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State disputes claims of 'soaring costs' in Medicaid program

State House Bureau

October 12. 2017 9:24PM

CONCORD — Gov. Chris Sununu has responded to U.S. Sen. Ron Johnson, R-Wis., who is investigating overspending on Medicaid, telling Johnson his numbers on New Hampshire are all wrong.

Johnson is chairman of the U.S. Senate Committee on Homeland Security and Governmental Affairs, which is investigating what it claims are excessive Medicaid expenditures in eight states.

In a Sept. 27 letter to Sununu, Johnson claimed “costs per enrollee are surging in New Hampshire, going up 322 percent between 2014 and 2015 alone.”

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.”

The Department of Health and Human Services had Johnson’s numbers reviewed by its actuarial consulting firm, which claims that the Congressional analysis is flawed in several ways.

The report by Milliman actuaries, headquartered in Wisconsin, concludes that the growth rates and costs of Medicaid expansion, known as the N.H. Health Protection Program, are nowhere near as high as Johnson suggests.

“Milliman’s evaluation of the committee staff analysis concludes that the growth rates and costs of the program identified in your Sept. 27 letter … are not supported by the actual experience of the Health Protection Program,” wrote Sununu. “We hope that the Milliman letter responds to your questions and concerns, and sets the record straight regarding the assumptions in your inquiry.”

The four-page analysis by the state’s actuaries dissects the Johnson letter in great detail, to come to the following conclusion: “The information presented in the Senate letter appears to significantly overstate the growth in New Hampshire’s Medicaid expansion costs from 2014-2015.”

One of the major problems, according to Milliman, was the failure of the Congressional committee staff to properly account for the implementation of Medicaid expansion in New Hampshire.

“The mid-August 2014 implementation of Medicaid expansion in New Hampshire complicates the cost comparisons and causes 2014 costs to look artificially low relative to 2015,” the letter states.

Milliman also claims Congress failed to properly “annualize” partial year costs in 2014. “Adjusting for these factors alone reduces the 322 percent growth rate in the Senate letter to 47 percent,” according to the state’s actuary.

The company also maintains that enrollment in expanded Medicaid has stabilized at around 50,000 members, and is consistent with predictions of 51,500 made in 2013 when expanding Medicaid was debated, despite claims in Johnson’s letter that “New Hampshire enrollment is growing faster than projected.”

The state Legislature is currently debating the future of expanded Medicaid in New Hampshire, since the program sunsets at the end of 2018 unless it is reauthorized by lawmakers.

Health State Government

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