Viewpoint

Things are beginning to turn around in NH

As a state senator, I travel constantly around the towns of the Monadnock region and the southern border of New Hampshire. I talk to a lot of people, and have heard a lot about the Affordable Care Act over the past year or so.

Some of the things people told me were pretty mixed or even downright negative, especially late last year and early this year. People generally liked the idea of insurance for more people if affordable, and many were particularly relieved to know they could get coverage even if they had a pre-existing medical condition or went to work for a small business that didn’t offer insurance.

But there were also some real concerns. Recently I visited a family practice office in the region. Because Monadnock Community Hospital wasn’t included in the network offered by Anthem as part of the marketplace, the practice and its doctors had lost some patients who now had to seek care in Keene or even as far away as Manchester.

They also remained concerned about mental health care service and placement: Their story of a patient who had an ER stay for nine days awaiting a bed at the State Hospital is an example of an intolerable situation for patients, families and health care workers. This must be fixed in our state! Since the spring, however, the news has been more positive, and people are now beginning to feel better about what is happening and what is ahead.

First of all, the new ACA marketplace for insurance in New Hampshire has been overwhelmingly popular. The goal was to sign up 20,000 people in 2014. The final number was 40,000. And the insurance has turned out to be very affordable: New Hampshire residents who buy the most popular Silver Plan paid an average of only $87 per month after tax credits. This is high-quality insurance, covering far more than even more expensive plans used to do.

Because the marketplace has been so successful, new insurance carriers announced that they will compete in New Hampshire in 2015. That means that, instead of just one company, there will now be five companies and more than 50 plans to choose from next year. Every hospital in the state will be included in at least three insurance company networks. So patients who needed to switch hospitals will be able to switch back and get both the lower cost of coverage through the marketplace and the convenience of going to their nearest provider.

There will also be a lot more people covered in 2015. This spring, the New Hampshire Legislature passed a bipartisan agreement that I helped to negotiate to expand affordable private health insurance to 50,000 lower income New Hampshire citizens using federal Medicaid funds. These are funds that New Hampshire has been sending to Washington previously without return. This was welcome news, not only to uninsured families, but also to doctors and hospitals, who will save millions on uncompensated care, something we all pay for in the long run. In fact, getting all of these people covered will help reduce insurance premiums for everyone else by reducing the cost-shifting we have seen from caring for those without insurance.

Part of that bipartisan deal paved the way for federal Medicaid funds to treat substance abuse disorders and to expand community mental health services. This should mean much better treatment in the years ahead, and hopefully many fewer stories of people stuck in the ER waiting for help.

There have been some real bumps in the road, especially with the transition to a new system. And, the work is far from complete to meet the goals of insuring most people and lowering the cost of care. But, we have made a real start toward an overall healthier New Hampshire.

Peggy Gilmour is the State Senator representing District 12, the towns of Brookline, Greenville, Hollis, Mason, New Ipswich, Rindge, and Wards 1.2.5 in the city of Nashua.

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