Editorial: Just call us ‘The Donor State’

Last modified: 5/30/2013 12:09:00 AM
Senate President Peter Bragdon and his fellow Republicans on the Senate Finance Committee, Sens. Bob Odell of Lempster, Jeanie Forrester of Meredith and Chuck Morse of Salem, want to make New Hampshire “The Donor State.” The full Senate should tell them no thanks.

New Hampshire residents traditionally get a smaller percentage of their federal tax payments back in funds from the federal government than residents in almost every other state. One recent analysis put New Hampshire fourth from the bottom, behind Connecticut, New Jersey and Nevada, at just 71 cents on the dollar. If New Hampshire refuses to accept federal money under the Affordable Care Act, it will almost certainly move to dead last and become the state that pays the most but gets the least for its money. Those three states all plan to accept federal money to expand Medicaid to cover low-income adults, albeit grudgingly on the part of New Jersey Gov. Chris Christie, a staunch opponent of Obamacare.

Listen, Sens. Bragdon, Odell, Forrester and Morse, to Christie, as he explained his decision:

“Accepting these federal resources will provide health insurance to tens of thousands of low-income New Jerseyans, help keep our hospitals financially healthy and actually save money for New Jersey taxpayers. Expanding Medicaid is the smart thing to do for our fiscal and public health,” Christie said at a press conference in February. New Jersey expects to save $227 million by expanding Medicaid access.

On a smaller scale, the same thing would happen here, which is why Gov. Maggie Hassan, the House, the state hospital association, Health and Human Services Commissioner Nick Toumpas, advocates for the poor and countless others support the expansion.

Bragdon and his fellow Republicans instead want to spend $200,000 to create a commission to study the impact on the state of expanding Medicaid. But no commission will be able to give the opponents the assurance they want: that no future president or Congress will vote to reduce the federal government’s 90 percent share of the cost of the expansion. But in the unlikely event that happens, the law allows New Hampshire, or any other state, to opt out of the program.

The opponents also want to see hard evidence that expanding Medicaid will improve health-care outcomes and save money. Logic, and lots of health care experts, including the consultants hired to provide an analysis of the expansion’s effects, say savings will occur, particularly if patients receive care that keeps them out of emergency rooms. But achieving savings from prevention could take years.

Meanwhile, New Hampshire will lose $2.5 billion in federal funds in the next seven years alone. An estimated 22,300 people will go without coverage, the cost of caring for the uninsured will continue to be shifted to the insured and the businesses that employ them, and poor people who need health care will be denied it. Lost too will be the 700 jobs the federal money is expected to create and the boost to the state’s economy that comes with a massive federal infusion of cash.

The federal government has pledged to pay 100 percent of the cost of expanding Medicaid in the first three years, 93 to 95 percent for the next three, and at least 90 percent thereafter. If New Hampshire doesn’t take the money, insurance costs for everyone else will increase, its residents will pay to provide health care for most of the nation’s poor while denying care to their own state’s low-income residents. New Hampshire lawmakers would in effect be saying, “Sure, tax us and send nothing back. We’re the Donor State.”

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