Concord Chamber considers Medicaid expansion

Last modified: 12/12/2015 12:49:06 AM
As the Greater Concord Chamber of Commerce considers whether to take a stand on the contentious issue of expanded Medicaid coverage, it faces a problem familiar to businesspeople: A decision is needed before all of the information is in hand.

“One of the things I have to caution people against is thinking we’re going to have all the answers right now,” Steve Norton, executive director of the New Hampshire Center for Public Policy Studies, cautioned a breakfast gathering of the chamber.

Expansion of the federal health program for the poor was adopted by New Hampshire in August 2014, but Norton said not enough time has passed for all of its effects to be clear.

It is known, he said, that the expansion added about 40,000 to the 140,000 who were previously covered under the program, and has contributed to a sharp drop in use of emergency rooms by people without any insurance, much to the relief of hospitals that have to cover the expense of what is known as uncompensated care.

But details about what effect this has had on people’s health and what effect it is going to have on health care costs for businesses – not to mention costs to the state – have yet to be determined. Even details of its financial effect on hospitals are uncertain.

“It has had a significant effect . . . but whether the Affordable Care Act has fundamentally changed their financials, we just don’t know,” Norton said.

Charlie Arlinghaus, president of the Josiah Bartlett Center for Public Policy, a free market think tank, told chamber members they shouldn’t expect to see any windfall in terms of lower insurance premiums, partly because the savings from uncompensated care will be less than are sometimes predicted.

“Are your rates going to go down? No, they are not,” said Arlinghaus, who semi-jokingly referred to himself as the speaker who gets called on when a panel wants somebody who is not a booster of expanded Medicaid coverage.

Because the federal government is going to be reducing its coverage of expanded Medicare from 100 percent to 90 percent in a couple of years, the state Legislature is searching for a way to cover what will be at least $40 million in new costs.

“In a state budget where they routinely fight over a million here and a million there, finding $40 million is not an easy thing. They don’t want to use general funds because that would mean cutting other programs,” Arlinghaus said. “There are two parties they’re looking at to pay for this: Businesses and hospitals.

“They’re going to get the money by looking at who benefits. If the business community talks too loudly about how they benefit . . . they’ll get the bill,” Arlinghaus. “If you’re too loud, they’re going to hit you.”

Rejecting expanded Medicaid because of that $40 million in state costs would mean losing at least $360 million that would come into the state as the federal government’s match, several speakers noted.

The third panelist, Borja Alvarez de Toledo, president and CEO of Child and Family Services of New Hampshire, told the crowd that his organization had seen a huge benefit from Medicaid expansion, both in the people it serves and, in some cases, its own staffers, whose wage of under $10 an hour made it impossible to afford health insurance.

He also argued that businesses were already picking up the health care costs for people who had been previously uninsured, even if they didn’t realize it, because so much of their charity dollars went to that.

“It’s very hard to say no to people who have mental health issues and need them. So in the past, we did see a lot of these people,” he said. “Who paid for that? You did 
. . . when you get requests for contributions, requests to fund all this.”

Further, he said, if the Legislature decides not to continue with expanded Medicaid because of the costs, thus imperiling health coverage for tens of thousands of people who were added to the Medicaid rolls in the past year, he has a plan.

“If this doesn’t get approved . . . what I want to do is go to the legislators and say, do you mind making the phone call yourself? We have people who have been using the services, getting better doing something great for their family, and suddenly it will be taken away. So I wonder if you would call them. I have a list,” he said.

The Greater Concord Chamber of Commerce has not decided whether it will take an official position on the matter, said chamber President Timothy Sink. Thursday’s breakfast event at the Grappone Center was designed to help the decision.

(David Brooks can be reached at 369-3313,, or on Twitter 

Concord Monitor Office

1 Monitor Drive
Concord,NH 03301


© 2019 Concord Monitor
Terms & Conditions - Privacy Policy