Nashua Telegraph: Medicaid expansion carries some risks to state
By REP. JACK FLANAGAN
Imagine if you are a minority voice at a meeting on a program that will cost the state an estimated $150 million dollars from 2017-20. Imagine that the current state budget is spending $50 million more than estimates say will be received in revenue. Imagine the state economy has been flat for the last four years, (with no change in sight). Imagine the state’s largest employer is Wal-Mart.
The Sept. 5 editorial criticizing my comments about the tax impacts of Medicaid expansion seems to be based more on emotions and less on facts. Currently, the state of New Hampshire cannot afford the 10 percent portion that would be required to be paid under Medicaid expansion. The verdict is still out on any savings the state will receive with more people being insured versus not. Under that assumption, if we had to cut the program, I can see the media now: “Legislature makes draconian cuts to the poor”.
But let’s look at the facts:
• Twenty-six states have chosen not to expand Medicaid because of similar concerns listed here.
• Experts are indicating that, of the 58,000 who would be eligible, 34,000 already have private insurance.
• The National Council of State Legislators states that if interest rates go up, it will have a direct impact on federal spending.
• New Hampshire currently receives only 50 percent reimbursement on Medicaid payments now.
• President Barack Obama already proposed a $100 billion Medicaid cut in the debt ceiling negotiations.
• As shown in history, the federal government has already cut funding on other programs: Special education reimbursements have gone from 40 percent funding to 17 percent.
So, I repeat, my question: Where is New Hampshire going to get the money? What will The Telegraph’s response be when we have to cut the program? Will the media criticize the federal government if and when they reduce reimbursements?
With medical expenses being one of the largest cost drivers in the federal budget and state retirement system, how will New Hampshire pay for this new program? As a state, we have limited sources of revenue: Rooms and meals, Business Enterprise and Business Profits taxes, liquor, cigarette and gas taxes, to name just a few. When we add a potential cost of hundreds of millions of dollars, an income tax will certainly be brought up as an option to keep this program. Not something I would support, nor this new program of Medicaid expansion.
It is easy to criticize a position when you don’t look at all the facts. Trust me, the uninsured and the unemployed are constantly on my mind while serving in Concord. The editorial also implies that I have a “kill-Obamacare-at-all cost” mentality. As someone with a background in insurance, I can tell you that there are some good provisions in the law. However these are considerably outnumbered by its problems and unexpected negative consequences. Expanded Medicaid is only one part of Obamacare that should be looked at completely and for the long term. My position is, if Medicaid expansion is put in place, New Hampshire cannot afford the program after the initial three years. If the past is any reflection on the future, New Hampshire also will have limited funding sources to pay for this new program when interest rates go up and funding percentages go down, too.
Rep. Jack Flanagan, R-Brookline, serves on the House Committee on Labor, Industrial and Rehabilitative Services.