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Refusing to extend Medicaid comes with real cost

This is an open letter to Sen. Chuck Morse of Salem.

Dear Senator Morse,

I was among the several hundred taxpayers in the State House Nov. 12 to observe and testify on bill to extend Medicaid health coverage to the roughly 58,000 residents unable to afford other forms of health coverage.

As we saw only your back while you presented Senate Bill Number One to your colleagues on the committee, I couldn’t tell whether your pious concern about providing for this unfortunate percentage of our population was actually said with a straight face.

But your conclusion was very clear — protecting New Hampshire taxpayers.

From what?

Surely these people already cost the state large sums of money for lost work time, emergency room visits as the health care of last resort, as victims of crimes committed when behavior modification medications cannot be afforded, and the even higher direct cost to the state of punishment and incarceration. How do we create savings for the New Hampshire taxpayer here?

Your bill to grab federal dollars relies on use of uncertain “waivers” to circumvent the intent of the Affordable Care Act. Even if federal waivers were granted, Senate Bill Number one has no plan for the future. In fact it quite clearly rejects any responsibility to address long term needs by including “sunset triggers” designed to terminate coverage the moment our federal tax dollars don’t provide 100 percent of the funding. “People who sign up for this plan will do so in the knowledge that it may end at any time,” was one explanation I heard during the afternoon.

So what is your purpose in crafting this bill beyond avoiding criticism that there is a pile of money (which we NH taxpayers have provided) and New Hampshire should be sure to get its share?

There is a punitive and unrealistic feature, too in the requirement that those eligible also enroll with the Department of Employment Security to find a job. How does the poor man, already working two jobs, still unable to afford a cortisone shot to alleviate a work related injury find time to go to DES? Oh, and speaking of protecting the taxpayers, is the unemployment office prepared to suddenly handle an additional 58,000 clients? And where is the money to pay for that?

Earlier in the day, one of your Republican colleagues addressed the House Chamber on the importance of placing a “cap” on Medicaid Spending. Where is the legislation to place a cap on illness and suffering?

Frequently during the hearings in both House and Senate we heard that this is a “pivotal moment” in New Hampshire history. I would agree. New Hampshire has been traditionally tight fisted when it comes to spending. And a certain New England frugality is to be commended. But refusing to extend Medicaid simply and openly is a decision to perpetuate the social and economic costs of a permanent under class in our state.

Often poorly educated, these 58,000 people are struggling to make lives at the fringe of our society. Low paying jobs without health benefits allow a marginal existence out of sight of the folks in Concord. Then calamity strikes in the form of unexpected major illness. Paying for such a catastrophe breaks the budget, leaving these New Hampshire taxpayers with no protection.

Soon, these families have to choose between medical payments, food and utilities and rent. The narrow balance they have created is upset often causing them to lose their homes and placing yet another burden on the NH social system.

So, Senator Morse, seize this pivotal moment in history and recognize that your primary goal — to protect New Hampshire taxpayers — does not work in this single issue vacuum of limiting expenditures on Medicaid. In fact embracing federal leadership (even from the opposite party) provides remedial action to help many unfortunate members of our state not to need many expensive services from our state GNP. Affordable Health Care leads the way to healthy, productive lives for these people, allowing them to become productive taxpaying members of New Hampshire society.

Oh, yes, it is also the right and caring course for our government to take.

Herbert J. Motley is a resident of Jaffrey.

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