State Senate GOP Rejects Medicaid Money

Suppose you lent a friend some money. Afterwards, you had medical problems, but didn't have the money to pay your bills. Your friend offered to
pay back the money you borrowed to help pay them, but you refused to take it
saying, "I don't want your money." Your friend said that if you
didn't take the money he owed you, he would have to give it to others to repay
debts. He added (somewhat unkindly), "That's crazy. I don't think you need
medical care. I think you need psychiatric care."

Well, that essentially is what State Senate Republicans are doing -
refusing money from the federal government we paid in taxes that could now be
used to help pay the state's medical bills. If we don't take back the money we
gave Washington, the federal government will distribute it to other states.
Perhaps, since all Republicans in the State Senate declined the money,  they could all benefit from not just individual psychiatric treatment to treat their bizarre reasoning, but also group therapy.

What exactly is the problem? Democrats in the State House passed
legislation expanding the Medicaid provisions of the Affordable Care Act. Democratic governor Maggie Hassan also supports the expansion. This change would add to Medicaid anyone under 65 who earns up to 138 percent of federal poverty guidelines, which is about $15,000 for a single adult. If adults at the 138
percent level work 40 hours per week, they are earning about $7.50 per hour.
They have about $1300 per month to pay for rent, groceries, utilities, and
gasoline. So little, if anything, is left to pay for medical care. 

When their medical problems becomes severe, low income people go to  hospital emergency rooms, where treatment is expensive, but nonetheless free for them. However, there is a catch -  their costly treatment fees are picked up by
the rest of us. It would be more cost effective to provide needy people with
preventive care via the Medicaid expansion before their problems become so
severe that they require expensive emergency room treatment.

If Medicaid is expanded, estimates are that 58,000 Granite Staters will be added to the program. What is the federal government prepared to do to help pay for this expansion?  The state would be given $2.5 billion to pay for medical costs over seven years at a cost of $85 million to the state. The federal money would cover 100 percent of costs for the first three years and 90 percent thereafter.

Medicaid expansion was defeated by all Republicans in the State Senate. (Nancy Stiles, Andy Sanborn, John Reagan, Jim Rausch, Russell Prescott, Bob Odell, Chuck Morse, Jeanie Forester, Sam Cataldo, Sharon Carson, Peter Bragdon, Jeb Bradley, and David Boutin)  

What didn't GOP members like about the idea? Republican senate president Peter Bragdon proposed that a committee by formed to study the issue. As if the Affordable Care Act (also known as Obamacare) hasn't already been studied enough. Perhaps, Bragdon could call it the Rip Van Winkle Committee. Members could retreat to a cave and go to sleep for 20 years while the issue disappeared from public consciousness.

Other GOP Senate members argue that the federal government might stop
making Medicaid payments, leaving New Hampshire holding the financial bag. They conveniently overlook the fact that the government has previously paid Medicaid benefits without fail for the past 45 years. Even more telling, these
Republicans choose to ignore that the Medicaid expansion proposal allows a
state to drop the program at any time. As Freud noted, denial of the facts is a
convenient defense mechanism for  avoiding the truth. More counseling is apparently needed for our Republican state senators who seem to be in a deep state of denial.

Then, Republicans in the Senate argue that the Affordable Care Act is
a federal program, so the federal government, not the states, should administer
it. Of course, New Hampshire would be walking away from $2.5 billion in the
process. As Democratic State Senator Andy Hosmer has noted, Republicans, for
whom states' rights are supposedly sacred, are quite willing to abdicate state
control over the Medicaid expansion and turn it over to Washington. Go
figure.

And then there is the mouse on the kitchen floor that Republicans want
to ignore. Medicaid expansion is part of part of President Obama's Affordable
Care Act. Any move to incorporate it in New Hampshire would be seen (horror or
all horrors) as giving Obama a political victory. And, as we well know, the two
major planks in the Republican platform are (1) obstructing all of Obama's
programs and (2) creating election laws that make it difficult for Democrats to
vote. God forbid that the GOP might create policies that would actually benefit
the American people.