Most people who don’t rely on Medicaid assume it has little to do with their lives.
I used to be one of them.
Then I attended a recent community presentation hosted by our local library and led by NH Medicaid Matters, a statewide coalition of more than 80 health care providers, advocacy organizations and business groups. What I learned challenged one of the most common misconceptions in New Hampshire: that Medicaid is someone else’s issue.
As the speakers discussed recently enacted state and federal changes to Medicaid now being implemented — and the significant risk they pose to coverage for many recipients — I found myself thinking about my late mother.
Near the end of her life, after health care expenses had exhausted her savings, Medicaid helped provide the nursing home care she needed. It allowed her to spend her final months in comfort and dignity. Until that evening, I had never fully appreciated how many New Hampshire families have stories like hers.
Nor had I considered how deeply Medicaid is woven into the fabric of our rural communities.
The statistics are startling. While about one in eight people statewide receive Medicaid benefits, in my North Country community the ratio is closer to one in five. In a neighboring town, nearly one in three residents are enrolled.
Think about that for a moment.
These aren’t strangers. They are our neighbors, relatives, coworkers, veterans, children, caregivers and people with disabilities. They are the people we see at the grocery store, at school events and at town meetings.
That reality changes the conversation.
When fewer people have health insurance, the effects don’t stop with those who lose coverage. Rural hospitals face greater financial strain. Health care providers absorb more uncompensated care. Local services come under pressure. Costs are shifted to private insurance, Medicare, municipal budgets and ultimately taxpayers.
The consequences spread far beyond the people whose names appear on Medicaid enrollment rolls.
That realization hit me as I looked around the library meeting room. Many of us there could be directly affected by the changes now being implemented. Others, including those who have never received Medicaid benefits, would likely feel the impact through higher medical costs, reduced services, a weakened health care system and growing pressure on local property taxes.
The challenges ahead are serious. But they are not inevitable.
Public policy is shaped by public engagement. When citizens understand what’s at stake, share their experiences, and make their voices heard, lawmakers pay attention. Communities that are informed can advocate for themselves.
Medicaid is often discussed as a budget item or a political talking point. In reality, it is part of the infrastructure that helps hold communities together. The more we understand its role, the better equipped we are to make thoughtful decisions about its future. This is an issue that deserves public discussion in every corner of our state.
Judith Saum lives in Rumney.