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Without expanded Medicaid, employers would lose: for a certain group of employers, those with no control over price, the expansion has been crucial.

In industries that rely on a large number of low-wage workers, Medicaid expansion has been providing companies with an alternative solution for the costs of meeting the requirements of the employer mandate. A potential 35,000 New Hampshire residents, who previously didn't have access to health insurance, qualify for Medicaid under expansion, and many of those people are low-wage workers.

For a certain group of employers, those who have no control over price, Medicaid expansion has been crucial. While businesses like Walmart can simply raise prices by a few pennies to cover the new health benefits for its low-wage employees, there are some industries that have no control over pricing, like nursing homes and home health organizations--their level of compensation is set by the state. The state pays part of Medicaid reimbursement to these facilities, and, as a result, these employers have very little control over what they charge--and under the mandate they have to provide health insurance to all of their employees.

Congress expanded Medicaid for full-time low-wage workers to help both businesses and their low-wage employees.

Employers in low-wage industries find it difficult to pay the cost of insurance, and the insurance those employers can afford often comes with a very high deductible, which does not cover the employee's family. Medicaid has no deductible and covers the entire family; it is a far better alternative.

Now the state is not only deciding how much money facilities can make, they're also deciding whether or not to renew Medicaid expansion.

Without Medicaid expansion, the cost of the employer mandate will fall on the elderly and taxpayers--the elderly will have to pay for benefits that they do not currently pay for and/or taxpayers will see state tax rates increase. That's because the only way these facilities can get the revenue to cover their employees is if the state pays higher Medicaid reimbursement levels (via taxpayers) or if the elderly pay more.

This is completely unnecessary. Until 2020, Medicaid expansion is 100 percent paid for by the federal government, through the tax dollars that New Hampshire residents already pay into Medicaid. In 2020, that percentage of federal subsidy only drops to 90 percent.

If you don't expand Medicaid you're making a decision that you, the state, want to pay more and put the tax on taxpayers and the elderly.

Ben Geyerhahn, CEO and founder of BeneStream, a company that helps employers comply with the employer mandate through Medicaid migration, is a member of New York Gov. Andrew Cuomo's Health Benefit Exchange Regional Advisory Committee.

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Title Annotation:NH BUDGET
Author:Geyerhahn, Ben
Publication:New Hampshire Business Review
Geographic Code:1U1NH
Date:May 15, 2015
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