In states that remain undecided about whether or not to expand Medicaid, as Obamacare prescribes, hospitals have lobbied furiously in expansion’s favor. That’s not surprising, on its face; hospital executives’ eyes widen at the possibility of hundreds of billions in additional taxpayer subsidies under the law. But an analysisfrom the Lewin Group, a prominent health care consulting firm, finds that if New Hampshire expands Medicaid, Granite State hospitals will actually lose $228 million in revenue over the next seven years. How is that possible? Read on.
Democrats control the House, Republicans the Senate
Half of Obamacare’s effort to expand coverage to the uninsured flows through an expansion of Medicaid, America’s government-run health care program for the poor. Thanks to the Supreme Court, states get to choose whether or not to participate in the Medicaid expansion.
The General Court of New Hampshire—the state legislature—must pass a law in order to expand Medicaid; today, party control in Concord is split. Democrats hold a 42-seat majority in the House, while Republicans carry a two-seat majority in the Senate. Maggie Hassan, the governor, is a Democrat. So the expansion will go through if Democrats can convince two Senate Republicans to sign on.
In 2012, the Lewin Group set out to analyze whether or not New Hampshire should expand its Medicaid program, as Obamacare prescribes. Their report, authored by Megan Cole, Randy Haught, and Mengxi Shen, reflects some of the most comprehensive work yet done in a state considering the Medicaid expansion.
Moving people with private coverage into Medicaid
Their findings are revealing. While expanding Medicaid will cost New Hampshire billions of dollars in unfunded liabilities, the expansion would only reduce the number of uninsured individuals in the state by 22,300. A larger number would be moved out of higher-quality, private insurance, and into the dysfunctional Medicaid program.
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