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Opt out: Say no to Medicaid expansion
Now that it can do so without penalty thanks to Thursday’s Supreme Court ruling on the Affordable Care Act, New Hampshire should opt out of the act’s unnecessary and expensive Medicaid expansion. Unfortunately, the state will probably need a new governor to make that happen.
Obamacare achieved a good deal of its “universal” health insurance coverage not by making insurance more affordable or improving the system, but by making more people eligible for Medicaid. The law required states to offer Medicaid coverage to eligible households with incomes of up to 133 percent of the federal poverty level.
New Hampshire has long set Medicaid eligibility at 63 percent of the poverty level. The federal government is to pay 95 percent of the cost of those new enrollees — for now. But the changes also required states to more aggressively pursue people who were eligible under the old rules but had not signed up. The states would be responsible for 100 percent of the costs of those new enrollees. The changes were estimated to cost the state about $30 million a year.
New Hampshire simply cannot afford that. But Gov. John Lynch never raised a forceful public objection to the expansion. While other governors strongly opposed the Medicaid expansion, Lynch made a few meek statements of concern.
On Thursday, the Supreme Court ruled that the expansion was unconstitutional because the law did not simply adjust the Medicare law, but “transformed” the program. States now have the option of saying no to the new enrollment plan and keeping their existing Medicaid guidelines. New Hampshire cannot afford any expansion, so it needs to opt out. But can we count on Lynch to do that? Probably not.
That would leave this overdue and necessary act to the next governor.
Voters need to ask the candidates how they would handle that decision. Tens of millions of dollars — a year — hang in the balance.
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