Report: Medicaid expansion would hurt NH hospitals financially

CONCORD – A new report concludes New Hampshire’s acute-care hospitals would make out slightly worse financially if the state expands its Medicaid population. The report found that the expansion would add nearly 60,000 people to the Medicaid rolls and $92.7 million in costs for their care compared with $69 million in costs for the same group without the expansion. That’s because the new population added under the federal Affordable Health Care Act would otherwise have private commercial insurance that reimburses more to health care providers than the government run health care programs do. “This was a bit of a surprise to us, but it makes sense once you understand the profile of our system,” said Lisabritt Solsky, deputy director of the state’s Medicaid program. The Lewin Group report concludes a two-part analysis of the expansion for the state Department of Health and Human Services. The new federal health care law as adopted by Congress required all states to extend Medicaid up to 138 percent of the federal poverty level, or just under $30,000 a year for a family of four. Adults earning up to $18,000 a year can be eligible for Medicaid in New Hampshire, although children can be covered in families that earn up to 185   The U.S. Supreme Court ruled the Medicaid mandate was unconstitutional, leaving it up to state governors and Legislatures to decide whether they wish to participate.    Under the law, Washington would pick up 100 percent of the cost of benefits for the expanded population from 2014-16 and 90 percent from 2017-20.    States have to pay the cost of administering the program. For anyone who is already eligible but later decides to enroll in Medicaid here, the state would be awarded only 50 percent of the cost.    An analyst for the New Hampshire Fiscal Policy Institute said the report contains plenty of ammunition in support of the expansion.    “Based on Lewin’s calculations, New Hampshire could insure 40 percent more people with an increase of just over one quarter of a percent in state costs,” said policy analyst Deb Fournier, with the left-leaning fiscal think tank.     “The $2.5 billion in federal dollars coming to New Hampshire as part of the new Medicaid rules would stimulate the economy, add jobs and contribute to a healthier workforce.”     The state Legislature and Gov. Maggie Hassan get to decide whether this expansion will occur.