November 6, 2013
Expanding Medicaid can be about one of the following two goals, but not both: 1) Getting more people onto Medicaid, or 2) Helping the uninsured gain access to quality insurance coverage. If New Hampshire is to participate in any form of “Medicaid expansion,” it should pursue the latter goal.
When the Legislature convenes in a special session today to consider expanding eligibility for Medicaid, it will have on the table an impressive proposal from Senate President Chuck Morse and Majority Leader Jeb Bradley.
Studies of Medicaid enrollees show that the program improves health care access, but not measurable health outcomes. And because it pays doctors and hospitals a fraction of what it actually costs for treatment, it does not solve the problem of cost-shifting. Nonetheless, there is pressure to expand eligibility from the state’s current 63 percent of the federal poverty level to the Obamacare-demanded 138 percent.
Morse and Bradley have proposed a better way. Rather than throw people onto Medicaid, they would use Medicaid funding to enhance the state’s premium support program. Low-income families would get better-quality private insurance, which pays full hospital and doctor reimbursement rates. And unlike straight Medicaid expansion, eligible people who are already privately insured would not be lured onto Medicaid.
There is little appetite in New Hampshire for doing nothing to expand access to insurance for low-income families. Just saying “no” is likely to result in full Medicaid expansion by making it the only option. The Morse-Bradley plan is a far better alternative.