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Dave Solomon's State House Dome: A number we can count on

March 10. 2018 9:11PM

The fight to keep expanded Medicaid alive in New Hampshire now moves to the House of Representatives, after a 17-7 vote in the state Senate late Thursday to give the program a five-year lease on life, with new work requirements for enrollees and a new funding source.

Extension of federally funded health insurance to another 50,000 New Hampshire residents through the Affordable Care Act (Obamacare) has been widely touted as a key tool in the fight against opioid addiction.

According to the program's proponents, many in the newly covered population have taken advantage of treatment that would otherwise be unavailable or unaffordable. The big question has been: How many?

Thanks to Department of Health and Human Services Commissioner Jeffrey Meyers, we now have a number that can inform the debate as it moves to the House. And the number is 12,700.

That's a little more than half the number that's been cited for months by everyone from Gov. Chris Sununu to Democratic Sen. Dan Feltes and advocacy groups like New Futures. In venue after venue, time after time, we heard that 23,000 individuals have taken advantage of substance abuse treatment since expanded Medicaid took effect in 2015.

State Rep. John Burt, R-Goffstown, an opponent of Medicaid expansion, was suspicious about the 23,000 figure, sought clarification from the Office of Legislative Research, and was told the number is closer to 11,000. Two weeks ago we set out to find the real number, and on Wednesday Meyers had an answer.

"I know there have been a lot of questions about the exact number of people receiving substance use disorder services through the expansion program," Meyers said. "My staff had some data; some of the advocates in the advocacy community had some data; and when we informed the governor early on about what we thought the numbers were, not all those numbers were correct."

"Having dug deeply into it, it's very clear to me now that from the beginning of the program, through the current time, there have been 12,700 unique individuals who have accessed substance use disorder services," said Meyers.

On average, there are about 6,000 individual requests for addiction recovery services every quarter through expanded Medicaid, according to Meyers, but many of those requests come from the same people. Isolating "unique individuals" served is more challenging.

"To the extent that there's been confusion about that, no one intended to mislead anybody," said Meyers. "We've been trying to manage some of this data as we've been upgrading our systems at the same time, but I feel very comfortable now with this number."

Medicaid's role in the opioid battle is a key justification offered for continuing the program, but it's not the only one. And while 32,000 is a big portion of 50,000 served, 12,700 is no small number in a state the size of New Hampshire.

No number is going to be big enough to convince opponents in the House, especially the 30 or so members of the Freedom Caucus.

"We're very much against it," says Freedom Caucus Rep. J.R. Hoell, R-Dunbarton. "The bill as drafted still incentivizes people to stay stuck at some level of income, and that's the worst type of social program out there. Instead of a hand up it's a hand out, and it offers a perverse incentive to stay tucked below the income limits."

On the way up, and out

As expected, Associate Justice Robert Lynn was confirmed as chief justice of the state Supreme Court by the Executive Council on Wednesday, even though he will only serve a little more than a year before mandatory retirement.

The real focus is on Sununu's as yet undesignated nominee to replace the vacancy on the court created by the pending retirement of incumbent Chief Justice Linda Dalianis.

While Lynn's confirmation by the Executive Council was expected, the resignation of Commissioner Jeff Rose at the Department of Natural and Cultural Resources came as somewhat of a surprise.

Rose was the head of the Department and Resources and Economic Development, until Sununu decided with legislative approval to break DRED into two departments - Business and Economic Affairs and Natural and Cultural Resources.

New appointee Taylor Caswell took over Business and Economic Affairs, and Rose, a former BAE executive, ended up with Natural and Cultural Resources.

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