NHDP - ICYMI -- Telegraph Editorial: "Republican plan a cruel joke"

Key Point: :"That Republicans offered anything in response is an indication that they grasp the political consequences of just saying “no” to so many people in real need of more consistent medical assistance. They realize that they have to put something on the table.

 
"Their proposal is a cruel joke. It would cost the state $46 million, cover less than a quarter of the people covered by the federal plan, and cost those remaining beneficiaries more out of their own pockets. It was authored by a senior fellow at the Manhattan Institute at the request of committee member Sen. Nancy Stiles, R-Hampton."


Nashua Telegraph Editorial: Republican plan a cruel joke

Sunday, September 15, 2013
Seriously, folks, even David Lynch couldn’t make this stuff up.
 
We’re talking about the New Hampshire Legislature and health care.
 
On Tuesday, the special committee charged with coming up with a recommendation on expanding Medicaid coverage to nearly 60,000 Granite State residents met to hear a Republican alternative to the federal plan that is part of the Affordable Care Act.
 
That Republicans offered anything in response is an indication that they grasp the political consequences of just saying “no” to so many people in real need of more consistent medical assistance. They realize that they have to put something on the table.
 
Their proposal is a cruel joke. It would cost the state $46 million, cover less than a quarter of the people covered by the federal plan, and cost those remaining beneficiaries more out of their own pockets. It was authored by a senior fellow at the Manhattan Institute at the request of committee member Sen. Nancy Stiles, R-Hampton. Maybe it was a good idea in principle, but even Republicans had a hard time cozying up to the notion of paying more and getting less.
 
Republicans called Democratic condemnation of the plan an overreaction and said the proposal was at least a first step in trying to find a “New Hampshire solution.” Whether Republicans can dress up this pig enough so it can become part of a “minority” response to the committee’s final report remains to be seen. Certainly, there is a lot of work to be done in a short time.
 
The key phrase in the partisan exchange is “New Hampshire solution.” For months now, Republicans have been lecturing the public that the biggest reason the state should not sign on to the administration’s Medicaid expansion program is because the federal government can’t be trusted to come through with the promised Medicaid funding. Sure, the argument goes, the feds say they’ll pay 100 percent of the cost for the first three years and 90 percent per year after that, but look how they reneged on special-education funding.
 
That’s a fair point, until one considers Wednesday’s hearing by a special commission assigned to decide if the state should broaden the number of taxes it levies on hospitals.
 
The panel was told that the federal government allows states to apply hospital taxes to 19 categories. New Hampshire taxes just two. That leaves many other categories ready for the picking.
 
What kind of taxes are these? Why, Medicaid- reimbursed taxes, of course.
 
For a couple decades, the state has taxed hospitals so it could get matching Medicaid money to run the state government and reimburse hospitals for caring for the poor. Until 2011, the state refunded the taxes to hospitals, and everyone was more or less happy with an arragement affectionately referred to as “Mediscam.” Hospitals were held harmless, and the state received a revenue windfall.
 
Then, two years ago, the state stopped paying the hospitals and kept the money to balance the state budget. That prompted a legal suit that has yet be resolved.
 
There is much debate over what medical services could or should be taxed. It’s unlikely that the special commission will recommend going after all categories. Even if it recommends a few, though, that could mean millions more in Medicaid dollars flowing into the state’s treasury.
 
Whatever decision the commission makes, one thing is certain. Republicans will reject it out of general principal because, as they’ve been schooled, the federal government can’t trusted to make good on its Medicaid promises.