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State House Memo: Medicaid expansion is important to North Country

e_SSLqA half a million dollars,” says the young man and nods toward the shiny, red fire engine parked in one of the two bays of the Stark Fire Department. Nearby hungry customers are bowed over a hearty breakfast to raise money for the local fire-safety operation.

“Nice,” I say, and wonder how a town with just 516 residents can afford such a luxury in such tough times. Assuming all this, a more senior member of the department explains that the town applied for a federal grant and lo and behold got it. Stark is proud of its fire engine and ideologically content with taking from the federal dole.

New Hampshire likes federal money too – with a full 30 cents of every dollar of state revenue coming from the federal government. If we weren’t such a wealthy state, we could grab more. The logic has been that it’s better to pick the pocket of the federal government than that of local taxpayers. Republican legislative leaders are breaking from this tradition and want to take a stand on principle by refusing big federal bucks to expand Medicaid to cover low-wage workers. A few years ago, the state notably found a way to peel Medicaid money from poor people to fill a persistent budget gap.

Medicaid provides health care services to low-income and some disabled people. It is managed by the states, and New Hampshire is one of the few states to continue to use a so-called “fee for service” model, meaning each procedure has a set price established and has the distinction of having the lowest provider reimbursement rate in the country.

This leaves the providers – in most case the hospitals – short. Typically, the state pays about 50 cents on every Medicaid billed dollar. But short is better than nothing, which is what providers get when a patient is without coverage – so expanding Medicaid is very popular with the state’s financially ailing and overstressed hospitals, especially those in the North Country with a high rate of uninsured and poor.

If Medicaid is expanded, an estimated 5,000 people in the North Country, mostly people holding low-paying jobs (from service workers to school para-professionals) who can’t afford health insurance or much preventive care, will get basic coverage. And they will presumably catch problems and seek treatment sooner and use health care more efficiently and not use the most expensive portal to health care – the emergency room. Now, when forced by accident or illness to get care, they burden our local hospitals and eventually the cost of all of our insurance premiums. Another benefit with expanding Medicaid is that it rewards and encourages work. It puts work on par with welfare – and who could be against that?

Senate President Peter Bragdon said this is a “risky gamble” because the feds might back out and leave the state hanging. It’s a logic lost on Republican governors around the country who see a deal they can’t refuse. Saying no to federal money doesn’t reduce the federal deficit – it only shifts money away from our residents, hospitals and local economy. By extending Medicaid, we leverage federal money to solve local problems.

(State Sen. Jeff Woodburn is a Democrat from Dalton.)

Legacy Comments9

Hey folks, whether we accept this or not, the Federal taxes we NH residents pay will cover the cost of Medicaid expansion in other states. What kind of morons would we be, knowing we have so many working poor who'd benefit, along with the jobs and economic development that goes along with increased access to healthcare, to say "no thanks; we'll continue to fund everyone else but ourselves?" For all the griping some do about how little return NH sees from its Federal taxes paid by residents, you'd think we'd jump on this. The road-blockers in the Senate have no logical explanations for delay. A "study" has already been done - they just don't like its conclusions.

St. Sen. Woodburn, I know how much any additional revenue means to the north country, especially for health care. That said, do you really have constituents who believe something comes for free? Somebody else is putting in hours on the job to pay for the added benefit. Is that what they have been told;, "You get more care for free!". Look at CA; " Quoted from Forbes, "..California claimed that its version of Obamacare’s health insurance exchange would actually reduce premiums. “These rates are way below the worst-case gloom-and-doom scenarios we have heard,” boasted Peter Lee, executive director of the California exchange. But the data that Lee released tells a different story: Obamacare, in fact, will increase individual-market premiums in California by as much as 146 percent" 146%! Maine mandated more "free" care for children (Bill Clinton's reason for almost everything) - then extended to adults and then will not pay for it! Putting more burden on hospitals and providers. Is this what New Hampshire needs?

T - the Forbes article may not be a good source for unbiased info on this subject. Have a look at Ezra Klein's critique of the Forbes writer's methodology. http://www.washingtonpost.com/blogs/wonkblog/wp/2013/06/01/the-shocking-truth-about-obamacares-rate-shock/

Pub, Could be right but axiom is unshaken. High level professional care (or anything else for that matter) do not come for free. The cost comes out of the pocket of someone who put in work hours. if it is agreed upon shared societal obligation, that is one thing but if its a "Robin Hood" move (taken from someone that some else thinks has more money than they need - that stinks. In addition - if the case is the latter - that tax weapon can also be used on you! Current events illustrates the current administration will shamelessly steal tax payer money to put forward thier socialist agenda.

Ezra Klein. Founder of Juro List, a forum of leftiest journalists who plot to destroy conservatives and promote Obama. Klein thinks that the Nazis were not all that bad. Hitler was a vegetarian, and they did a pretty good job of promoting economic growth and provided a good standard of living. Yeah that is a source that one should look to for accurate, unbiased information.

RabbitNH, you are on a hot streak today.....taking the wind from my sails......you nailed it as usual

This is the genetic fallacy in spades. If you can't argue the facts, take a shot at the speaker. And some people (Itsa, for example) fall for it without thinking.

""Stark is proud of its fire engine and ideologically content with taking from the federal dole"" anyone agreeing to this philosophy has no right to complain about "any" amount they are taxed. If this town can be given a fire truck then why not every town in the country, they all pay taxes? A fire truck here, a town clock over there and a bridge to nowhere for every city. Everybody has their hand out as the citizens of these towns don't want to pay for their own town. Some like to say "That's the way it works so we need to get our share", well then stop complaining about the taxes you pay.

the demonizing democrats actually believe that FEDERAL $$$$ are FREE $$$$$$$.......in a country run by democrats when it comes to Santa Clause VS common sense frugal budgeting - what do you think wins?

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