By Aaron Day
Today the Republicans lead the charge to re-authorize Obamacare Medicaid expansion. The budget for New Hampshire for the past 27 years is built on a funding mechanism that borrows billions from children and ignores making real structural changes. Our healthcare system would be better and less expensive if we didn’t rely on the Federal Government and opened up the state to free markets in healthcare.
Here is a brief history of how New Hampshire got here. We will have to deal with this eventually. It is up to us to decide if we will address proactively or from a position of absolute crisis.
Step 1: In order to help a Republican Governor get elected to the US Senate, a loophole in a federal Medicaid matching program (Mediscam) was exploited to cover-up our fiscal irresponsibility at the state level. Instead of cutting spending, we opted to borrow billions from our children and grandchildren.
Source: http://bit.ly/Mediscam
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Step 2: To further cover-up our financial mismanagement, we shortchanged our non-profit hospitals out of proceeds from the Mediscam creating a $36 million budget shortfall for uncompensated care for the past year alone!
Source:
http://www.concordmonitor.com/New-Hampshire-facing-$36-mill
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Step 3: Only hospitals that accept Medicaid patients are eligible for this financing scheme. To protect this funding mechanism and protect our poor performing non-profit hospital system, the state has used the Certificate of Need to keep out new and innovative healthcare delivery options for the citizens of New Hampshire. This is why Cancer Treatment Centers of America was not allowed to open in New Hampshire.
Source: https://www.beckershospitalreview.com/
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Step 4: Seeing an opportunity to further expand Medicaid, Republican leadership designed a mechanism to extract additional Federal funds (to be repaid by future generations) and then funneled that money to private insurers. The architect of this program was a consultant who also architected the Medicare Part D Prescription Drug Program at the federal level. He was found guilty of lying to Congress about the cost implications of that program.
Source: http://bit.ly/Mediscam
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Step 5: To pay for the part of the expansion not reimbursed by the federal government, the state decided to place an additional tax on the hospitals that are already being shortchanged and add a tax to the private insurers as well (passed on as higher premiums in the private market).
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Step 6: Health and Human Services denied this new tax and has threatened to cut funding to the entire program by the end of 2018 unless a new solution is found.
http://www.unionleader.com/Trumps-HHS-to-NH:-Fix-Medicaid-e
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Step 7: To make-up for the illegal tax on hospitals and insurers, the state has proposed a sales tax on our state monopoly-controlled liquor stores, and are using the urgency of the opioid crisis as justification for this approach.
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Step 8: Alcoholism is a bigger problem in New Hampshire than the opioid crisis.
