The state government is in the process of trying to iron out the budget for the next two years. The House and Senate have both proposed bills, and versions, that have differences. We’re now in the phase where the serious horse trading happens and they resolve those differences. One of the key differences is the issue of expanded Medicaid. This proposal from the House would give health care coverage to approximately 58,000 NH residents. Sounds great, right? Unfortunately, this is one of those cases where you need to consider the content of the bill, rather than just the topic or concept.

Example – Who doesn’t love puppies? Who could vote against a bill that saved puppies? I mean really, you wouldn’t want to see yourself referred to in the news the next day as “Representative Puppy Killer”, would you? What if one of the provisions of that bill suspended your 4th Amendment rights and allowed police to search your home without a warrant to check on your puppy? Any responsible legislator would vote against it (and probably still be called “Rep. Puppy Killer” the next day by puppy PACs with advertising budgets and puppy lovers who never read the bill). The content of the bill is more important than the popular, slogan inducing concept.

Back to Medicaid – Of the 58,000 eligible under the formula, around 24,000 already have private insurance. Why in the world would you decrease the private insurance pool, putting the cost on the taxpayers, and because of the reduced pool, drive up rates for everyone else? Additionally, the supporters of this bill say that we should do it simply because the federal government will fund it. They claim that we’d be irresponsible to turn down this money. Well, nothing in life is free. The feds will fund most of it for around three years. After that, you and I will need to pony up. I submit that not only is it not compassionate to provide this coverage, it is cruel. It will make some politicians looking to get re-elected next year very popular. However, in three or four years, you (I mean you, the taxpayer) will be faced with a simple choice. Now that federal funding is over, will you pay a few hundred dollars a year yourself to fund this coverage, or will you have us take that coverage away from those people? There’s no third option. This is math, not politics.

Solutions – If we were serious about fixing this problem, we’d first exclude the 24,000 who already have coverage, and then provide funding for catastrophic coverage for those who have none. Any health care solution has to target the groups that actually need the help, and most importantly, be sustainable. We can’t be in the position three years down the road where we put a gun to the taxpayers’ heads and demand more money, or worse, end coverage for those who just received it. You can’t play with people’s lives like that.

What now? – It is rumored that House Democrats are going to dig in their heels on this. If the Senate continues to refuse to cave in, we won’t have a budget on time. That will then make a continuing resolution necessary to keep the state government running. Rumor further has it that House Democrats will not vote for a continuing resolution. They may be willing to shut down government if they don’t get their way. Need to register your truck? Too bad, we’re closed. Need to re-certify for Medicaid? Too bad, we’re closed. Need to renew your license? Take a hike, we’re closed. I can’t believe that enough House members would go this route, but the possibility is there. Some are willing to hold you hostage to get their way. My mantra when I first ran for office was “Don’t let’em get away with it“. It stands as good advice today. Call or write your Senator and tell them to stand firmly against this expanded Medicaid debacle. Call or write your Representative and tell them that if they play games with state services, you’ll un-elect them next time around. If you’ve never called or written before, this is the time to start. Let’s get past this nonsense, and then maybe both sides can begin working on a real, sustainable solution, that actually serves those who need it most.

I love dogs and puppies,

Steve