Hello Friends of the RLCNH,
I attended the Senate Republican press conference this afternoon regarding Medicaid expansion. I have enclosed a summary of where we are with both Medicaid expansion and the Republican alternative (spoiler alert: both plans are unacceptable). We only have until 11/21 to prevent the largest budget increase in New Hampshire state history. I have begun a liberty tour and will be traveling across the state discussing Medicaid expansion and recruiting candidates. I will share the details on the trip and look forward to meeting with you to discuss our strategy.
Medicaid Expansion Myths
Myth 1: Medicaid expansion is not part of Obamacare.
The expansion of Medicaid was mandatory under the Affordable Care Act. The Supreme Court ruled that states can opt-out of Medicaid expansion. A vote by New Hampshire Legislators in favor of Medicaid expansion is a vote for Obamacare.
Myth 2: Signing-up for Medicaid expansion will SAVE New Hampshire Money:
According to the Lewin Group, New Hampshire would actually save between $66-$114 million if Medicaid is NOT expanded (between 2014-2020).
Myth 3: Medicaid improves health outcomes:
A study of more than 12,000 adults published in the New England Journal of Medicine concluded that "Medicaid coverage generated no significant improvements in measured physical health outcomes." The study also "did not find significant changes in visits to the emergency department or hospital admissions."
Senate Republican Plan Myths
Myth 1: The Republican Senate leadership is opposing Obamacare: The Senate Republican plan involves taking $2.4 billion in federal money provided through Obamacare Medicaid expansion.
Myth 2: The Republican Senate plan uses private health insurance and will not expand Medicaid rolls in New Hampshire:
Although the plan may ultimately funnel federal money to private managed care organizations, for at least 10 months at the start of the program, the federal funds will be used to expand Medicaid in New Hampshire.
Myth 3: The Republican Senate plan will be 100% paid for by the federal government and NH will not have to implement and income tax:
The current Medicaid expansion plan contemplates 100% reimbursement for the first 3 years, and then a gradual reduction to 90% over a number of years thereafter. The Republican Senate plan contemplates that unless the federal government continues the 100% subsidy at the end of 3 years, the program will sunset. The probability of the NH legislature taking away an entitlement in 3 years is highly unlikely given the lack of precedent for any politician at the federal or state level demonstrating a willingness to take away an entitlement. By necessity, NH will have to implement a state income tax to cover the new costs.
Myth 4: We can count on the federal government to fund this program:
Due to a series of increases in the debt ceiling (now exceeding $17 trillion) and multiple government shutdowns, the credit rating of the United States has been downgraded by a number of entities (starting with Standard and Poor’s). The federal government has racked up over $128 trillion in unfunded liabilities directly related to entitlement programs. Over the years, the federal government has lowered their reimbursement rates through Medicare and Medicaid. In New Hampshire, the federal government cut their reimbursement rate for special education programs from 40% to 17%. Relying on the federal government to fund the largest budget expansion in New Hampshire state history is financially unwise, and will lead to a further erosion of state sovereignty.
Myth 5: We have to act now:
Obamacare has been hastily implemented with disastrous consequences. Just this week, 22000 New Hampshire residents received insurance cancellation notices. The exchanges are NOT functioning properly, and the Healthcare.gov website has been plagued with errors. While Governor Hassan would like to take advantage of this special session to cram through a massive entitlement, there is no need to act at all during this special session.
Aaron Day, Chairman
Republican Liberty Caucus of New Hampshire
75 South Main Street
Concord, New Hampshire 03301