CONCORD — Federal expenditures on Medicaid are "soaring in New Hampshire and per-enrollee spending is rising exponentially," according to the chairman of the U.S. Senate Committee on Homeland Security and Governmental Affairs, who wants some answers from Gov. Chris Sununu.
In a three-page letter delivered Wednesday morning, Sen. Ron Johnson, R-Wis., submitted a list of questions designed to determine why the cost for new Medicaid beneficiaries in the state is rising so dramatically, up 253 percent from 2014 to 2015.
"Please explain why newly eligible enrollment under the ACA Medicaid expansion is rising faster in New Hampshire than projected, and why per-enrollee costs under that expansion are rapidly increasing," writes Johnson. "Has New Hampshire taken any steps to control these costs, and, if so, what are those steps?"
Johnson’s committee is examining the Medicaid expansion implemented in many states, including New Hampshire, as part of the Affordable Care Act, aka Obamacare.
Medicaid expansion in New Hampshire sunsets at the end of 2018 unless the state comes up with a way to continue the program. A special legislative commission to evaluate the "effectiveness and future of the program" met Wednesday in Concord for an actuarial report on the growing costs of Medicaid expansion and its effects on premiums across the board.
Against that backdrop, Sununu is being asked to explain why the projected cost of newly eligible adults in New Hampshire for 2015 was $4,281, but ended up at $6,365, a 49 percent difference.
The governor is asked to respond to several data requests, including enrollment figures for 2016, per-enrollee spending on Medicaid expansion for 2016 and projected enrollment for 2017.
Johnson also asks Sununu to explain how the state determines eligibility for newly eligible Medicaid enrollees, and how the state verifies that applications are accurate.
"Please explain whether New Hampshire has commissioned or contemplated any audits to examine why the state’s ACA Medicaid expansion costs are rising and whether any individuals have been misclassified as newly eligible."
The letter also asks for all documents and communication between or among employees or contractors relating to the determination of eligibility.
"I respectfully ask that you please provide this information as soon as possible, but no later than 5 p.m. on Oct. 11," writes Johnson.
Similar letters went out to governors in California, West Virginia, Illinois, New York, Ohio, Michigan and Hawaii, where, according to Johnson, "Medicaid expansion’s soaring costs go far beyond initial projections."
"There’s a lot of data they’re looking for, so we’re going to dig in and see what we can provide and get to the root of this," said Sununu after Wednesday’s Executive Council meeting.
"Were going to find out exactly what is happening here in New Hampshire compared to other states and what’s happening nationally, so we can make better informed decisions moving forward."
Johnson appears to be most interested in whether states are declaring ineligible individuals as eligible to obtain additional federal funds for health care.