CONCORD — Rather than expand Medicaid eligibility under the Affordable Care Act, New Hampshire ought to be looking at reforming the federal-state health insurance program for the poor, children, elderly and disabled, said several representatives of groups opposed to expansion.
Speaking at a news conference Wednesday, Greg Moore, Americans For Prosperity NH executive director, said Medicaid is sub-standard, low-quality care without one in five New Hampshire doctors.
Instead of expanding a program that "is not a winner for New Hampshire," Moore said, the state should be using the opportunity to reform Medicaid.
Others said the federal government will not live up to promises and will leave the state to make up the difference, costing taxpayers hundreds of millions of dollars.
Others said the program will drive people off existing health plans, meaning able bodied, working adults will be on another entitlement that will never end.
Senators need to have the courage to vote against a program that will never go away and never get smaller, said former Sen. Ray White, R-Bedford. "Once this thing sets sail, it will be beyond the reach of the New Hampshire Legislature."
Several speakers warned Republican Senators who hold the key to whether expansion is approved, that they will face primary challenges if they vote for expansion.
"Thirteen people will make the decision. This is a core Republican issue," said Aaron Day, chair of the Republican Liberty Caucus of NH. "Anybody who votes for federal expansion of Medicaid can expect a very serious challenge."
Democrats and expansion supporters said the groups opposing expanding Medicaid are the fringe of the Republican Party.
"The New Hampshire Republicans radical crusade against affordable health care options for working families was on full display this afternoon," said Harrell Kirstein, NH Democratic Party communications director. "Despite all of the testimony from independent experts and the bipartisan support for the work done by the Medicaid expansion commission, the far right wing of the NHGOP continues to oppose this commonsense solution that would strengthen the economic security of New Hampshire families and small businesses."
Zandra Rice Hawkins, executive director of Granite State Progress, which supports expansion, said the speakers at the press conference did not talk about the people who would be helped by expansion.
"This press conference had every special interest group opposed to health care reform at the table, throwing every reason they could against the wall," she said. "The only thing missing was actual New Hampshire hospitals, doctors and consumers."
House and Senate leaders are working with Gov. Maggie Hassan's office to reach an agreement on an expansion plan lawmakers could vote on when they meet in Special Session next month.
If an agreement can be reached, a bill will be introduced Nov. 7 and voted on Nov. 21 after public hearings Nov. 12. If no agreement is reached, several bills could be introduced.
A negotiated bill is likely to resemble the framework of the Commission to Study Medicaid Expansion's recommendations that proposed expanding Medicaid eligibility in order to maximize the available federal money, while using private insurance to cover as many newly eligible people as possible.
State officials estimate that about 49,000 low-income adults will be eligible for the Medicaid rolls under expansion and the state's health care providers would receive $2.4 billion over the next seven years.
The Democratically-controlled House and Hassan favor expansion, while the Senate blocked it and instead wanted further study, which resulted in the Medicaid expansion commission that met this summer and into the fall.
At Wednesday's news conference, commission member Sen. Andy Sanborn, R-Bedford, said the commission was stacked with proponents of expansion. He said expansion could cost the state as much as $340 million annually even if the federal government lives up to its commitment, which he doubts.
He said President Obama told Americans they could keep their health care plan and their doctors. "In reality the President of America is lying to the people of New Hampshire," Sanborn said.
He said the state needs its own solution, but the federal government is making that impossible with its all-or-nothing offer including benefits that far exceed most private insurance plans.
Others said expansion is part of a program that would further entangle the federal government in health care.
"When government shows up and say we have a solution to this problem and we are going to fund it," said Rep. George Lambert, R-Litchfield. "That is the time to panic."
Others complained that expansion will allow groups like Planned Parenthood, which has a contract to provide "navigators" to help those using the health insurance exchange, to subsidize abortions.
"Medicaid expansion means more federal dollars to abortion providers who provide Medicaid Services," said Ashley Pratte, executive director of Cornerstone Action.