BIA Business Perspective: Expanded Medicaid is good for business in NHBy LINDA FANARAS
BIA Board Chair
March 31. 2018 11:18PM
On Thursday, the House is expected to take up Senate Bill 313, an act that would reauthorize New Hampshire's expanded Medicaid program for another five years. The proposal would change the way health insurance is delivered to the approximately 53,000 Granite Staters living at or below 138 percent of the federal poverty level.
The Business and Industry Association, New Hampshire's statewide chamber of commerce, supported the implementation of expanded Medicaid in New Hampshire in 2014 and reaffirmed that support for reauthorization in 2016. Our support was based on BIA's belief that a healthy workforce is a productive workforce.
Expanded Medicaid is an important tool in reducing barriers for work. With unemployment at historically low levels, employers have been struggling to find people to fill jobs. No one can be left on the sideline. In addition, it is simply better for economic prosperity when individuals and families are insured.
The uninsured don't receive appropriate health care services when and where they need them, which ultimately leads to a costlier health care system. Health care providers aren't reimbursed for treating uninsured patients, which ultimately impacts the amount of cost shifted onto other payers.
There were then, and continue to be today, conditions for our support. These include that any program should strive for better health outcomes for individuals and families; the program should not place an additional tax burden on businesses; and should the federal government provide funding for Medicaid expansion at an amount less than previously committed (which will be at 90 percent by 2020), then lawmakers should reevaluate the feasibility of continuing with expanded Medicaid.
Last month, BIA's 30-person executive board examined SB 313 and determined its passage met these conditions and would, overall, be better for the business community than letting the program sunset at the end of the year. Allowing the program to end would throw 53,000 people off health insurance and result in increased cost-shifting to employers providing health insurance to their employees; severely impact the health of tens of thousands of New Hampshire residents; and adversely impact New Hampshire's economy.
To date, expanded Medicaid has put downward pressure on insurance rates. That's because when those without insurance seek care in the emergency room instead preventative care in the doctor's office, the bills get very expensive. And if they don't pay for their care, or can't pay, the cost gets shifted to the rest of us.
SB 313 moves the expanded Medicaid population into a managed care program, one in which enrollees are proactively directed to preventative services and other care. In doing so, they will see better health outcomes. When individuals are ready to enter or rejoin the workforce, BIA wants them to have their diabetes under control, their high blood pressure in check, and their depression and mental health needs tended to.
We need them to be in recovery if they've had substance abuse problems. Gov. Sununu has noted that expanded Medicaid is one of the most effective tools we have in New Hampshire to combat the opioid epidemic.
There are other offsetting cost savings. Managed care for this population will mean the program will cost the state less to run. The proactive model of managed care will mean enrollees are more likely to take advantage of preventative medicine, so the need for more expensive medical services down the road should be less.
Should lawmakers fail to reauthorize the program, those unable to access routine care will be less healthy and less likely to be productive members of the workforce. In addition, more than $400 million in federal money for the program will be lost to our economy each year.
We urge House members to listen to the concerns of the business community and vote to pass SB 313. Going backward is a big mistake.
Linda Fanaras, president of the Millennium Agency, is the chair of the Business and Industry Association board of directors. The BIA produces this column monthly exclusively for the New Hampshire Sunday News.