CONCORD, N.H. (AP) — New Hampshire could save up to $114 million if it decides not to expand Medicaid under the new federal health care law, but it would lose $2.5 billion in federal aid toward health care for the state's uninsured.
The state Health and Human Services Department on Thursday released the first part of a study on the impact of expanding Medicaid that examines the cost to the state from 2014 to 2020. The report offers preliminary estimates of what the state might save if it decides not to expand the program as well as estimates of what it would cost.
If New Hampshire expands Medicaid, it could cost an estimated $85 million over seven years. But New Hampshire's health care providers would share in the $2.5 billion flowing into the state from the federal government over that period.
The agency hired the Lewin Group to look at the pros and cons of expanding the program. The U.S. Supreme Court ruled in June that expanding Medicaid was optional under the Affordable Care Act.
The second part of the report is expected to be released next month and will examine the impact that expanding the program would have on the economy, health care providers, other state agencies and health insurers.
Health and Human Services Commissioner Nicholas Toumpas said the decision on whether to expand Medicaid to cover more of New Hampshire's uninsured — largely adults — rests with the governor and Legislature.
Under the federal health care law, people under age 65 will qualify for Medicaid if they earn up to 138 percent of the federal poverty guideline. For a single adult, that means about $15,000 a year. The federal government will pay 100 percent of the cost to insure these newly eligible enrollees for three years beginning in 2014. Eventually, the federal government's share of the cost begins to shrink annually until it is 90 percent in 2020, and the state pays the rest.
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