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N.H. Medicaid Hearing Held

Concord — Hospitals, nurses, doctors and other medical providers urged New Hampshire on Tuesday to expand Medicaid to an estimated 49,000 poor adults under the federal health care overhaul law.

They told a special commission charged with making a recommendation to the Legislature by Oct. 15 that they are already treating many of the same people who would gain health insurance through expansion. Many go to hospital emergency rooms because they have no alternative now, they added.

“We see it both as a public health and economic imperative for our state,” said Henry Lipman, speaking for the New Hampshire Hospital Association.

Lipman said a Lewin Group study done for the state last year used old information when it estimated hospitals would be better off financially if New Hampshire did not expand Medicaid.

Americans for Prosperity, which opposes Medicaid expansion, had called attention to an analysis based on the Lewin study showing the providers would see a $45 million loss in net income if expansion is approved.

The providers said that expanding Medicaid would result in more cost-effective care to the poor.

Dr. David Green of Concord Hospital said when people don’t have insurance they are more likely to wait until their illness is an emergency and seek costly emergency room care. The urology specialist said he may see a patient with an infection that could have been treated much sooner and for a fraction of the cost by a primary physician.

Tess Kuenning, president and chief executive officer of Bi-State Primary Care Association, estimated 35,000 of the 122,000 patients seen by the association’s community health centers are uninsured. Expanding Medicaid won’t tax the health care system as some fear by adding patients to doctors’ appointment calendars, she said.

“These patients will not magically appear. Most are already in the system,” she said.

State Rep. Jack Flanagan, a Republican from Brookline, sounded a note of caution. Flanagan said he understood peoples’ concerns, but he was not sure expanding Medicaid was the solution. He also said eventually New Hampshire taxpayers will have to pick up more of the cost.

“I don’t know where we’re going to come up with the money. This may be the camel’s nose under the tent to an income tax,” he said. New Hampshire does not have a personal income tax.

New Hampshire’s current Medicaid program covers low-income children, parents with nondisabled children under 18, pregnant women, senior citizens and people with disabilities. The expansion would add anyone under age 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,000 for a single adult.

States can choose to expand Medicaid as part of the new federal law, which will be implemented starting Jan. 1. That’s when an estimated $2.4 billion in federal funding the state would get over seven years would kick in.

If New Hampshire were to expand the program, the federal government would pick up the full cost for the first three years and 90 percent over the long haul. States can withdraw from covering adults at any time without penalty.

The commission was established as a compromise in the budget debate. Democratic Gov. Maggie Hassan and the Democratic-led House wanted to authorize Medicaid expansion in the budget bill, but the Republican-led Senate insisted on establishing a commission to study the issue first.