Lily J. Greene of Wolfeboro is a third year medical student at Geisel School of Medicine at Dartmouth in Hanover.

As a medical student, I’ve spent countless hours learning about cancer —how to diagnose, prevent, and treat it. Cancer remains the second leading cause of death in the U.S., making it essential for all Granite Staters to have access to comprehensive cancer care.

However, this requires affordable health insurance coverage. The New Hampshire Medicaid expansion program provides this type of coverage to low-income individuals. However, the fate of Medicaid is at risk. In 2023, state legislators are considering reauthorization of the New Hampshire Medicaid expansion program. Without reauthorization, thousands of Granite Staters could lose their insurance and access to health care by the end of the year. The state legislature must reauthorize this program to ensure those enrolled continue to receive the care they deserve.

Expanding Medicaid in 2014 created an essential insurance safety net in the state. Before expansion, New Hampshire limited Medicaid enrollment to people with very low incomes. This constraint left thousands of Granite Staters uninsured, especially people who earned too much for Medicaid but not enough to buy individual insurance. Medicaid expansion helped fill this gap by easing the enrollment eligibility requirement, offering low-income adults insurance that would otherwise be unaffordable.

Over the past nine years, the New Hampshire Medicaid expansion program has provided healthcare access to over 200,000 people. As of December 2022, there were over 90,000 people enrolled in the program. Five years after the initial expansion, the number of uninsured citizens in the state dropped by 42%. Moreover, growing research shows that Medicaid expansion improves chronic and potentially life-threatening conditions like cancer.

We can learn from the dozens of states that have created Medicaid expansion programs like New Hampshire’s. For example, Medicaid expansion has increased breast and colon cancer screening, leading to disease diagnosis at more treatable stages. Researchers also observed earlier diagnoses for rare but harder-to-treat cancers, like pancreatic and stomach cancer. Earlier diagnosis can mean more surgery options, including less invasive colon and breast cancer procedures. For cancers diagnosed at a later stage, adequate insurance coverage is essential for timely treatment that can improve both the length and quality of life. The success of these programs shows that Medicaid expansion significantly improves all aspects of cancer care.

As the New Hampshire legislature considers Medicaid expansion reauthorization this term, they must examine the substantial benefits of this program. Medicaid expansion significantly increased health insurance coverage for low-income adults across the state. In addition, Medicaid improves healthcare access, increases the chances of timely treatment, and saves lives. Failing to reauthorize this program would be a grave disservice to the over 90,000 Granite Staters who rely on it and would drastically limit access to cancer care in the state.

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