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Should New Hampshire find alternate ways to fund Medicaid Expansion?

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Medicaid is health insurance coverage for certain low income groups of people, including dependent children and their parents, those 65 and older with disabilities, and pregnant women. The federal government and each state share the cost of covering almost 1/5 of America’s population that qualify for Medicaid.

In 2010, the U.S. Congress passed President Obama’s Affordable Care Act (ACA), with the intention of ensuring that all Americans had health care coverage.

A key component of the ACA was Medicaid expansion

Medicaid expansion extends health insurance to adults without dependent children and who aren’t disabled.

In order to encourage states to join the program, the Federal Government offered to fully fund the program through 2016, followed by a gradual shift of the cost to the states leveling off at 90% in 2020.

New Hampshire’s portion is estimated to cost the state approximately $50 million over the next two years.

How is NH currently footing its portion of the bill?

A bi-partisan group of legislators came up with a solution to avoid spending New Hampshire’s money. Instead of the state footing the bill, hospitals and insurers make voluntary donations, channeled through a non-profit, to cover the state’s portion of Medicaid. The state says it purposely does not know how much each individual hospital is contributing.

However, the federal government’s Center for Medicare and Medicaid Expansion believes that New Hampshire’s plan may be an illegal quid pro quo type of situation, whereby the donating providers may receive all or a portion of their donation back through Medicaid payments. They have given New Hampshire until 2019 to find another financing solution or face possible withdrawal of federal funds.

Not only are more people receiving much needed coverage but the state benefits too

Those who support New Hampshire finding alternate methods of funding Medicaid point to the 50,000 citizens who now rely on Medicaid expansion for their healthcare. Proponents say Medicaid expansion has created jobs resulting in a healthier economy. They also advocate that the savings recognized in other state programs offsets the costs of Medicaid expansion.

Others say it’s time to pull the plug

Opponents of Medicaid expansion argue whether the state budget should include giving able bodied adults who can work free health insurance. They say funding solutions, such as the institution of a broad-based tax, or cutting other state programs, are not viable, and call another plan that has been proposed—getting hospitals and insurers to pay a mandatory tax—unrealistic.

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