On March 27, 2014, New Hampshire became the 26th state to pass legislation allowing for Medicaid expansion under the Affordable Care Act.  Gov. Maggie Hassan signed Senate Bill 413 into law in front of a bipartisan gathering of legislators and supporters at the State House, including NHMS Past President Dr. Travis Harker, NHMS EVP Scott Colby and myself.  Read the Boston.com story here.

So what happens now?  The expansion will cover almost 50,000 lives, but not all at once.  This month, 12,000 adults who earn less than $16,000 annually, or 138 percent of the federal poverty level, will enroll in an existing program that uses Medicaid funds to subsidize private health insurance.  Then on July 1, the other 38,000 will be covered under the traditional Medicaid program through one of three companies that manage the care for the state.  During this transition time, state officials will ask for a waiver from the Obama administration to allow all the newly covered to be moved into private insurance under the Affordable Care Act’s marketplace.  If the waiver isn’t granted by March 31, 2015, the program will be phased out three months later.  The Medicaid expansion program will stop at the end of 2016 unless a future Legislature agrees to readopt it.  New Hampshire would opt out at any point if federal Medicaid reimbursement is less than 100 percent.

For physicians in New Hampshire, an increase of 50,000 covered lives likely will lead to more patients in the healthcare system; but rather than patients coming on an emergent basis due to lack of health coverage, they can be seen early in the medical process or even in preventative scenarios.  Will it lead to a “physician shortage” as has been discussed in the media?  Only time will tell.

The New Hampshire Medical Society supported Medicaid expansion because members felt it would lead to better and earlier care for our state’s citizens who would benefit significantly from the expanded coverage.  Let’s hope that as physicians we can deliver on that promise.  Read The New York Times article here.


Stuart J. Glassman, MD

Please send your questions or comments to president@nhms.org or post a comment below.


Enjoy your prior auths for ALL interventions and meds, visits from Medicaid Fraud Unit and a payment schedule that does not meet your cost of doing business. If you are an employed doc, your employer may have been juiced enough with state payments to make it work. If you are not employed, it does not work.