Now that the Legislature is back in session, the scramble is on to prioritize which bills, resolutions and amendments are deserving of attention first.
Several pieces of legislation addressing the state’s opiate addiction epidemic and its consequences have been among the first to receive space on the docket, and deservedly so.
Lives unquestionably hang in the balance there; and so, too, do they in the case of access to health care.
In 2014, in a bipartisan, brokered deal, the governor and Legislature agreed to expand the state’s commitment to helping those eligible for Medicaid, the state/federal partnership that offers medical coverage to the poor. The N.H. Health Protection Program has, since then, enrolled roughly 45,000 Granite Staters in private insurance plans backed by federal funding. But part of the deal was that coverage would only run through 2016, unless the Legislature renews its commitment. And under the Affordable Care Act, federal funding for the program will taper from 100 percent to 90 percent by 2020. So, the Legislature agreed to fund the program only as long as the feds pay the full freight.
The easy argument here is one we’ve made before: Extending access to affordable health care is the morally correct thing to do. No one should suffer declining health for want of the means to be treated. And that undeniably occurs when Americans are denied health care coverage.
But our state Legislature’s moral compass too often follows the money, rather than pointing true north. So let’s look at the fiscal argument, which is just as compelling.
For 2016, as in 2015, the argument is a no-brainer. Under Obamacare, the federal government is paying all of the cost of the expanded coverage. So, with no cost to the state government, there’s no debate for lawmakers.
Starting in 2017, however, the state will be on the hook for 5 percent of the cost. That’s estimated to cost taxpayers $12 million in the next biennial budget. By 2020, when the full 10 percent of the cost kicks in for the state, the total could be $36 million.
That’s a lot, though not overwhelming, as it would be less than 0.4 percent of an 11-figure biennial state budget.
Last summer, legislative leaders fought a three-month war with the governor to reduce state business taxes. When fully in effect, that tax cut would save the state’s businesses between $78 million and $90 million, depending on whose numbers you use.
On the other hand, expanding Medicaid access saved the state’s hospitals more than $142 million in 2015 alone, by reducing the cost of treating uninsured patients. That cost, which hospitals absorb or pass along by charging more to others, is expected to continue falling this year. And if you think hospitals, being nonprofit organizations, aren’t among the most important businesses in the state, consider Cheshire Medical Center/Dartmouth-Hitchcock Keene is this area’s largest employer.
The economic benefits to the state don’t stop there, though. The uncertainty surrounding whether the Legislature will continue the expanded coverage has been blamed for inflated health-insurance rates being charged to companies for their employees’ coverage.
And there’s the productivity increase attributable to having workers actually working, rather than taking time off because they’re sick, having foregone medical treatment because they had no insurance.
Granite State businesses understand the benefits. The Business and Industry Association of New Hampshire has been on board from the start, and a new organization, ExpandNH, has strong business support.
Oh, and regarding that opioid epidemic: About 1,700 Granite Staters gained access to substance-abuse treatment through the expansion in 2015. In a state where more than 400 deaths were registered in 2015 stemming from opioid overdoses, that’s worth something, too.
