Actually Tillie, ...your arguments are based on pure emotion".

If you want the truth about Obamcare and it is the most in depth analysis, you know the "facts" you should read The Obamacare Survival Guide by Nick Tate to see just how Draconian this new law is. Here are the ISBN numbers: ISBN-10: 0893348627 ISBN-13: 978-0893348625 In there you will find exact verbiage and an in depth factual analysis of what is in the bill.

Let me guess... Hmm, none of those people who showed up to speak in opposition to this bill to forbid Medicaid expansion will actually have to pay the taxes necessary to afford this boondoggle. Just another way to raid the bank accounts and pocketbooks of those who work and save to give money to those who won't work or save.

I earn a middle-class income. I pay taxes. I'm in favor of the expansion. I would have testified against the bill if I'd been there. I'm wondering if Mr. O'Brien has thought about what will happen to those people who earn less than $15,000 and will be required to have medical insurance next year or face a fine? A healthy community is the goal here. Uninsured sick people are a drain on the economy and on our productivity. Insuring these people is an investment that will pay off over time.

Cause and effect. Those folks will face a fine due to faulty legislation and a poor health care bill and program. Either way we pay for the uninsured, the difference is that under the present system, those of us who pay our fair share and pay the freight of those who have made poor life choices, don't feel like government is holding a gun to our heads and to be honest, government does little well. Insuring people as an investment is faulty logic, just look at the investment in education and the trillions we have spent to be well down the ladder in quality and what our children learn. Money helps but it it not the solution.

Another example of a post with opinions that don't fit the facts--other than the convenient fact the poster chooses to select. For example, the statement: "...to be honest, government does little well." You mean, for example, the infrastructure built during the Great Depression that put people back to work, and helped bring up out of that failure of unregulated capitalism. Or how about the federal government's role developing the "Arsenal of Democracy" during WW2, that defeated the Japanese, and helped defeat the Axis Powers in Europe? How about the atomic bomb? The Interstate Highway System? The space program that put men on the Moon. Computers? The Internet? Or how about the War on Poverty? It reduced black poverty from 40% to 22% between 1966 and 2000. Half that reduction occurred between 1966 and 1969. The idea that "welfare programs" were a failure is a myth--much poverty among both blacks and whites was eliminated during this time--thanks to investments by the federal government.

The assertion that those who oppose this bill don't pay taxes in general, or don't pay taxes necessary to "afford this boondoggle", as fearless put it, is in error. Nearly everyone pays taxes--gas taxes, property taxes, sales taxes, payroll taxes ( a portion of which help support Medicare). This claim is a conservative smokescreen to divert attention from the fact that incomes in this country have been stagnant for the vast majority over the last 3 decades, while the top 2% have made huge gains--accounting for upwards of 60% of the overall wealth generated during this period. The EITC, a conservative idea embraced by Ronald Reagan and Milton Friedman, is a major reason many Americans pay little or no federal income tax--not unlike GE, for example, which also manages to avoid paying taxes via its own "deductions". One corrective to this dilemma would be to raise the wages of those engaged in the service sector of our economy to a taxable level. This of course would be as popular an idea as the quaint notion that the rich should have their taxes increased. But for most Americans, their overall tax burden is greater than that of, say, a certain recently failed presidential candidate.

Income has been stagnant over the past four years, yes. Over the past three decades? I figured it out and being an average salary earner, my wages over the past three "decades" have risen 100%, so have most of my colleagues. Those GE deductions were compromises made so that liberals could get more taxes and pass more bills. If you raise the wages in the service sector, companies will not be as profitable and they will not staff with as many people. Should a person at McDonalds make $15? $20? What will that do to other wages? It will only inflate those too. Nice plan for inflation, but that is about all.

Got that right ITSA. All one has to do is see what happened with FDR. And why the Great Depression when on for so long. President Obama is doing the exact same thing.

Well, that settles it then. Because your personal experience doesn't correspond with the description of the national trend, that trend must be in error. Good logic there! And it's always good to rely on personal anecdotes whenever one needs to dispute the facts. My post understates the facts on income and wage stagnation for males. Since 1970, the median income for men, when adjusted for inflation, has actually declined by as much as 19%.

So this is what was going on at the State House yesterday. I was downtown yesterday and the streets and parking garages were all clogged. I thought it was another gun rally. But no, it's just O'Brien & Co with the same old, same old. You wore out your welcome a long time ago Mr. O'Brien. Five in favor and 45 opposed. I think we know where this bill is headed.

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