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State Battles over Medicaid Expansion Heating Up

Christopher Cheney, for HealthLeaders Media, April 3, 2014

"In the end, it had to come from the Republican Senate," Sherman said of the Granite State's Medicaid expansion plan. "We couldn't get anything through that they couldn't live with… Nobody got exactly what they wanted out of this."

He says expanding Medicaid in New Hampshire took political will and the realization that expansion of the program was needed to address uncompensated care in the Granite State.

"The real winners are all of the residents of New Hampshire because we are all affected by the people who lack health insurance," said Sherman, a freshman lawmaker and practicing gastroenterologist. "This isn't welfare. This is not a handout. This is financial security for people with health needs."

Resistance Could be Futile
States that are resisting Medicaid expansion are feeling heavy pressure from healthcare providers and business leaders.

"Hospitals that see people who are uninsured are putting lots of pressure on political leaders," Saloner said. "Some hospitals more than others do see people who are uninsured… The money is there to help hospitals finance their care."

Business leaders in states that have not expanded Medicaid fear competitive pressures from neighboring states that have moved forward with expansion, he said. "Your workforce is going to be different," Saloner said of states without Medicaid expansion, citing the negative economic impact of poor access to healthcare on individuals and employers.

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