October 03. 2013 8:50PM

Expanding coverage: Will NH go DC's way?


Preparing for a final vote on Medicaid expansion, the state commission appointed to discuss (not study) the issue has sort of endorsed expanding subsidized health insurance — but not necessarily Medicaid — to people who make no more than 138 percent of the federal poverty level. But why?

On Tuesday the commission voted to recommend offering subsidized health insurance coverage up to Obamacare's income target for expanded Medicaid, which happens to be 138 percent of the federal poverty level. New Hampshire now cuts off Medicaid eligibility at 63 percent of the poverty level. The only reason for the new cutoff level is because Nancy Pelosi, Harry Reid and Barack Obama settled on it as a politically viable figure. This is no way for New Hampshire to make state policy.

New Hampshire, famously frugal, always has found less expensive, more efficient ways to meet policy goals. Expanding Medicaid eligibility to the arbitrary cutoff of 138 percent of the poverty level (why not 100 percent, or 125?) is neither compassionate nor efficient nor cost-effective. (People would be much better off with private coverage than with Medicaid.) Expanding subsidized health insurance coverage (the state already offers premium support for certain low-income residents) is a better way, but the state, not Washington, should decide the details.

Obamacare has pushed the state down a path that it cannot afford to travel, and the commission is preparing to clear the way. But it is the Obama way, the Washington way, not the New Hampshire way. If we do not find our own course, it will be a monumentally costly mistake.