CONCORD — The state's business climate will improve with more people on government-paid health insurance, according to Senate Republican leaders Tuesday as they pushed a bipartisan proposal to increase Medicaid eligibility.
Business leaders, health care providers and social service advocates supported Senate Bill 413 with most saying it should help lower insurance premiums that are some of the highest in the country.
But opponents argued the proposal sponsored by three Republican and three Democratic senators is an open-ended entitlement that could bankrupt the state without improving health care outcomes for the 50,000 Granite Staters who would benefit from expansion.
"Why do you want to bring Obamacare to New Hampshire?" asked Greg Moore, state director of Americans for Prosperity, at a news conference before the public hearing on SB 413. "It's time for the Legislature to start taking a serious look at fixing New Hampshire's problems, not trying to jam a bad Washington policy onto the Granite State."
Senate President Chuck Morse, R-Salem, and Senate Majority Leader Jeb Bradley, R-Wolfeboro, touted their plan as a New Hampshire solution to the state's health care problems by using federal money for a pilot program that will reduce premiums, increase competition among insurers and provide private insurance coverage instead of a government entitlement program.
Everyone with private health insurance is paying a hidden tax totaling about $427 million annually through higher health insurance premiums, co-pays and deductibles, said Bradley, because Medicaid and the uninsured use health care services but do not pay the full costs or pay nothing.
Instead, those costs are shifted to private insurance and, ultimately, to employers and employees, he said, which is why business owners around the state say health care costs are a key issue.
But Sen. Andy Sanborn, R-Bedford, pushed Bradley and others to say how much uncompensated cost would be reduced by expanding Medicaid eligibility. He believes that many more people will join the program than initially anticipated, as happened in states that expanded Medicaid, he said.
"Who doesn't want free health insurance when someone else is paying for it," Sanborn said.
Bradley said the uncompensated costs are not going to disappear.
"If you do not want to face facts, you can kill the bill," Bradley said, "but you still have to pay for it. You're paying for it now."
A number of business owners and officials agreed with Bradley, saying the increasing cost of health care is hampering their businesses.
The vice president and chief financial officer of an Upper Valley business said the increase in health care costs last year prevented the company from expanding and adding jobs.
Mary Bihrle of Hypertherm, Inc. of Hanover, said a healthy workforce is good for productivity so providing health insurance to employees is a good business decision as well as being socially responsible.
Despite the company's best efforts, health care costs increased 70 percent of the national average for this year and that curtailed expansion plans including adding jobs, Bihrle told the committee.
Justin VanEtten, who owns Stewart's Ambulance Service in Meredith, also supported the bill although as a Republican, he said he dislikes the Affordable Care Act. He said his company passes on its uncompensated care costs to the communities his company serves.
VanEtten said when he submits bids to towns for ambulance service he checks the average income of residents. If it is below average, he said, his rates are two to three times higher than if the income is above average.
"This is a New Hampshire plan," VanEtten said. "It takes federal dollars we have a right to."
Other Republicans took a different view of SB 413.
At the news conference prior to the hearing, Aaron Day, chairman of Republican New Hampshire Liberty Alliance, said calling the bill a New Hampshire plan was patently false and does not represent the views of 99 percent of the state's Republicans.
He also took issue with the sunset provision, which ends the program Dec. 31, 2016, unless the Legislature reauthorizes it.
Who is going to vote to end an existing program serving 50,000 residents prior to an election? he asked.
Day said his organization has found people to run in primaries against sitting Republican senators who support expansion.
The new proposal would allow the state to begin the program by July 1, although it would end in a year if the state does not receive federal waivers for key aspects of the plan.
Those who have health insurance through their employers — an estimated 12,000 people — could begin the program as soon as May 1 under the state's existing Health Insurance Premium Payment program.
Others newly eligible for the Medicaid program would join the state's current managed-care program and would remain on "the bridge program" until Jan. 1, 2016, when they would have go to a private plan offered through the state's health insurance exchange although Medicaid would pay the premiums.
The new program would also end if the federal government fails to pay 100 percent of the cost any time before Dec. 31, 2016.
Under the ACA, state health care providers would receive about $2.4 billion in federal money.
New Hampshire is one of six states deciding whether to expand Medicaid eligibility under the ACA. To date, 26 states and Washington, D.C., have agreed to expand Medicaid eligibility.
The Senate hopes to take action on the bill by its March 6 session, and the House expects to vote on the bill by the end of March.