"Real liberty is neither found in despotism or the extremes of democracy, but in moderate governments.
Alexander Hamilton

Sunday, June 25, 2017

Medicaid Critical For New Hampshire

The US Senate last week released it's version of a healthcare bill which proposes a fundamental restructuring and deep cuts to Medicaid.
A study from 2011 by the American Cancer Society Cancer Action Network , was meant to show how important Medicaid is for Granite Staters with serious health care needs, focusing on four groups, the number of Granite Staters with cancer, diabetes, chronic lung disease, or heart disease or stroke who rely on Medicaid for their health coverage.
The following charts are the results of the study.



















Keep in mind that much of the Medicaid Expansion under the Affordable Care Act had not occurred at the time of the study, so in all probability, the above numbers would be even higher.

The Senate bill is proposing capping Federal funding to states for Medicaid on a per capita basis and let each state essentially determine how that money is distributed.  According to the report  "Without a guaranteed federal match that moves in tandem with state spending, states would have more difficulty operating their Medicaid programs in hard times, making Medicaid a much less reliable health care safety net.
Cuts to the Medicaid program, whether cuts in federal Medicaid funding or cuts at the state level, would mean the loss of essential health care for Granite Staters who rely on Medicaid, including thousands of Granite Staters with serious health care needs."

Not covered in the above report is the potential impact to long term care and nursing homes in NH. Under federal law, state Medicaid programs are required to cover nursing home care. Each state though can decide how much to pay nursing homes. In NH where we have very limited revenues, budgetary pressure  could decrease what they pay or restrict eligibility for coverage. Nationally, 42% of all Medicaid spending is on long term services. 
 In New Hampshire, Medicaid accounts for about 65 percent of the revenue of the state’s nursing homes, according to  the Nursing Home Operators Association New Hampshire nursing homes get about $161 per Medicaid patient, which is last in the nation. If Medicaid is capped at a time when the NH demographic is aging and more and more residents will need long term care, where will the money come from? If it's county nursing home, the answer is easy: your county tax rate will go up.

These are critical issues that must be factored into any decision on health care legislation, whether in Washington or Concord. The discussion instead has focused on ideology and politics instead of people. These are matters that should transcend politics and political ideology. Real people and families will be impacted, not just statistics. 




1 comment:

William M Marsh said...

Happy 4th Paul!

You might also point out how the repeal of Medicaid expansion might affect state, local, school and hospital budgets.

Here are some good links:
http://www.nhha.org/index.php/whats-new/1419-nhha-statement-on-cbo-score-of-proposed-senate-better-care-reconciliation-act
http://www.sentinelsource.com/news/local/n-h-schools-warn-proposed-medicaid-cuts-could-hurt-local/article_07b9ae28-6691-508a-9187-5523ae68ebc2.html
http://www.insidesources.com/sununu-medicaid-expansion/

I spoke against a bill to repeal Medicaid Expansion this session: (speech begins at 11:03.00)
http://sg001-harmony.sliq.net/00288/Harmony/en/PowerBrowser/PowerBrowserV2/20170309/-1/13178

Rep. Marsh