Policy: Entitlements

Uninsured, providers urge expanding Medicaid

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Associated Press,New Hampshire,Medicare and Medicaid,Entitlements

CONCORD, N.H. — Uninsured New Hampshire residents and medical providers urged House and Senate panels considering competing plans Tuesday to back expanding Medicaid to cover an estimated 49,000 poor adults.

Kyle Boesch, a 23-year-old recovering heroin addict from Northfield, told the House Finance Committee he earns about $275 a week from two jobs. Boesch said he's been in jail but is turning his life around. He said he recently needed a cortisone shot for his back that cost $900 he does not have.

"If something happened to me, I'd lose both jobs," he said.

A number of residents of Phoenix House, a drug rehabilitation facility in Dublin, told the House committee they can't afford the ongoing treatment they need to keep them from spiraling back into alcohol or drug addiction.

"I'm asking, better yet, I'm begging you to vote to expand Medicaid," said Shawn Chapin, who said he struggles with drug and alcohol addiction.

Later Tuesday, spokesmen for hospitals, doctors and other health care providers told a special Senate panel considering a different approach that they support expansion and hope the House and Senate can reach a compromise.

Steve Ahnen, president of the New Hampshire Hospital Association, said it is critical for New Hampshire to provide access to health care to the uninsured.

"Failure should not be an option," he said.

The House and Senate expansion plans are essentially the same for the first year, but take different approaches after that. Both start by using federal Medicaid funds to pay for private insurance for eligible adults already on employer-sponsored plans and enrolling others into a managed care program. The House continues that for two more years while the Senate shifts people onto private insurance through the federal insurance marketplace.

Both plans would require federal waivers and would end the expansion if federal financial support fell below promised levels. The Senate would give the government one year to approve its use of the marketplace or the expansion would end.

The Senate plan also would end automatically at the end of three years when federal funding begins dropping below 100 percent unless the Legislature reauthorized it.

"This is not an entitlement," Senate President Chuck Morse, prime sponsor of the Senate bill, testified.

Insurance Commissioner Roger Sevigny cautioned the Senate panel that its timeline is ambitious. Sevigny said he has not heard of any companies preparing to enter the marketplace as the Senate plan envisions in 2015 to join the lone provider, Anthem Blue Cross and Blue Shield.

Kevin Klein of Well Sense Health Plan, one of three companies providing managed care to the existing Medicaid population, said his company spent a couple million dollars developing the network it has and would have to spend a similar amount developing a new product to become a qualified health plan in the marketplace.

"I'm not saying it's impossible, but it would have to make business sense," he said.

Meanwhile legislative leaders and Gov. Maggie Hassan continue to work behind closed doors to find a compromise.

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