As we enter the New Year, I encourage our new Legislature and Gov. Chris Sununu to focus on four health care priorities.
First, it is time for New Hampshire to develop a paid family and medical leave program. All working citizens deserve the opportunity to take a reasonable amount of time off from work, without risking financial collapse, in order to care for an unexpected illness, the increased medical needs of a disabled family member or the arrival of a new child.
A paid leave program would be funded by a small weekly contribution from the employee and his/her employer, and would provide each worker a portion of their salary during the time they are on leave. Such a program would strengthen the health of families, stabilize our work force, attract young families to our state and enhance workers’ morale and productivity.
Second, in the spring of 2018 New Hampshire renewed participation in expanded Medicaid. Persons with incomes up to 138 percent of the federal poverty level are eligible to enroll. The 138 percent figure translates into an annual income of $16,753 for an individual and $34,658 for a family of four.
In the next few months the Granite Advantage Medicaid expansion law will require all enrollees, save those with exemptions, to engage in 100 hours per month of work or alternative forms of community engagement.
Imposing a work requirement on Medicaid recipients remains a controversial policy with as yet uncertain results. Our governor and the Department of Health and Human Services should carefully measure and analyze the impact of this experimental work requirement. Particularly important data to follow include a comparison of the number of insured and uninsured persons in the Granite Advantage eligible population, and an analysis of the health outcomes and the amount of uncompensated care and emergency department visits these two groups generate over time.
Third, the 10 Year Mental Health Plan for New Hampshire, recently released by the Department of Health and Human Services, has received enthusiastic support from clients, providers and advocates in the mental health system. This plan proposes to further integrate mental health care and primary medical care and to increase substantially the size of our state’s mental health work force. In addition, the plan seeks to invest increased resources to address the current opioid crisis and fix the cruel and unacceptable pattern of requiring persons in mental health crisis to wait several days to weeks in hospital emergency departments before being transferred to New Hampshire Hospital.
Gov. Sununu and the new Legislature should endorse and fully fund this 10-year plan.
Fourth, the New Hampshire House and Senate will consider bills this session that propose to establish a commission to study the costs and benefits of different ways to reorganize our national health care in order to provide “health care for all.” At the federal level various proposals under discussion include “Medicare for All,” maintaining the current mix of multiple private insurance companies, and adding a public option to our current choices of private insurance. It would be foolish not to prospectively consider these various models of health care funding as we face the need for fundamental improvement in the cost and clinical results of our health care.
So, we in New Hampshire have a lot of work ahead of us to improve the quality, cost and availability of health care for all Granite Staters. I encourage each citizen to join the conversation by speaking up about the problems and successes we are experiencing in dealing with our health needs.
Let our health care providers, our family members and co-workers, our insurers, and, yes, our legislators know about the financial and organizational burdens we face in trying to maintain our health in our current system of care.
Please remain attentive to our Legislature’s actions and our governor’s decisions on the above four health care priorities. And let us be inspired by the shared conviction that affordable, effective health care is a right for all of us and not a privilege for some of us.
(Dr. Randy Hayes is a retired family doctor, co-convener of the Kent Street Coalition Healthcare Working Group and member of Canterbury Citizens for Democracy.)