Mental Health Laws and Legislation
By Chris Dugan – Local business leaders, public health officials, advocacy groups, community members and elected officials gathered Monday to discuss Senate Bill 313, a legislative proposal aimed at continuing the state’s Medicaid Expansion effort beyond 2018.
Authorized in 2014, NH’s Medicaid Expansion program extended health care benefits to Granite Staters who previously did not qualify for Medicaid coverage.
“The program extended the threshold for being covered to 138 percent of the Federal Poverty Level,” explained Michele Merritt, CEO of New Futures.
Merritt, Manchester Mayor Joyce Craig, Chamber CEO Mike Skelton, Manchester Public Health Director Tim Soucy and State Senators Bob Backus, Lou D’Allesandro, and State Rep. Pat Long were among the many speakers during the 90-minute-session held downtown at the Greater Manchester Chamber headquarters.
“This issue is all interconnected,” said Skelton. “More people with health care coverage means less uncompensated care at local hospitals and hopefully downward pressure on health care costs and insurance premiums.”
Without legislative action to extend the program somehow, 50,000 Granite Staters who currently benefit from the program could be left in the lurch.
Mayor Craig told the group that 8,000 of those in the program are from Manchester and called the need to continue it “critical to Manchester.” She also pointed to the fact that the substance abuse treatments covered by Medicaid are vital to the City’s work in combating the opioid crisis.
While the Monday gathering of about 30 people was largely in favor of the program, several saw the work requirement issue of the proposal as a potential sticking point. The work requirement, which can be granted via a waiver from the federal government, has already been enacted as part of Medicaid eligibility in Kentucky and Indiana. Long viewed that as a possible “bone of contention” as the bill is debated and said further discussion would be needed but added “I’m confident that something will pass.”
Public Health Director Soucy and his colleague Anna Thomas spoke to the favorable impact Medicaid Expansion has had on the health of Queen City’s underserved population.
“Thanks to these new resources, about 80 percent of those previously without insurance are now covered,” Soucy said. He added that the downstream impact meant people are getting treated earlier leading to better health outcomes. He also noted that the Manchester Health Department serves as a Federally Qualified Health Center (FQHC) with Catholic Medical Center serving a contractor. The FQHC designation is important as that is the only way a health center can get 100 percent reimbursement from Medicaid.
In speaking on behalf of continued funding, Thomas said that the program was “an absolute game-changer which is truly changing the trajectory (of improved health) for so many.”
The group also discussed funding for the potential initiative as government support decreases. Past funding for expansion has come from an amalgam of insurance taxes and the state’s high-risk pool. However, this past summer that mechanism was deemed illegal by the Centers for Medicare and Medicaid Services (CMS) leaving New Hampshire in search of other options. Under the proposed legislation, a portion of the support could come from the state’s Alcohol Fund, but it’s still too early to determine all future funding sources.
The parties around the table, some of whom were patient advocates, also stressed the importance of public education, not just on the proposed legislation but on Medicaid services overall. Many in need don’t know what they qualify for or even how to get started.
“There’s a reticence in seeking health care and services due to not having enough coverage,” said William Rider, President and CEO of the Greater Manchester Mental Health Center.
In a political climate marked in many ways by partisan issues, the group agreed that there was strong support on both sides of the aisle to work toward common ground to protect New Hampshire’s vulnerable population. “This is a truly a bi-partisan issue,” Skelton said.
“This program saves lives and makes people’s lives better,” D’Allesandro said. “We just have to get to the middle.”
The proposed legislation, called the Granite Advantage Health Care Program, is sponsored by Senator Jeb Bradley, R-Wolfeboro, and will continue to be studied in the coming days.