NH lawmakers host hearing on Medicaid expansion


CONCORD, N.H. (AP) — Low-paid health care workers who provide critical services deserve access to quality care themselves, supporters of expanding New Hampshire's Medicaid program told House lawmakers Thursday.

The state is deciding whether to expand Medicaid under the federal health overhaul law to include more poor adults in addition to the children, pregnant women and other groups who are currently covered. If it opts for expansion, the federal government would pick up the entire cost for the first three years and 90 percent after that, though some opponents question whether that promise would be kept.

While Gov. Maggie Hassan backs the idea, the Legislature has the final say, and a pair of House committees held a public forum Thursday to hear from those who would be affected by the decision. Several spoke on behalf of home health aides and other low-paid workers, saying it wasn't right that many of them go without health care coverage given the important work they do.

"They work with the neediest of people," said Merrianne McDonald of Salem, who described the broad range of services her disabled grandsons receive. "I would like every one of you to (care for) a special needs child for a weekend and see what caregivers go through."

Rebecca Hutchinson, director of the Lutheran Social Services In-Home Care program, said there are several hundred home health aides across the state who are not insured through their employers, and even those who do have insurance are vulnerable to losing it because their hours often change. For example, if a client dies, a worker's weekly hours may fall below the threshold for receiving the limited health care benefits the agency offers, she said.

"There is something particularly disheartening that the very people who help us remain in our own homes, safe and independent, as we age, and at the same time help reduce health care costs for all of us, are not covered by health insurance themselves," she said.

Others described the fear and stress of living without health insurance. Susan Bruce, a freelance writer and community organizer from Dunbarton, said she has been staying afloat with part-time work since her last full-time job ended in 2008 and her husband died in 2009. She told the committees that while she doesn't look poor — she saved nice clothing from her last well-paying job and has a friend who cuts her hair — "It's all smoke and mirrors. I'm treading water as hard as I can, and I'm not the only one."

"There are many middle-aged people in this situation," she said. "We've worked hard all our lives, and now we live in fear."

The Rev. Gail Kinney, pastor at the South Danbury United Church of Christ, described a family in her congregation in which both parents lost their jobs during the recession. They got new jobs, but don't have health benefits. One of their children took Kinney aside and whispered that his mother needs to see a doctor and had looked online to see whether she could take any of her young son's medicine to treat herself.

"That level of desperation is not right for the state of New Hampshire," Kinney said.

The committee also heard from public policy experts, including Deb Fournier of the New Hampshire Fiscal Policy Institute. Based on an analysis commissioned by the state, she concluded that Medicaid expansion would likely be budget neutral or result in savings for the state.

The analysis released earlier this year estimated that expanding Medicaid New Hampshire would boost enrollment by about 58,000 people by 2020, and together with the overhaul law's other provisions, would reduce the number of uninsured residents from roughly 170,000 to 71,000.

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